AANA journal
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Clinical Trial Controlled Clinical Trial
The intraoperative use of Amicar to reduce bleeding associated with open heart surgery.
In an effort to reduce morbidity associated with transfusion of blood products, Amicar is used as a prophylactic inhibitor of hyperfibrinolysis associated with diffuse perioperative bleeding in patients undergoing open heart surgery. Previous studies indicate a significant reduction of intraoperative and postoperative bleeding in patients receiving Amicar during open heart surgery. ⋯ The study found a significant reduction in postoperative chest tube output for the group receiving Amicar, as well as a reduction in perioperative blood product transfusion in patients who received Amicar. One patient in the Amicar group experienced a thrombotic event.
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Scoliosis surgery presents the anesthetist with specific clinical challenges. Since scoliosis is the most common problem for which patients of congenitally short stature present to the operating room, the preoperative evaluation of dwarfs is discussed here in the context of a patient with spondyloepiphyseal dysplasia congenita. ⋯ Consideration is given to cervical spine abnormalities, congenital absence of the odontoid process, pulmonary function abnormalities, and mucopolysaccharidosis (a syndrome which may compromise airway management). The intraoperative monitoring of somatosensory evoked potentials and their significance are also discussed.