scholarly journals Disorders of the hemostasis system while doing coronary shunting on a working heart

2019 ◽  
Vol 86 (7) ◽  
pp. 23-26
Author(s):  
A. P. Mazur ◽  
P. V. Gurin ◽  
M. M. Babich
Keyword(s):  
Blood Loss ◽  
Colloidal Solution ◽  
Infusion Therapy ◽  
Control Group ◽  
Colloidal Solutions ◽  
Hemostasis System ◽  
Therapy Program ◽  
Group I ◽  
Working Heart ◽  
Blood Loss Volume

Objective. To investigate the connection between application of solutions for infusion and parameters of the hemostasis system while the elective operations performance of coronary shunting on the working heart. Materials and methods. The results of examination and surgical treatment were analyzed in 80 patients, in whom coronary shunting on the working heart was conducted. The patients were divided into three groups: the Investigation Group I (IG I) – 20 patients, in whom colloidal solution of hydroxyethyl starch (HES) 130/0.4 was applied intraoperatively, the Investigation Group II (IG II) - 20 patients, in whom colloidal 4% solution of gelatin was used intraoperatively, and a Control Group, consisted of 40 patients, in whom only crystalloidal solutions were included in the infusion therapy program. The coagulation hemostasis indices, the blood loss volume and the need for hemotransfusion were compared. Results. In the IG I patients the volume of perioperative blood loss was more than in the IG II patients – (615 ± 191) and (438 ± 62) ml, accordingly (p=0.0003), and the coagulation hemostasis indices were trustworthily lower at the operation ending, demanding the erythrocytic mass transfusion doing in 3 (15%) patients. The IG II patients, comparing with the Control Group, suffered more volume of the blood loss - (560 ± 164) and (438 ± 62) ml, accordingly (p=0,02), and the changes in the coagulation indices, similar to changes in patients of the IG I, comparing with the Control Group patients. Any patient from the IG II needed hemotransfusion perioperatively. Conclusion. Application of colloidal solutions while doing elective operations of CSH on the  working heart leads to disorder of coagulation hemostasis, the intraoperative blood loss and the need for hemotransfusion enhancement.

Operative vaginal delivery: outcomes for mothers and newborns

2020 ◽  
Vol 69 (2) ◽  
pp. 33-42
Author(s):  
Margarita D. Leonova ◽  
Natalia V. Aganezova ◽  
Sergey S. Aganezov ◽  
Elena V. Frederiks ◽  
Yulia R. Dymarskaya
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Good Condition ◽  
Injury Rate ◽  
Control Group ◽  
Vacuum Extraction ◽  
Group Iii ◽  
Operative Vaginal Delivery ◽  
Group I ◽  
Abdominal Delivery

Hypothesis/aims of study. The frequency of surgical abdominal delivery in Russia, as in the world, continues to grow, reaching 29.3% in 2017. Operative vaginal delivery is an alternative to abdominal delivery in the second stage of labor. This study was aimed at analyzing the outcome of labor for mothers and newborns using different operative vaginal delivery methods. Study design, materials and methods. We studied 293 cases of childbirth in the period from 2015 to 2018. Three groups were distinguished: (I) the main group consisting of 172 women delivered by the operation of applying obstetric forceps (OF); (II) the comparison group including 85 patients delivered by the operation of vacuum extraction (VE) with the fetal head being near the pelvic floor; and (III) the control group comprising 34 cases of vaginal birth without use of instrumental delivery. In group I, 114 patients were delivered by the low forceps operation (subgroup IA), and 60 individuals by the mid forceps operation (subgroup IB). Results. Vaginal lacerations were found in 21.3% of cases in group I, less often less often in groups II (10.6%, p 0.05) and III (2.9%, p 0.05). Vaginal hematoma occurred in one patient of group III (2.9%) and three women of group I (1.7%, p 0.05). There were no cases of damage to the anal sphincter. The greatest blood loss was recorded in subgroup IB (554 44.9 ml), when compared to subgroup IA (473 20.7 ml; p 0.05), group II (418 24.9 ml; p 0.05), and group III (347 33.4 ml; p 0.05). There were no differences in blood loss between the outlet OF and VE groups (p 0.05). Most newborns were born in good condition (84.5%, 77.6%, and 88.2% of cases in groups I, II, and III, respectively). Cephalohematoma in newborns was more common after VE (32.9%) than after OF (9.2%, p 0.01) and in control (5.9%, p 0.01). No retinal hemorrhage was recorded in newborns. There were no significant differences in the frequency of children being transferred to the childrens hospital (7.5%, 9.4%, and 8.8% of cases in groups I, II, and III, respectively; p 0.05). Conclusion. The use of OF is an effective and safe method of vaginal operative delivery. It does not increase the fetal injury rate, the frequency of newborn cephalohematoma being 3.5 times less than with VE. Complications of OF and VE (except for a greater number of vaginal lacerations in cases of OF), blood loss, and the course and duration of the postpartum stay in the maternity ward are comparable.

