Faculty Opinions recommendation of Measuring the accuracy of propofol target-controlled infusion (TCI) before and after surgery with major blood loss.

Abstract PurposeTo compare the efficacy and safety of percutaneous short-segment pedicle screws fixation (PPSF) with or without intermediate screws (IS) for the treatment of thoracolumbar compression fractures.MethodsFrom January 2016 to March 2019, a retrospective study of 38 patients with thoracolumbar compression fractures conducted. The patients were divided into a 4-screw group (without IS) and a 6-screw group (with IS) according to whether pedicle screws were placed in the fractured vertebrae. Combined positional reduction effects with the technique of pre-contoured lordotic rods were used to reduce the fracture by lengthening the anterior column of the fractured vertebrae. The posterior structure of the fractured vertebrae was undertaken as the fulcrum point for both groups. The operation time, intra-operative blood loss, visual analogue scale (VAS), anterior vertebral body height (AVBH), segment kyphosis（SK）before and after operation and complications were recorded.ResultsAlthough the operation time and blood loss in the 6-screw group were higher than in the 4-screw group, difference was not significant (P＞0.05). There was no significant difference in VAS, AVBH and SK between the two groups (P＞0.05). Nevertheless, these results were significant differences between the preoperative and the immediate postoperative, between preoperative and follow-up groups (P < 0.001). No neurologic injury was observed in either groups. ConclusionsIn the treatment of thoracolumbar compression fractures, percutaneous short-segment pedicle screws fixation without intermediate screws in the 4-screw construct may obtain the same clinical effect as that in the 6-screw construct.

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Александръ Яворовскій. Полное выпаденіе матки и рукава. Надвлагалищная ампутація маточной шейки. Заднее и переднее искусственное зарощеніе рукава. (Medycyna,№ 23, 94)

Journal of obstetrics and women s diseases ◽

10.17816/jowd89848-849 ◽

2020 ◽

Vol 8 (9) ◽

pp. 848-849

Author(s):

B. Polonsky

Keyword(s):

Blood Loss ◽

Outer Surface ◽

Unmarried Woman ◽

Before And After

The author demonstrated the patient before and after the completion of her operation in the Lubel Society of Physicians for the sake of the rare extraordinary size and volume of the parts that fell out. A 30-year-old unmarried woman who has never given birth is engaged in heavy physical labor, to which she attributes her real suffering. The duration of the disease is 5 years. Menstruated from the 16th year of life is always correct. Half a year ago, there were constant blood loss from the ulcerated places of the fallen out sleeves and the outer surface of the vaginal part.

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Peculiarities of the menstrual function of adolescent girls, internal migrants from the highland regions of Kyrgyzstan

Heart Vessels and Transplantation ◽

10.24969/hvt.2018.71 ◽

2018 ◽

Vol 2 (Issue 3) ◽

pp. 70

Author(s):

Jyldyz Isakova ◽

Aynura Sayakova ◽

Gulnara Beishenbieva

Keyword(s):

Menstrual Cycle ◽

Blood Loss ◽

Adolescent Girls ◽

Place Of Residence ◽

Menstrual Function ◽

Hemostasis System ◽

Before And After ◽

Internal Migrants ◽

The Republic ◽

Being There

Objective: To study the nature of changes and peculiarities of the menstrual function in adolescent girls, internal migrants from the highland regions of the republic, depending on the length of stay in lowland areas. Methods: Overall 387 migrants from high-altitude girls were examined. The obtained data were compared with those of 280 girls, permanent residents of Bishkek. We examined the residence duration in both highlands and lowlands, the age of the menarche, the length of the menstrual cycle, the number of menstruation days, the frequency and the amount of blood loss before and after moving to lowland conditions. Results: Lengthening of the menstrual cycle and an increase in menstruation days, as well as, a slight increase for blood loss during menstruation were revealed. The change in place of residence also affects the regularity of the menstrual cycle, which may be due to some hypocoagulation state of the hemostasis system in them during de-adaptation to low-mountain conditions. These changes are particularly pronounced when the term of residence in the lowlands is up to 1 year. Conclusion: Thus, the study of peculiarities of menstrual function and tendencies of its changes in response to the move from highland region to the lowland region for adolescent girls showed that there is a slight increase of a menstrual cycle and an increase in the menstruation itself. In addition, there was an increase in the amount of blood loss during menstruation. The change of place of residence influenced the regularity of the menstrual cycle as well, which may be due to some hypocoagulation state of the hemostasis system in them during de-adaptation to low-mountain conditions. These changes are especially expressed for girls who just move in to the lowland region and being there for up to a year.

