The use of autologous platelet gel (APG) for high-risk patients in cardiac surgery — is it beneficial?

Perfusion ◽  
2009 ◽  
Vol 24 (6) ◽  
pp. 381-387 ◽  
Author(s):  
Jens Litmathe ◽  
Christian Philipp ◽  
Muhammed Kurt ◽  
Udo Boeken ◽  
Emmeran Gams ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cardiac Surgery ◽  
High Risk ◽  
Wound Complications ◽  
Control Group ◽  
Study Group ◽  
Platelet Gel ◽  
High Risk Patients ◽  
Risk Patients ◽  
Autologous Platelet

Background: Wound healing in cardiac surgery has become a major problem due to the impaired risk profile of many patients. The aim of this study was to prove the influence of autologous platelet gel (APG) on wound healing in a special group of high-risk patients undergoing coronary surgery. Patients and Methods: We performed a prospective, double-blind study in 44 patients with a special risk constellation relating to wound complications (obesity, diabetes, smoker, New York Heart Association (NYHA) III-IV and peripheral vascular disease). The study group was treated with APG, prepared using the Magellan© platelet separator, the control group underwent conventional wound treatment. Results: The incidence of major and minor wound complications at the thoracotomy, as well as in the area of saphenous vein harvesting, was not pronounced in either of the groups. Blood loss and pain sensations did not differ significantly either. Stay in the intensive care unit (ICU) and the in-hospital mortality were also comparable. The duration of the entire operation and the time until removing the chest-tubes were prolonged in the study group. Conclusion: Despite promising results in other fields of surgery, APG shows no beneficial effect in high-risk patients undergoing cardiac surgery. Probably, it depends on different types of microcirculation in atherosclerotic patients, which are quite different from those of other surgical areas. This factor may offset the existing beneficial platelet effects which could be observed, for example, in maxillo-facial surgery.

scholarly journals Elastography and Metalloproteinases in Patients at High Risk of Preterm Labor

2021 ◽  
Vol 10 (17) ◽  
pp. 3886
Author(s):  
Izabela Dymanowska-Dyjak ◽  
Aleksandra Stupak ◽  
Adrianna Kondracka ◽  
Tomasz Gęca ◽  
Arkadiusz Krzyżanowski ◽  
...  
Keyword(s):  
High Risk ◽  
Preterm Delivery ◽  
Plasma Concentrations ◽  
Cervical Length ◽  
Control Group ◽  
Study Group ◽  
Median Length ◽  
High Risk Patients ◽  
Ultrasound Evaluation ◽  
Risk Patients

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Its etiopathology is multifactorial; therefore, many of the tests contain the assessment of the biochemical factors and ultrasound evaluation of the cervix in patients at risk of preterm delivery. The study aimed at evaluating the socioeconomic data, ultrasound examinations with elastography, plasma concentrations of MMP-8 and MMP-9 metalloproteinases, and vaginal secretions in the control group as well as patients with threatened preterm delivery (high-risk patients). The study included 88 patients hospitalized in the Department of Obstetrics and Pregnancy Pathology, SPSK 1, in Lublin. Patients were qualified to the study group (50) with a transvaginal ultrasonography of cervical length (CL) ≤ 25 mm. The control group (38) were patients with a physiological course of pregnancy with CL > 25 mm. In the study group, the median length of the cervix was 17.49 mm. Elastographic parameters: strain and ratio were 0.20 and 0.83. In the control group, the median length of the cervix was 34.73 mm, while the strain and ratio were 0.20 and 1.23. In the study group, the concentration of MMP-8 in the serum and secretions of the cervix was on average 74.17 and 155.46 ng/mL, but in the control group, it was significantly lower, on average 58.49 and 94.19 ng/mL. The concentration of MMP-9 in both groups was on the same level. Evaluation of the cervical length and measurement of MMP-8 concentration are the methods of predicting preterm delivery in high-risk patients. The use of static elastography did not meet the criteria of a PTB marker.

scholarly journals Application of Autologous Platelet-Rich Plasma (PRP) on Wound Healing After Caesarean Section in High-Risk Patients

2016 ◽  
Vol 18 (7) ◽  
Author(s):  
Afsaneh Tehranian ◽  
Bahareh Esfehani-Mehr ◽  
Reihaneh Pirjani ◽  
Negar Rezaei ◽  
Somaye Sadat Heidary ◽  
...  
Keyword(s):  
Wound Healing ◽  
High Risk ◽  
Caesarean Section ◽  
Platelet Rich Plasma ◽  
High Risk Patients ◽  
Risk Patients ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Does Autologous Platelet-Rich Plasma Improve Wound Healing and Pain Perception after Cesarean Section in High-Risk Patients?