scholarly journals Influence of Rhesorbilact on rheological properties of blood in patients with acute peritonitis

2020 ◽  
pp. 94-94
Author(s):  
D.B. Khamidov ◽  
Z.K. Kosimov ◽  
B.R. Boboev ◽  
U.R. Khalifaev ◽  
Sh.E. Kholnazarov
Keyword(s):  
Initial Data ◽  
Rheological Properties ◽  
Blood Viscosity ◽  
Main Group ◽  
Infusion Therapy ◽  
Control Group ◽  
Average Dose ◽  
Acute Peritonitis ◽  
Therapy Program ◽  
Fibrinogen Content

Objective. Study of the effect of Rheosorbilact on the rheological properties of blood in patients with acute peritonitis. Materials and methods. 62 patients with acute peritonitis at the age from 20 to 87 years were examined. The patients were divided into two groups depending on the inclusion of Rheosorbilact solution in the infusion therapy program. The first group (control) included 30 patients with the infusion therapy program consisted of conventional crystalloid and colloidal infusions. The second (main) group included 32 patients with the treatment of Rheosorbilact infusion therapy program at an average dose of 5.7-6.6 ml/kg (400 ml per day). The rheological properties of blood were studied by determining the relative blood viscosity with a VK-4 viscometer, hematocrit, fibrinogen and ESR according to generally accepted methods. Results. In patients with acute peritonitis, when Rheosorbilact (main group) is included in the infusion therapy program, there is a significant improvement in the rheological properties of blood compared with the results of the control group who received crystalloids and colloids. After treatment in patients of the control group, the indicators of the rheological properties of blood were characterized by a decrease in hematocrit – by 16.5 %, blood viscosity – by 11.6 %, fibrinogen content – by 15.2 %, ESR – by 18.2 % compared to the initial data. In patients of the main group who received Rheosorbilact in the infusion therapy program, the rheological properties of the blood significantly improved and amounted to 24.0 % in comparison with the initial data on hematocrit, 18.7 % in blood viscosity, 21.0 % in fibrinogen, and 23.4 % in ESR. Conclusions. In patients with acute peritonitis, a significant violation of the rheological properties of blood is observed. The inclusion of Rheosorbilact in the infusion therapy program contributes to the correction of impaired blood.

scholarly journals A STUDY TO ASSESS THE EFFECTIVENASS OF IMMEDIATE BREAST FEEDING ON DURATION OF THIRD STAGE OF LABOUR AND BLOOD LOSS DURING THE SAME IN SELECTED HOSPITALS

2020 ◽  
Vol 8 (11) ◽  
pp. 1048-1068
Author(s):  
Ujwala Rajendra Parker ◽  
Keyword(s):  
Data Collection ◽  
Blood Loss ◽  
Breast Feeding ◽  
Sampling Technique ◽  
General System ◽  
Control Group ◽  
Check List ◽  
Third Stage Of Labor ◽  
Group I ◽  
Third Stage

