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A M Laguardia

Publications and source records attributed to A M Laguardia.

9 recordsLinked to original sources
PubMed1997

Autotransfusion in major orthopaedic surgery: experience with 1785 patients.

Using a prospective audit, we have evaluated the efficacy of an integrated autotransfusion regimen which comprised predepositing and intra- and postoperative blood salvage in major orthopaedic surgery. We examined prospectively the records of 1785 patients (1198 females, 5867 males, mean age 62 (range 16-90) yr, preoperative haemoglobin concentration 13.4 (SD 1.4) g dl-1) undergoing total hip arthroplasty (THA, 1229 patients), THA after removal of internal fixation devices (RFD + THA, 18 patients), total knee arthroplasty (TKA, 263 patients), revision surgery of the hip (HR cup + stem revision, 197 patients; cup revision, 53 patients; stem revision, 16 patients) and total knee revision (TKR, nine patients). We estimated that the number of predonations (MSBOS = maximum surgery blood order schedule) was 2 u. for THA, TKA and TKR, and 3 u. for partial or total hip revision and total hip arthroplasty with fixation removal. We found that it was possible to obtain the MSBOS in 1597 patients (89.5%). Homologous red blood cell (HRBC) transfusions were carried out in 131 patients (7.3%). We found that the need to use HRBC was significantly associated with failure to meet the number of MSBOS, female sex, lower preoperative haemoglobin concentration, use of calcium heparin for antithrombosis prophylaxis, more extensive surgery, higher ASA rating and co-existing diseases such as coronary artery disease.

Adolescent↗
PubMed1993

Autotransfusion: 15 years experience at Rizzoli Orthopaedic Institute.

The program of blood saving, result of 15 years of experience, includes predeposit (1977) hemodilution (1979) intra (1984) and postoperative (1985) salvage, careful intra and postoperative bleeding control, use of homologous transfusion only in case of intolerated anaemia even for 7-8g/dl Hb values. The use of autologous compared to homologous transfusion passed from 19% in 1984 to 62% in 1992. In 1992 in the surgical division of the 1st Anaesthesia and Intensive Care unit, 414 patients underwent prosthetic hip and knee surgery, 8% of these patients were homologously transfused.

Adult↗
PubMed1992

Prevention of deep vein thrombosis in orthopaedic surgery. Comparison of two different treatment protocols with low molecular weight heparin ('Fluxum').

The efficacy of two treatment protocols with a low molecular weight heparin used for the prevention of post-operative deep vein thrombosis was compared in 40 patients undergoing hip replacement surgery. The aim was to assess whether the different timing--2 hours before (Group A, 19 patients) or 2 hours after (Group B, 21 patients) the surgical operation--of the first dose administered (15,000 aXaU) of a therapeutic cycle of 7 days could affect the results, both with respect to the preventive efficacy and to the risk of haemorrhage often connected with antithrombotic therapy. The results showed that the incidence of deep vein thrombosis was very similar and extremely low in the two groups, only 1 patient in each group having a positive diagnosis on phlebography. The effectiveness of a single daily dose of 15,000 aXaU in orthopaedic surgery was also confirmed. This dose guaranteed effective prophylaxis against the onset of deep vein thrombosis and did not appear to have any local side-effects (such as burning or pain at the site of injection) which could diminish patient compliance.

Aged↗
PubMed1991

[Spinal trauma].

Explore the source record for details and available documents.

First Aid↗
PubMed1989

[Reduction and early surgical stabilization of fractures and fracture-luxations in cervical vertebral and spinal cord injuries].

A series of 21 patients with cervical spinal trauma, 12 patients with complete spinal lesion and 9 with incomplete spinal lesion, is reported. All these patients have been treated with surgical reduction and stabilization at average 9 hours after trauma. The authors point out pre- and intraoperative anesthesiological problems connected with early surgical operation and discuss the postoperative complications. At the follow-up of average 2 years the results were: among the 12 patients with complete spinal lesion, 2 died, 2 improved until the deambulation, 7 didn't change and 1 had no follow-up; among the 9 patients with incomplete spinal lesion, 7 improved until the deambulation, 1 didn't change and 1 worsened. Independently of the neurological recovery, the early surgical stabilization enables to reduce remarkably the incidence of the complications, to start precociously a rehabilitation, to improve the patient's expectation of life.

Adolescent↗
PubMedDate not supplied

Anterior surgery of the upper part of the cervical spine by prevascular extraoral approach.

Anterior surgery of the upper part of the cervical spine, that is, proximal to C3, may be performed by transoral approach, possibly enlarged by glossomandibulotomy, by a retrovascular extraoral approach, or by a prevascular extraoral approach. The authors describe the surgical method of prevascular extraoral approach that allowed them to effectively treat osteoma localized at C2 and C3, post-laminectomy instability at C3 and C4, solitary metastasis at C3. As compared to transoral surgery the prevascular extraoral approach has the advantage of avoiding the risk of infection from germs in the oral cavity and of allowing for easier postoperative management, avoiding tracheotomy and/or prolonged dysphagia. As compared to a retrovascular approach the prevascular approach obtains a truly anterior exposure instead of an anterolateral one. Prevascular extraoral approach should thus be used whenever possible. Transoral surgery is indicated for decompression, of the brainstem and a bilateral retrovascular approach may be used to perform anterolateral fusion at C1-C2.

Aged↗