2021 ◽  
pp. 1-7
Author(s):  
Nabih I. Elkhouly ◽  
Osama A. Elkilani ◽  
Hend A. Kolaib ◽  
Reem M. Elkhouly ◽  
Dalia I. Morsi
Keyword(s):  
Wound Healing ◽  
High Risk ◽  
Cesarean Section ◽  
Pain Perception ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Control Group ◽  
High Risk Patients ◽  
Risk Patients ◽  
Autologous Platelet Rich Plasma

<b><i>Objective:</i></b> The aim of the present study was to evaluate the effect of autologous platelet-rich plasma (PRP) on wound healing and pain perception after cesarean section in high-risk patients. <b><i>Design:</i></b> This was a prospective randomized controlled trial. <b><i>Participants/Materials, Settings, and Methods:</i></b> This was a randomized controlled trial of 200 patients who came to the outpatient clinic of Menoufia University Hospital for elective cesarean surgery. The women were randomly assigned to 2 equal groups. The intervention group received PRP subcutaneous injection in the wound after surgery; however, the control group received the usual care. Outcome variables included the redness, edema, ecchymosis, discharge, approximation (REEDA) scale, Vancouver scar scale (VSS), and in addition to the visual analog scale (VAS). <b><i>Results:</i></b> From April 2018 to July 2020, the PRP group showed a greater reduction in the REEDA score compared to the control group on day 1, day 7, and this was continued till 6 months (1.51 ± 0.90 vs. 2.49 ± 1.12, <i>p</i> &#x3c; 0.001). Compared with the control group, the PRP group had a significantly greater reduction in the VSS and VAS scores beginning on the seventh day (3.71 ± 0.99 vs. 4.67 ± 1.25, <i>p</i> &#x3c; 0.001) and (5.06 ± 1.10 vs. 6.02 ± 1.15, <i>p</i> &#x3c; 0.001), respectively, and continued till 6 months. <b><i>Limitations:</i></b> Pain was not measured by the use of analgesics, and we did not investigate the effects of varying platelet concentrations, centrifuge duration, or speed. <b><i>Conclusions:</i></b> PRP has positive effects on wound healing and pain reduction in high-risk patients undergoing cesarean section in low-resource settings.

scholarly journals Study of amniotic fluid and its co-relation with pregnancy outcome in high risk pregnancies

2017 ◽  
Vol 6 (3) ◽  
pp. 819
Author(s):  
Shazia Rashid ◽  
Shivani Abrol ◽  
Farhat Jabeen ◽  
Perveen Fareed
Keyword(s):  
High Risk ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Control Group ◽  
Study Group ◽  
Amniotic Fluid Index ◽  
High Risk Patients ◽  
Adverse Perinatal Outcome ◽  
Risk Patients

Background: Amniotic fluid is an important part of pregnancy sac and helps in fetal development. There is a consistent association between low AFI and conditions like pregnancy induced hypertension, postdated pregnancy and IUGR resulting in poor fetal outcome. In fact, high risk patients with low amniotic fluid index need to deliver quickly. So, an assessment of amniotic fluid volume has become an important component of antenatal testing for the high risk pregnancy. The objective was to study the correlation between Amniotic fluid index less than 5 cm (AFI˂5) and adverse perinatal outcome in high risk pregnancies.Methods: It was a hospital based prospective, comparative study. 150 high risk patients were selected from inpatient department of obstetrics and Gynecology Government Medical College Srinagar, Jammu and Kashmir, India over a period of one and half year. High risk pregnancies belonging to study group with AFI˂5 were demographically matched with high risk pregnancies with AFI >5 serving as comparison group. Perinatal outcome, rate of caesarean section and early intervention need were compared between the two groups.Results: 77.3% women in study group underwent caesarean section as compared to 28% in control group to prevent adverse perinatal outcome. 60% babies in study group had APGAR score less than 6 at 1 minute compared to only 8% in control group. 61.4% babies in study group needed NICU admission compared to 10.7% in study group.Conclusions: AFI is predictor of adverse outcome for high risk pregnancies. The early recognition alerts an obstetrician to prevent perinatal catastrophe if timely intervention is done along with antepartum and intrapartum fetal monitoring.

scholarly journals Comparison of the EuroSCORE I, EuroSCORE II and STS Scales in Cardiac Surgery of High-Risk Patients with Complicated Forms of CAD

2020 ◽  
pp. 15-21
Author(s):  
O. Gogayeva
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Chronic Obstructive ◽  
Study Group ◽  
Heart Team ◽  
Obstructive Pulmonary Disease ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease ◽  
American Society