An experimental study was conducted to assess the effectiveness of immediate breast feeding on duration of third stage of labour and blood loss during the same in selected hospitals of Pune city. The conceptual framework adopted for the study was General System Model. The sample size was 60 full term mothers in active labour, divided into two groups. Purposive sampling technique was used for selection of sample. Where, Group I is experimental group and Group II is an control group. Each consisted of 30 samples. Data collection was accomplished by using observation check list as a tool. It consists of three sections. First section dealt with demographic profile of the samples. Second section dealt with observation check list to assess duration of labour.Third section dealt with amount of blood loss.Pilot study was conducted to assess the feasibility of the study. It was conducted on 14 mothers.Final data collection was done. Data gathered was analysed by using descriptive and inferential statistics. Based on the analysis interpretations were made.The study analysis shows that immediate breast feeding statistically reduces the duration of third stage of labor and the amount of blood loss.

scholarly journals BLOOD AND URINE ELECTROLYTES DYNAMIC PATTERN OBSERVED AT DIFFERENT MONITORING STAGES IN PATIENTS SUFFERING FROM TOXIC SHOCK SYNDROME AND UNDERGOING VARIOUS TYPES OF INFUSION THERAPY

2018 ◽  
Vol 8 (4) ◽  
pp. 300-303
Author(s):  
E. V. Ivakhnenko
Keyword(s):  
Toxic Shock Syndrome ◽  
Colloidal Solution ◽  
Electrolyte Composition ◽  
Infusion Therapy ◽  
Colloidal Solutions ◽  
Toxic Shock ◽  
Treatment Results ◽  
Rapid Restoration ◽  
Urine Electrolytes ◽  
Therapy Strategies

The need to study how the infusion therapy affects the electrolyte composition of blood is a topical issue nowadays. Such a study will provide the necessary answers and help us to introduce the most effective infusion therapy strategies for patients suffering from severe hemodynamic disorders accompanying toxic shock syndrome (TSS). The study analyzes and summarizes the examination and treatment results of 111 patients suffering from various forms of severe infectious disease complicated by TSS. As a result of the study, it was determined that infusion therapy using a combination of hypertensive and colloidal solutions significantly contributes to the rapid restoration of electrolyte composition and compensates for acidosis. Given these data, a combination of 10% sodium chloride solution with 6% colloidal solution can be considered a preferable solution for initial infusion therapy in patients suffering from TSS.

scholarly journals STRATEGY OF INFUSION-TRANSFUSION THERAPY IN OPERATIONS WITH MASSIVE BLOODWORK IN CHILDREN WITH TUMOR ABOMALOMAL LOCALIZATION TUMORS

2018 ◽  
Vol 8 (2) ◽  
pp. 56-64 ◽  
Author(s):  
E. I. Belousova ◽  
N. V. Matinyan ◽  
L. А. Martynov
Keyword(s):  
Blood Loss ◽  
Malignant Tumors ◽  
Electrolyte Imbalance ◽  
Coagulation System ◽  
Infusion Therapy ◽  
Transfusion Therapy ◽  
Group I ◽  
Crystalloid Solutions ◽  
Combined Anesthesia ◽  
Balanced Crystalloid