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Diagnosis and surgical treatment of liver echinococcosis

Medicni perspektivi (Medical perspectives) ◽

10.26641/2307-0404.2021.4.248172 ◽

2021 ◽

Vol 26 (4) ◽

pp. 113-117

Author(s):

V.O. Shaprinskyi ◽

O.O. Vorovskyi ◽

O.A. Kaminskyi ◽

Ya.M. Pashynskyi

Keyword(s):

Blood Loss ◽

Pleural Cavity ◽

Abdominal Cavity ◽

Diagnostic Value ◽

Results Of Treatment ◽

Before And After ◽

Residual Cavity ◽

Right Lobe ◽

The Right ◽

Duration Of Operation

The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р<0.05), stay in hospital – 3.3 times (р=0.002). There were no fatal outcomes. Before and after operation antirelapse antiparasitic therapy with albendazole (Vormil) was performed in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was calculated at a rate of 15 mg/kg/day. There were 2 (2.8%) cases of relapse, there was no mortality.

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Gynecologists May Underestimate the Amount of Blood Loss during Total Laparoscopic Hysterectomy

Obstetrics and Gynecology International ◽

10.1155/2018/3802532 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Masakazu Sato ◽

Minako Koizumi ◽

Kei Inaba ◽

Yu Takahashi ◽

Natsuki Nagashima ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Blood Loss ◽

Laboratory Testing ◽

Ovarian Tumor ◽

Open Surgery ◽

Laparoscopic Hysterectomy ◽

Total Laparoscopic Hysterectomy ◽

Before And After

Background. We considered the possibility of underestimation of the amount of bleeding during laparoscopic surgery, and we investigated comparing the amount of bleeding between laparoscopic surgery and open surgery by considering the concentration of hemoglobin before and after surgery as indicators. Methods. The following procedures were included: A, surgery for ovarian tumor; B, myomectomy; and C, hysterectomy either by laparoscopic surgery or open surgery. Patients who underwent the above procedures in between January 1, 2010, and December 31, 2017, were enrolled. We identified 1749 cases (A: 90, B: 105, and C: 325 of open surgery and A: 667, B: 437, and C: 125 of laparoscopic surgery). We considered the sum as an estimation of blood loss during surgery and the change in the value of hemoglobin in laboratory testing one day before and after surgery. Results. During laparoscopic surgery, the measurements of blood loss included the following: A: 59.8 ml; B: 168.6 ml; and C: 206.8 ml. During open surgery, measurements of blood loss included the following: A: 130.7 ml; B: 236.7 ml; and C; 280.9 ml. The reduction of hemoglobin after surgery compared with that before surgery was less in laparoscopic surgery than that in open surgery in A and B; however, this reduction was not significantly different in C. Conclusion. Our results suggest that the estimation of the bleeding in A and B was appropriate; however, the estimation might be underestimated in C during laparoscopic surgery.

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Changes in von Willebrand factor during cardiac surgery: effect of desmopressin acetate

Blood ◽

10.1182/blood.v71.6.1648.1648 ◽

1988 ◽

Vol 71 (6) ◽

pp. 1648-1655 ◽

Cited By ~ 83

Author(s):

M Weinstein ◽

JA Ware ◽

J Troll ◽

E Salzman

Keyword(s):

Cardiopulmonary Bypass ◽

Blood Loss ◽

Drug Treatment ◽

Von Willebrand Factor ◽

Drug Induced ◽

Before And After ◽

Artery Disease ◽

Von Willebrand ◽

The Relationship ◽

Willebrand Factor

Abstract Patients who receive desmopressin acetate (dDAVP) after cardiopulmonary bypass bleed less during operation and in the first 24 hours after operation than do patients who receive a placebo. To study the mechanism of improved hemostasis in bypass patients, we examined the relationship between von Willebrand factor (vWF) and blood loss in 70 cardiopulmonary bypass patients, one-half of whom received desmopressin intraoperatively. vWF concentration and multimeric composition were analyzed before and after bypass, after drug treatment, and 24 hours after operation. Before operation, patients with valvular disease had lower percentages of vWF high-mol-wt multimers (HMWMs) than did healthy subjects or patients with coronary artery disease, but subsequent blood loss, vWF activity, and bleeding times were not related to this finding. Irrespective of drug treatment, patients who had low preoperative vWF and who had a net loss of the protein during bypass bled more after bypass than did similar patients who had a net increase of vWF during bypass. HMWMs rose to above normal levels after bypass regardless of desmopressin infusion. Differences in the concentration of vWF between desmopressin and placebo patients after receipt of the drug, although small, were better correlated with reduced blood loss than were differences in HMWM distribution. We conclude that the beneficial effect of desmopressin on hemostasis following cardiopulmonary bypass cannot be attributed to a drug-induced change in HMWM distribution but may be related to an increase in overall vWF concentration.

