Journal of anesthesia
-
Journal of anesthesia · Jun 2016
Comparative StudyComputational simulation and comparison of prothrombin complex concentrate dosing schemes for warfarin reversal in cardiac surgery.
Prothrombin complex concentrate (PCC) is increasingly used for acute warfarin reversal. We hypothesized that computational modeling of thrombin generation (TG) could be used to optimize the timing and dose of PCC during hemodilution induced by cardiopulmonary bypass (CPB). ⋯ Pre-CPB administration of full or divided doses of PCC prevents extremely low TG peak during surgery, and maintains hemostatic TG peaks in both 40 and 60 % hemodilution models. Although PCC's hemostatic activity appears to be highest using the full dose after CPB, hypercoagulability may develop in some cases.
-
Journal of anesthesia · Jun 2016
Blood transfusion, colloid therapy and the possible saving of albumin volumes during surgery: data analysis of the survey for certified hospitals of the Japanese Society of Anesthesiologists.
Third-generation hydroxyethyl starch (HES) 130/0.4 has a larger dose limitation (up to 50 mL/kg/day) than HES 70/0.5 (up to 1000 mL/day) which has been used in Japan for 40 years. The aim of this study was to survey the current intraoperative blood transfusion and volume therapy and to predict the possible reduction of intraoperative albumin consumption assuming further replacement by HES 130/0.4 using data obtained from a survey by the Japanese Society of Anesthesiologists (JSA), although HES130/0.4 was not launched in Japan during this survey period. ⋯ Blood loss (15,111 L) was replaced with allogeneic transfusion (53 %), auto-transfusion (12 %), albumin (9 %) and HES 70/0.5 (51 %) during surgery in April 2012. The predicted volume of 5 and 4.4 % albumin saved during this 1-month period if HES 130/0.4 had been used up to a dose of 50 mL/kg was 1189 L (86 % of actual amount used).
-
Journal of anesthesia · Jun 2016
Propofol reduces liver dysfunction caused by tumor necrosis factor-α production in Kupffer cells.
The present study, conducted in rats, investigated whether propofol attenuates lipopolysaccharide (LPS)-triggered liver dysfunction via regulation of tumor necrosis factor (TNF)-α production in activated Kupffer cells. ⋯ Propofol (5 mg/kg/h) attenuated LPS-triggered liver dysfunction via inhibition of TNF-α production in activated Kupffer cells. These results suggest that propofol is capable of inhibiting inflammation-induced liver dysfunction in vivo.