Surgeries for thoracoabdominal tumors in children predispose to water and electrolyte imbalance, imbalance in the coagulation system, etc. In spite of abundance of recommendations for children, the volume of basic infusion therapy is uncertain.Study purpose. To estimate the clinical effectiveness of the conducted infusion therapy with isotonic balanced electrolyte solution in children who underwent thoracoabdominal surgeries accompanied with massive blood loss and a complex estimation of the conducted infusion and transfusion therapy.Materials and methods. The intraoperative and early postoperative (days 1–5) periods were analyzed in 22 patients (ASA II–III) who underwent an operation for thoracoabdominal malignant tumors with massive perioperative blood loss in 2016–2017. Group I included 11 patients who had infusion with balanced crystalloid solutions of 5 to 10 ml/kg/hour under combined anesthesia. Group II includes 11 patients who had infusion with balanced crystalloid solutions of 11 to 20 ml/kg/hour under combined anesthesia.Results. According to the conducted study, a higher hemodynamic stability was observed in patients from the group of basic infusion therapy with balanced crystalloid solutions of 11–20 ml/kg/hour. It was expressed as the decrease of the mean dose of the used vasopressors and volume of the infusion of colloidal solutions. The patients also had a less intense response to stress.

scholarly journals The Effect of Smith-Peterson Osteotomy on Blood Loss during Surgical Correction of Adolescent Idiopathic Scoliosis

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 503-508
Author(s):  
Anastasia Ivanova ◽  
Mikhail Mikhaylovskiy ◽  
Vyacheslav Novikov ◽  
Aleksandr Vasyura ◽  
Vitaliy Lukinov ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Surgical Correction ◽  
Intraoperative Blood Loss ◽  
Transpedicular Fixation ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Blood Loss Volume

Introduction: Surgical correction of adolescent idiopathic scoliosis is inevitably accompanied by blood loss. About 37–85% of patients undergo allogeneic transfusions associated with a risk of serious complications. Prediction of the expected blood loss volume remains a topical problem. In this regard, there is a need to clarify predictors of increased blood loss. Aim: To assess the effect of vertebrectomy on the intraoperative blood loss volume during surgical correction of adolescent idiopathic scoliosis. Materials and methods: A retrospective study included 511 adolescents who underwent posterior correction of spinal deformity. Two groups were allocated: Group I consisted of 303 patients who underwent multilevel transpedicular fixation; Group II included 208 patients who underwent multilevel transpedicular fixation combined with Smith-Peterson osteotomy. Results: Intergroup comparisons revealed significant differences in the number of transpedicular fixation levels and the volume of blood loss, which were higher in Group II. After aligning the groups by the number of transpedicular fixation levels using the Propensity Score Matching method, no statistically significant difference was observed. We derived formulas for calculating the expected blood loss volume in Groups I and II. Comparison of the formulas revealed that the formula for Group II predicted a significantly lower volume of blood loss, by 2.51%, while the formula for Group I predicted a significantly higher volume of blood loss, by 3.27%. In our opinion, application of the formula that overestimates expected intraoperative blood loss is most reasonable due to a possibility of the worst case scenario during surgery; therefore, the formula for Group I approaches a universal model for use. Conclusion: Smith-Peterson osteotomy did not affect the amount of blood loss during surgical correction of adolescent idiopathic scoliosis, considering the number of transpedicular fixation levels.

scholarly journals THE COMPARISON OF OUTCOMES AFTER LAPAROSCOPIC MYOMECTOMY WITH THE USE OF DIFFERENT UTERINE SUTURE TECHNIQUES

2020 ◽  
Vol 1 (1) ◽  
pp. 58-69
Author(s):  
B. Habrat ◽  
O. Lytvak ◽  
B. Lysenko ◽  
A. Habrat
Keyword(s):  
Blood Loss ◽  
Reproductive Function ◽  
Tissue Perfusion ◽  
Laparoscopic Myomectomy ◽  
Control Group ◽  
Cell Mediated Immunity ◽  
Aseptic Inflammation ◽  
Group I ◽  
Suture Tension ◽  
Suturing Technique

