Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2019
Perioperative Blood Management, Red Cell Recovery (Cell Salvage) Practice in an Australian Tertiary Hospital: A Hospital District Clinical Audit.
Data on red cell recovery (cell salvage) utilization in Australia are limited and national guidance is based on a single Australian audit conducted at a hospital that excludes cardiothoracic surgery. This clinical audit aimed to analyze the utility of red cell recovery at a tertiary health care facility which includes cardiothoracic surgery. Secondary aims of this study were to identify specific surgical procedures in which red cell recovery is most beneficial and to quantify this benefit. ⋯ Overall, our center demonstrated good compliance with national red cell recovery guidelines. This audit adds to the existing data on red cell recovery practice in Australia and provides a benefit-specific surgical procedure guideline that includes cardiothoracic surgery.
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Anesthesia and analgesia · Jun 2019
Mixing Studies in Patients With Prolonged Activated Partial Thromboplastin Time or Prothrombin Time.
Patients presenting for surgery may have isolated or combined prolonged activated partial thromboplastin time (aPTT) and/or prothrombin time (PT). In patients not receiving anticoagulants or with no identifiable cause for abnormal clot formation, a mixing study is performed. The index of circulating anticoagulant (ICA) has been used to predict the presence of an inhibitor, usually a lupus anticoagulant. ⋯ Normalization of the aPTT and PT in a mixing study was associated with low clotting factor activity. The ICA may be helpful in predicting the presence of a lupus anticoagulant. As anesthesiologists take ownership of the perioperative surgical home, we need to understand the clinical implications of the results of mixing studies.