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Implementation of Perioperative Point-of-Care Platelet Function Analyses Reduces Transfusion Requirements in Cardiac Surgery: A Retrospective Cohort Study

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0040-1710582 ◽

2020 ◽

Author(s):

Lihui Wang ◽

Oswaldo Valencia ◽

Simon Phillips ◽

Vivek Sharma

Keyword(s):

Blood Loss ◽

Red Blood Cells ◽

Platelet Function ◽

Blood Cells ◽

Platelet Transfusion ◽

Postoperative Blood Loss ◽

Transfusion Rate ◽

Cabg Surgery ◽

Packed Red Blood Cells ◽

Before And After

Abstract Background Platelet dysfunction is a common cause of bleeding, perioperative blood transfusion, and surgical re-exploration in cardiac surgical patients. We evaluated the effect of incorporating a platelet function analyzer utilizing impedance aggregometry (Multiplate, Roche, Munich, Germany) into our local transfusion algorithm on the rate of platelet transfusion and postoperative blood loss in patients undergoing coronary artery bypass grafting (CABG) surgery. Methods Data were collected on patients undergoing CABG surgery from January 2015 to April 2017. Patients who underwent surgery before and after introduction of this algorithm were classified into prealgorithm and postalgorithm groups, respectively. The primary outcome was the rate of platelet transfusion before and after implementation of the Multiplate-based transfusion algorithm. Secondary outcomes included transfusion rate of packed red blood cells, postoperative blood loss at 12 and 24 hours, length of stay in the intensive care unit, and the hospital and mortality. Results A total of 726 patients were included in this analysis with 360 and 366 patients in the pre- and postalgorithm groups, respectively. Transfusion rates of platelets (p = 0.01) and packed red blood cells (p = 0.0004) were significantly lower following introduction of the algorithm in patients (n = 257) who had insufficient time to withhold antiplatelet agents. Receiver operating characteristic curves defined optimal cutoff points of arachidonic acid and adenosine diphosphate assays on the Multiplate to predict future platelet transfusion were 23AU and 43AU, respectively. Conclusions The introduction of a Multiplate-based platelet transfusion algorithm showed a statistically significant reduction in the administration of platelets to patients undergoing urgent CABG surgery.

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Effect of Different Doses of Intraumbilical Oxytocin on Third Stage of Labor

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1435 ◽

2016 ◽

Vol 8 (4) ◽

pp. 286-289

Author(s):

Devyani Sawai ◽

Susheel Kumar Sharma ◽

Geeta Jain

Keyword(s):

Blood Loss ◽

Randomized Study ◽

Multiple Pregnancy ◽

Medical College ◽

Medical Disorders ◽

Third Stage Of Labor ◽

Third Stage ◽

Before And After ◽

Different Doses ◽

Singleton Pregnancies

ABSTRACT Objectives A prospective randomized study was conducted from May 2012 to April 2014 at the Department of Obstetrics and Gynecology, Dr. Sushila Tiwari, Memorial Government Hospital and Government Medical College, Haldwani. Its aim was to study and compare the effects of different doses of intraumbilical oxytocin on 3rd stage of labor with respect to duration and amount of blood loss. Materials and methods The study comprised 200 antenatal cases and included patients with singleton pregnancies at term and spontaneous onset of labor while excluding those with medical disorders of pregnancy, antepartum hemorrhage (APH), multiple pregnancy, polyhydramnios, chorioamnionitis, severe anemia, Rh negative pregnancy, pregnancy-induced hypertension (PIH), prior cesarean delivery, and forceps or ventouse application during delivery. History and examination was taken in each patient before delivery and hemoglobin and hematocrit were noted before and after delivery. Progress of labor was monitored and each patient was randomized into one of the four groups according to the dose of oxytocin to be given. Results Increasing doses of oxytocin resulted in decrease in duration of 3rd stage of labor and amount of blood loss. Conclusion Third stage of labor and amount of blood loss significantly reduced by increasing the dose of oxytocin to 30 IU. How to cite this article Sawai D, Sharma SK, Jain G. Effect of Different Doses of Intraumbilical Oxytocin on Third Stage of Labor. J South Asian Feder Obst Gynae 2016;8(4):286-289.

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Blood Saving Effect of Tranexame at Hip Joint Replacement

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200916413-18 ◽

2009 ◽

Vol 16 (4) ◽

pp. 13-18

Author(s):

Nadezhda Ivanovna Arzhakova ◽

A I Bernakevich ◽

E V Shushpanova ◽

N I Arzhakova ◽

A I Bernakevich ◽

...

Keyword(s):

Blood Loss ◽

Main Group ◽

Hemoglobin Level ◽

Postoperative Blood Loss ◽

Plasma Transfusion ◽

Hip Joint Replacement ◽

Before And After ◽

Antifibrinolytic Drugs ◽

Saving Effect ◽

Donor Plasma

Study of the efficacy (by the results of blood saving action assessment) and application safety of tranexamic acid (home antifibrinolytic drug Tranexame) at hip arthroplasty was performed. Perioperative blood loss (intraoperative + postoperative blood loss by drainages during 24 hours), need in hemotransfusion, laboratory indices (hemoglobin, hematocrit, coagulograms) before and after operation were analyzed in 43 patients. Twenty patients received 4 g of Tranexame daily (main group) and 23 patients did not receive antifibrinolytic drugs. In the main group reliable decrease in blood loss as compared with control perioperative one, lower decrease of hemoglobin level and less need for donor plasma transfusion (in combination with autodonor blood and other blood savings methods) was noted. Safety of the drug was proved by the absence of thrombosis signs at ultrasonography of lower extremities vessels.

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