Purpose: to improve the outcomes and speed up the recovery after laparoscopic myomectomy in females with uterine leiomyoma, based on the comprehensive study and comparison of different uterine suturing techniques. Material and methods. The study enrolled 130 patients, including 100 females underwent laparoscopic myomectomy. Based on the simple randomization, the sample of 100 surgically treated females was subdivided into two subsamples depending on the applied uterine suturing technique:         group I – extracorporeal knotting (n=50); and group II – intracorporeal continuous suturing (n=50). The control group included 30 apparently healthy females (group III). The clinical examination was performed before surgery in the outpatient setting, and in the hospital – after procedure and at the discharge (day 2). We assessed the parameters of myometrium tissue perfusion and the severity of inflammation in the surgical alteration area 1 month before and 1 month following the procedure. The ultrasound signs of myometrium regeneration completeness in the uterine scar area were determine 3 months after surgery. The late outcomes after myomectomy and catamnesis of reproductive function were evaluated at 6-month and 1-year follow-up. Results and discussion. We established that the use of intracorporeal continuous suturing technique in patients underwent laparoscopic myomectomy was favorable for preservation of microcirculatory bed in myometrium, related to a more uniform distribution of suture tension in the tissue and a more even distribution of pressure exerted on the wound edges, as compared to extracorporeal knotting technique. These advantages of intracorporeal continuous suturing technique over the extracorporeal knotting one are useful for the significant reduce of tissue hypoxia and myometrium ischemia in the alteration area. Additionally, this technique is in favor of the physiological programmed suture absorption and the cell-mediated immunity, and associated with the lower risk of necrotic areas formation. In contrast to the intracorporeal continuous suturing technique, the tight and non-uniform extracorporeal knotting is associated with the suppression of staged elimination of blood microclots and other factors of aseptic inflammation in the surgical alteration area. Conclusions. The use of extracorporeal knotting technique had no advantages over the intracorporeal continuous suturing, and, in the majority of cases, was associated with longer duration of procedure, inappropriate blood loss, as well as excessive consumption of suture material. The intracorporeal continuous suturing is the most optimal technique for uterine wound edges approximation, and associated with the positive outcomes regarding the reproductive function (the reproductive function could be realized in 3 months after the use of intracorporeal continuous suturing technique, in contrast to 6 months – after the extracorporeal knotting one), the minimal frequency of complications and favorable economic profile. The laparoscopic myomectomy in case of myoma sized 10 cm and more is associated with the risk of significant uterine wall defect and excessive blood loss, indicating the need for the intracorporeal continuous suturing technique for closing tissue defects in the area of surgical alteration of myometrium.

scholarly journals A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

2017 ◽  
Vol 6 (10) ◽  
pp. 4230
Author(s):  
Amira Mohammed Badawy
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Operative Time ◽  
Pressure Effects ◽  
Control Group ◽  
Group Iii ◽  
Abdominal Myomectomy ◽  
Octreotide Acetate ◽  
Group I ◽  
Group Ii

Background: Symptomatic Uterine leiomyomata may lead to many symptoms including abnormal uterine bleeding, mass pressure effects and infertility. Myomectomy is an option for conservative management, however, it is associated with some disadvantages, mainly increased intra-operative blood loss. Intra-myometrial vasopressin injection during myomectomy is an effective method to decrease the intraoperative bleeding due to its vasoconstrictor effect. Octreotide Acetate (OA) is another vasoconstrictor agent that have not been tested for gynaecologic indications. The current study was conducted to assess the efficacy of local injection of OA in reducing blood loss during conventional abdominal myomectomy, and to compare it with local instillation of vasopressin.Methods: 60 cases with symptomatic leiomyomata were recruited and planned for abdominal myomectomy, they were divided randomly into 3 groups, 20 cases in each. Group I, where local vasopressin was used, group II, where OA was used, and group III (the control group), where no specific medication was used and only free Saline was injected locally.Results: The overall results showed that OA group had significantly less operative time and less blood loss compared to control group. However, when compared to cases in group I, operative time and blood loss were significantly higher. Postoperative haemoglobin levels were significantly lower in group III compared to groups I (P = 0.039) and II (P = 0.044). Blood transfusion was indicated in 9 cases among group III, while only one case needed blood transfusion in group II, and no cases in group I.Conclusions: The use of local intra-myometrial OA is an option for reducing blood loss during myomectomy, but still efficacy is less than local vasopressin. This may be attributed to the low concentrations used, and to the less potency of OA as a vasoconstrictor agent.