Before performing cardiac surgery, risk stratification is necessary in order to predict the outcome of the operation. Today, there are European risk calculators EuroSCORE I, EuroSCORE II and the scale of the American Society of Thoracic Surgeons – STS. The aim. To compare prognostic scales for high-risk patients with complicated forms of coronary artery disease (CAD). Materials and methods. Post-hoc analysis of the data obtained from 100 random high-risk patients with complicated forms of CAD who were operated and discharged from Amosov National Institute in the period from 2009 to 2019. For all patients, risk factors were analyzed and calculated using three risk scales. Results. In addition to the initial severity of cardiovascular disease, the patients of the study group had comor-bidities like diabetes mellitus (23%), obesity (33%), and chronic kidney disease (34%), atherosclerosis of brachio-cephalic arteries (57%), chronic obstructive pulmonary disease (78%), a history of cerebrovascular accident (9%) etc. The predicted operative mortality was 19.2% according to the ES I scale, 8.6% according to the ES II, and 2.6% according to the STS scale, while mortality in the study group was 0%. An analysis of the ten-year experience of National Amosov Institute in the surgical treatment of CAD in more than 15,000 patients showed 0.9% mortality in complicated forms of high-risk CAD, which is significantly less than the forecast according to all the three scales. The ES I scale is characterized by a significant overestimation of mortality rates, the STS scale is cumbersome, time consuming, predicts 9 indicators that are not statistically significant in comparison with real practice. The most modern and convenient to use, but though not 100% reliable, is the ES II scale. The scales are necessary to stratify the risk and to understand the severity of the patient’s condition. It should be kept in mind that, in addition to comorbidities as well as cardiac and non-cardiac factors, the result of surgical intervention is influenced by the coordinated work of the Heart Team consisting of a cardiologist, interventional cardiologist, functional diagnostics doctor, cardiac surgeon, anesthesiologist and resuscitator.

scholarly journals Audio-guided self-hypnosis for reduction of claustrophobia during MR imaging: results of an observational 2-group study

2021 ◽  
Author(s):  
Adriane E. Napp ◽  
Torsten Diekhoff ◽  
Olf Stoiber ◽  
Judith Enders ◽  
Gerd Diederichs ◽  
...  
Keyword(s):  
High Risk ◽  
Mr Imaging ◽  
Odds Ratio ◽  
Control Group ◽  
Waiting Room ◽  
High Risk Patients ◽  
Imaging Results ◽  
Before And After ◽  
Risk Patients ◽  
And Coping

Abstract Objectives To evaluate the influence of audio-guided self-hypnosis on claustrophobia in a high-risk cohort undergoing magnetic resonance (MR) imaging. Methods In this prospective observational 2-group study, 55 patients (69% female, mean age 53.6 ± 13.9) used self-hypnosis directly before imaging. Claustrophobia included premature termination, sedation, and coping actions. The claustrophobia questionnaire (CLQ) was completed before self-hypnosis and after MR imaging. Results were compared to a control cohort of 89 patients examined on the same open MR scanner using logistic regression for multivariate analysis. Furthermore, patients were asked about their preferences for future imaging. Results There was significantly fewer claustrophobia in the self-hypnosis group (16%; 9/55), compared with the control group (43%; 38/89; odds ratio .14; p = .001). Self-hypnosis patients also needed less sedation (2% vs 16%; 1/55 vs 14/89; odds ratio .1; p = .008) and non-sedation coping actions (13% vs 28%; 7/55 vs 25/89; odds ratio .3; p = .02). Self-hypnosis did not influence the CLQ results measured before and after MR imaging (p = .79). Self-hypnosis reduced the frequency of claustrophobia in the subgroup of patients above an established CLQ cut-off of .33 from 47% (37/78) to 18% (9/49; p = .002). In the subgroup below the CLQ cut-off of 0.33, there were no significant differences (0% vs 9%, 0/6 vs 1/11; p = 1.0). Most patients (67%; 35/52) preferred self-hypnosis for future MR examinations. Conclusions Self-hypnosis reduced claustrophobia in high-risk patients undergoing imaging in an open MR scanner and might reduce the need for sedation and non-sedation coping actions. Key Points • Forty percent of the patients at high risk for claustrophobia may also experience a claustrophobic event in an open MR scanner. • Self-hypnosis while listening to an audio in the waiting room before the examination may reduce claustrophobic events in over 50% of patients with high risk for claustrophobia. • Self-hypnosis may also reduce the need for sedation and other time-consuming non-sedation coping actions and is preferred by high-risk patients for future examinations.

Sign in / Sign up

Export Citation Format

Share Document