Search PubMed⌕ Search

Biomedical subjects

B Borghi

Publications and source records attributed to B Borghi.

64 records · Page 4Linked to original sources
PubMed1989

Effect of perioperative transfusions on survival in osteosarcoma treated by multimodal therapy.

We report on a retrospective study of 155 patients amputated for nonmetastatic osteosarcoma of the long bones. Among the various prognostic variables considered, a significant correlation was found only between survival and transfusions. In this report, the authors consider some hypotheses reported by others for tumors of a different nature and site and conclude that perioperative transfusion may induce depression in the immune response, which is the cause of a shorter survival in the patients reviewed.

Adolescent↗
PubMedDate not supplied

Pulsed venous flow pattern with hemodilution.

Venous flow pattern changes and venous flow were assessed in relation to the degree of hemodilution. Femoral vein flow was measured with a duplex scanner in two groups of 11 patients 20 days and 5 days preoperatively, and 1 day postoperatively. In group I, hemodilution was used and patients gave three autologous blood predonations between day 20 and day 5. Perioperative blood loss was reintegrated by electrolyte solution. In group II, hemodilution was not used and autologous blood predonations were not carried out. These patients received a perioperative homologous blood transfusion of 800 mL. Hemoglobin was lower on day 5 (11.3 +/-1.4 vs 13.1 +/-1 g/dL, p<0.05) and on postoperative day 1 (8.9 +/-1.6 vs 10.6 +/-1, p<0.05) in group I. The decrease in hemoglobin was associated with an increase in blood flow and a pulsed venous flow pattern in 14 of 22 veins after autologous blood predonation and in 21 of 22 veins on postoperative day 1 (p<0.05). Increased venous flow in hemodilution is associated with a pulsed venous flow pattern.

Aged↗
PubMedDate not supplied

Methods of blood saving in revision surgery of the hip.

The blood saving protocol, which is the product of 15 years of experience, has gradually been improved, until the current form has been achieved, which includes predeposit, acute intentional isovolemic hemodilution, controlled hypotension, intraoperative blood recovery, postoperative monitoring and blood recovery, external compressive elastic dressing. The acceptance of values for hemoglobin which may even be < 8 g/dl during the late postoperative period, as long as this is well-tolerated by patients, has allowed us to drastically reduce the use of homologous transfusions. Over the last 2 years, out of 59 autotransfused patients submitted to revision surgery of the hip, only 9 (equal to 15%) required homologous transfusion. An analysis of the data shows that the use of homologous blood is associated with the presence of ischemic cardiopathy (p < 0.001) and with a predeposit which is less than 4 units of blood (packed red blood cell+fresh frozen plasma) (p = 0.05).

Adult↗
PubMedDate not supplied

Asymptomatic carotid disorder and hemodilution: a perioperative study in major orthopaedic surgery.

The aim of this study was to assess the pattern of adaptation to severe Haemodilution in pts with normal or stenotic carotid vessels. We enrolled 180 consecutive pts undergoing total hip replacement: 138 pts had echo-Doppler documented normal carotid arteries, 10 pts had kinking and 32 pts had monolateral or bilateral stenosis of internal carotid arteries (lesions, class of stenosis 1-49%). Haemoglobin values on the 4th day after surgery was 8.7 +/- 1.2 g/dl with no statistically significant differences in pts (patients) with carotid disorders versus normal pts. No pt showed clinical signs of cerebral ischemia or brain damage in the postoperative period. These results are consistent with experimental and clinical data showing that normovolaemic anaemia is well tolerated without disabling symptoms in pts with mild or moderate stenosis of carotid arteries.

Carotid Artery Diseases↗
PubMedDate not supplied

Proximal deep vein thrombosis: the use of the echoDoppler for diagnosis and therapeutic indications.

Our objective was to assess the impact of echo-Doppler technique on the diagnosis of Deep Vein Thrombosis (DVT) in major orthopedic surgery (80% of DVT diagnosed are asymptomatic). We therefore analyzed 200 consecutive pts submitted to elective surgery for total hip replacement. The postoperative echo-Doppler study indicated DVT in 13 pts: these pts underwent a postoperative lower limb phlebography. Echo-Doppler and phlebography had concordant results in 11 of 13 echo assessed proximal DVT. These observations suggest that Duplex scanning is a good method to diagnose and to guide therapy for proximal DVT in orthopaedic clinic.

Anticoagulants↗
PubMedDate not supplied

Antibiotic and antithromboembolic prophylaxis in hip arthroplasty (a review of 700 primary implants).

The authors report the results obtained with antibiotic and antithromboembolic prophylaxis used in 700 consecutive primary total hip arthroplasties. As for antibiotic prophylaxis (5 cases of infection: 0.7%) the various types of antibiotic used always kept the infection rate under 1%, confirming the effectiveness of the preventive use of antibioticotherapy. The incidence of deep venous thrombosis and pulmonary embolia were 3.7% and 0.7%, respectively (26 cases of DVT and 5 of PET). The incidence of DVT rose to 34.4% in a selected group of cases in which phlebography had been carried out even in the absence of symptoms of DVT. This confirms that the routine use of this method would without a doubt be useful in preventing complications with a high risk for the life of the patient (pulmonary embolia). As for pharmacological prophylaxis, indobufene and calcium heparin were the drugs used most: their effectiveness was nearly similar, despite the fact that the use of calcium heparin in patients considered to be at a higher risk for thromboembolic complications should be made clear.

Adult↗
PubMedDate not supplied

Autotransfusion with intra- and postoperative blood recovery in prosthetic hip surgery. A study conducted on 1368 cementless prostheses.

With regard to increasing reservations as to homologous transfusions and the objective risks that they involve, since 1984 we have been using an autotransfusion technique in total hip arthroplasty constituting blood predeposit for hemodilution, and intra- and postoperative blood recovery. When this method was used postoperative complications were not very significant even when patients were high-risk (cardiopathic); furthermore, the use of homologous transfusions was required in 2.2% of the patients in 1994 as compared to 90% in 1985. The use of our orthopaedic protocol allows for rapid recovery of movement in the patient thus reducing time bed-ridden and related risks (DVT and/or PTE); the transfusion protocol allows for a return to normal of hemodynamic conditions a few days after surgery. Finally, the reduced incidence of complications caused by homologous transfusions (hepatitis, AIDS...) constitutes a financial saving for the government.

Aged↗