Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 1997
Randomized Controlled Trial Clinical TrialA pump-prime aprotinin dose in cardiac surgery: appraisal of its effects on the hemostatic system.
To examine pump-prime aprotinin action on coagulation and fibrinolysis in patients undergoing primary coronary revascularization. ⋯ Pump-prime aprotinin minimized, even if not completely inhibited, the activation of coagulation and fibrinolysis during CPB, possibly ensuring a less complicated and safer postoperative recovery. It seemed to allow the maintenance of a correct balance of hemostatic systems, avoiding the risk of thrombotic phenomena.
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J. Cardiothorac. Vasc. Anesth. · Dec 1997
Comparative StudyPlatelet concentrate effects on thromboelastography.
This study evaluated platelet effects on thromboelastography to determine how morphologically abnormal platelets affected native whole blood analysis. ⋯ Viscoelastic changes in whole blood coagulation after the addition of platelet concentrates are not dependent on morphologically intact or functionally normal platelets. This in vitro study predicts that transfusion of poorly preserved platelet concentrates as well as fresh platelets would increase clot strength on thromboelastography if the recipient's blood were tested immediately after administration.
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J. Cardiothorac. Vasc. Anesth. · Dec 1997
Coagulation tests predict bleeding after cardiopulmonary bypass.
To determine the accuracy of coagulation profile laboratory tests, thromboelastography, and Sonoclot (SCT) values for predicting microvascular bleeding after cardiopulmonary bypass (CPB). ⋯ Contrary to previous studies, coagulation profile tests had the greatest sensitivity and specificity to differentiate patients with excessive bleeding (abnormal) from those without excessive bleeding (normal) after CPB. Therefore, these tests should be used to guide transfusion therapy in patients who have excessive bleeding after CPB.
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J. Cardiothorac. Vasc. Anesth. · Dec 1997
The incidence of artery puncture with central venous cannulation using a modified technique for detection and prevention of arterial cannulation.
Cannulation of the central circulation is essential for management of patients who require major surgery, and for patients who are critically ill. Arterial puncture is the most frequent complication associated with central venous cannulation, and is potentially fatal. Detection of arterial puncture can be problematic, especially in patients with cyanotic congenital heart disease. ⋯ Pressure transduction of the steel needle is a useful technique for detecting arterial puncture and preventing arterial cannulation during attempts to achieve central venous cannulation.