Liver Hemostasis by Using Cold Plasma

2017 ◽  
Vol 24 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Alexander Aleinik ◽  
Alexander Baikov ◽  
Georgiy Dambaev ◽  
Evgeniy Semichev ◽  
Pavel Bushlanov
Keyword(s):  
Blood Loss ◽  
Plasma Treatment ◽  
Bacterial Infections ◽  
Cold Plasma ◽  
High Efficiency ◽  
Nonequilibrium Plasma ◽  
Control Group ◽  
Surgical Interventions ◽  
Blood Indices ◽  
Group I

Surgical resection is associated with blood loss and bacterial infections. The aim of this study was to evaluate the effectiveness of cold plasma treatment during liver resection. Thirty adult male Wistar rats were divided randomly into 2 groups. Group I was the control group—intact animals (5 in total). The second group (25 in total)—experimental animals—had atypical resection of the left lobe of the liver with subsequent coagulation by “nonequilibrium” plasma. Histological tissue samples, biochemical blood indices, and hemocoagulation parameters were investigated on 3, 5, 7, 14, and 30 days after plasma treatment. The sterilization test was made to investigate the plasma bactericidal effects. Cessation of bleeding took less than 1 minute. Blood loss was negligible. Morphometric analysis of the liver revealed increased number of hepatocytes with signs of dystrophy after surgical intervention, which returned to the baseline values after 30 days. Biochemical blood parameters revealed significant differences in the groups only in terms of glucose ( P < .05); other parameters remained unchanged. High sterilization efficiency of cold plasma is confirmed. These results demonstrate the high efficiency of cold plasma treatment during surgical interventions.

Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I

2021 ◽  
Vol 20 (1) ◽  
pp. 11-20
Author(s):  
Yu.S. Raspopin ◽  
◽  
E.M. Shifman ◽  
A.A. Belinina ◽  
A.V. Rostovtsev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
High Risk ◽  
Caesarean Section ◽  
Blood Loss ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Control Group ◽  
Study Group ◽  
Group I

Prevention of postpartum haemorrhage is one of the important tasks of modern obstetrics, anesthesiology and intensive care. Objective. To assess the efficacy and safety of terlipressin usage as a means of postpartum haemorrhage development prevention during caesarean section in high-risk pregnant women. Patients and methods. From February to December 2020, a multicenter comprehensive cohort study, in which 5 medical centers participated, was conducted. The study included 454 pregnant women who underwent caesarean section and who were divided into two groups: control group I (n = 351) and study group II (n = 103), with the use of terlipressin injected into myometrium. Evaluation of the preventive effect of the drug was carried out in several main directions: the volume of blood loss, the need for additional methods of surgical hemostasis, the safety of intraoperative use. Results. Considerable differences were found in the assessment of significant risk factors for the development of postpartum haemorrhage, associated pathologies and comorbidity between the groups. The study group turned out to be more threatened by the postpartum haemorrhage development. In the control group, additional measures of surgical hemostasis were more often used, including hysterectomy (2.6% versus 1.9%) and relaparotomy (1.9% versus 1%). The median blood loss was statistically lower in the study group (700 ml versus 800 ml). Nevertheless, the considerable spread of data on the volume of blood loss should be noted, with a maximum blood loss of 10,000 ml in the control group and 4,500 ml in the study group. There were no serious complications in both groups. Conclusion. The study showed that the use of terlipressin can reduce the volume of blood loss in women with high risk factors for postpartum haemorrhage, as well as reduce the number of hysterectomies and relaparotomies. It is necessary to continue the prospective part of the study with an increase in the randomized sample of patients. Key words: obstetric haemorrhage, caesarean section, terlipressin

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