The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Oct 1999
Thoracoscopic reduction pneumoplasty for severe emphysema: do pleural adhesions affect outcome?
Pleural adhesions are frequently encountered in patients undergoing reduction pneumoplasty. We evaluated the impact that pleural adhesions had on the surgical technique and outcome of thoracoscopic reduction pneumoplasty. ⋯ Pleural adhesions may be associated with increased morbidity and less improvement in FEV1 but they do not contraindicate thoracoscopic reduction pneumoplasty.
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Thorac Cardiovasc Surg · Oct 1999
Randomized Controlled Trial Clinical TrialHemostasis management by use of Hepcon/HMS: increased bleeding without increased need for blood transfusion.
Extracorporeal circulation forces complete anticoagulation, most frequently achieved by complete heparinization. Activated clotting time (ACT) is the gold standard for monitoring, although there is a lack of correlation between heparin plasma level and ACT. Several systems for the estimation of free heparin have been developed: in this study we focused investigating on the influence of the Hepcon/HMS system on postoperative bleeding and transfusion requirements. ⋯ Use of the Hepcon/HMS-system for monitoring of heparinization during extracorporeal circulation is possible without increased risk of thromboembolism. Postoperative blood loss was slightly but significantly increased but there was no need for more heterogenous transfusion.