J Cardiovasc Surg
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Venous thromboembolism has been recognized as a potentially life-threatening complication following major thoracic trauma. Little or no attention has been directed at the difference in rates of venous thromboembolism in subjects with penetrating and nonpenetrating chest trauma. ⋯ Deep vein thrombosis and pulmonary embolism is rarely a cause of death within the initial 96 hours of hospitalization in individuals sustaining penetrating chest trauma.
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To investigate the utility of the arterial-venous PCO2 gradient (P(a-v)CO2) as a marker of the increased risk of postoperative complications in the early postoperative hours following myocardial revascularization. ⋯ P(a-v)CO2 represents a useful even if aspecific parameter to monitor patients during the early postoperative period after myocardial revascularization.
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Much routine cardiovascular surgery can be performed without blood transfusion. Complex cardiac surgical procedures, however, especially reoperations, are often associated with heavy blood loss and large transfusion requirements. ⋯ Three of the patients described had been refused surgery, on their terms, at other centres. We believe that no patient should be denied potentially life saving surgery on the grounds of excessive risk without blood transfusion.
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Randomized Controlled Trial Comparative Study Clinical Trial
Changes in coagulation patterns, blood loss and blood use after cardiopulmonary bypass: aprotinin vs tranexamic acid vs epsilon aminocaproic acid.
Cardiopulmonary bypass (CPB) increases risk of postoperative bleeding and need for transfusion. The aim of this study was to evaluate the effects of aprotinin, epsilon aminocaproic acid and tranexamic acid on coagulation patterns and need for banked blood transfusion. Ninety-six consecutive patients who underwent coronary artery bypass surgery were randomly assigned to 4 groups (24 patients each). ⋯ Transfused patients were 2, 4, 12 and 18 respectively in the aprotinin, epsilon aminocaproic acid, tranexamic acid and placebo treated group. In conclusion the use of protease inhibitors significantly reduces postoperative bleeding and transfusion. The aprotinin-treated group had the lower need for transfusion.
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During 18 months' period of war in northeastern Croatia 38 wounded with injuries of lower extremity arteries were operated on in Osijek Department of Surgery demanding the use of substitute conduit for vascular reconstruction; 26 synthetic prosthesis and 12 vein grafts were applied. Ankle-brachial index and life-table method were used for the construction of the initial and cumulative limb salvage rate at 40 months. Cumulative graft patency and limb salvage rates for synthetic grafts was 87.67% +/- 6.9 and for vein grafts 91.67% +/- 8.0 respectively and did not differ significantly for both synthetic prosthesis and autologous vein grafts.