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At least 865 records · Page 48Linked to original sources
PubMed2005

The platelet componentof hemostasis in aortic surgery.

The lack of significant changes in the count and function of platelets in aortic surgery without use of cardiopulmonary bypass (CPB) confirms that factors of extracorporeal circulation exert a remarkable adverse action on the platelet component of hemostasis. In operations performed under hypothermic perfusion or circulatory arrest, disorders of the platelet component even in case of the use of 2 mln. CIU trasylol (aprotinin) are most pronounced which gives rise to excessive postoperative blood loss in the given patient group. It may be assumed that the increase of the dose of trasylol up to 6 mln. CIU will allow, owing to its cytoprotective action, preserve as well as possible the quantitative and qualitative properties of platelets.

Aortic Aneurysm↗
PubMed2005

Vigilant surgical hemostasis challenged by ketamine or hypervolemia induced hemodynamic stress to minimize postoperative hemorrhage in patients with parasagittal/or parafalcian meningiomas: an interventional study.

BACKGROUND: Prevention of postoperative intracranial hemorrhage, a serious and sometimes fatal complication remains the cornerstone for successful neurosurgical procedures. The aim of this study was to test the hypothesis whether vigilant rehemostasis challenged by ketamine or hypervolemia-induced hemodynamic stress could minimize postoperative hemorrhage. METHODS: During a five-year period between 1995 and 2000, in an interventional study, 37 patients having parasagittal or parafalcian meningiomas were randomly allocated into three groups. After accomplishing tumor resection and securing initial surgical hemostasis, the patients received one of the following treatment regimens, i.e. group 1, 1.5 mg/kg of ketamine given intravenously, group II, 1 liter of isotonic saline, and group III, as the control group receiving conventional maintenance fluids intraoperatively, and in all the three groups, the time consumed to achieve rehemostasis at the tumor bed was recorded. Twenty four hours later, a brain computed tomogram was obtained to evaluate the hematoma volume to tumor volume ratio and extent of perifocal edema and the results were recorded. RESULTS: The calculated hematoma volume to tumor volume ratio and the edema score in the ketamine group was significantly less than the control group (P < 0.05). These measurements were also less in the hypervolemia group compared with the control group although the differences were not statistically significant. The rehemostasis time was also significantly more in the ketamine group compared with the control group (P < 0.05). The postoperative hospital stay however, was significantly shorter in the ketamine group (P < 0.05). On the other hand the occurrence of postoperative edema was significantly less in the ketamine group (P = 0.02) compared with the control group. CONCLUSIONS: It is concluded from our data that, vigilant rehemostasis challenged by ketamine or hypervolemia-induced hemodynamic stress minimizes postoperative hemorrhage without producing troublesome brain edema.

Adult↗
PubMed2005

Reductions in blood loss with use of a bipolar sealer for hemostasis in primary total knee arthroplasty.

Fifty primary total knee arthroplasties were performed in a prospective, randomized study comparing the use of a bipolar sealer device versus conventional electrocautery as the method of hemostasis. Both cohorts were evaluated for intraoperative blood loss, transfusion rate, postoperative drainage, hemoglobin levels, and Knee Society scores. A significant reduction in postoperative and total blood loss was found (p = 0.05 and p = 0.02, respectively), as well as an absence of tissue charring and smoke production in the bipolar sealer group. No difference in knee scores was found between both cohorts. These results suggest that use of this bipolar sealing device is at least as effective as standard cautery devices and can reduce blood loss, tissue damage, and smoke production in total knee arthroplasties without affecting the results.

Adult↗
PubMed1977

[Variations in hemostasis in the infant under deep hypothermia].

Effects on hemostasis of deep hypothermia on infant has been studied on 29 infants operated upon for a cardiopathy under deep hypothermia. Results of this study show a diminution of the coagulation factors rate, an augmentation of the fibrinolytic activity and an unforeseable variability of the residual heparin leading in all cases to a complement of the heparin neutralization by Protamine.

Cardiac Surgical Procedures↗
PubMed2006

[The hemostasis system state in patients with ulcerous gastrointestinal bleedings].

In patients with gastrointestinal bleedings there occurs activation of the hemostasis system directed to arrest of bleeding. Short-term hypercoagulation directed to arrest of the bleeding gives place to hypocoagulative changes. Their degree and duration depend on the severity and rate of blood loss. The excessive intravascular activation of blood is accompanied by the formation of fibrin deposits not only in the area of the bleeding source but in other regions of the blood channel. There appears disseminated intravascular coagulation of blood deteriorating the reparative processes in the ulcer, initiating and maintaining generalized plasminemia which promotes the thrombus lysis in the ulcer crater and recurrent bleeding.

Adolescent↗
PubMedDate not supplied

[Effect of low-intensity laser radiation on lipid metabolism and hemostasis in patients with myocardial infarction].

Progression of coronary atherosclerosis often causes complications resulting in myocardial infarction, early disability and death of patients with coronary heart disease. Low efficacy of medicines against coronary atherosclerosis progression after myocardial infarction gave rise to investigations of nonpharmacological methods, laser radiation, in particular. Our study shows a noticeable positive effect of low-intensity laser radiation on blood lipid spectrum and hemostasis. This makes laser therapy promising in combined rehabilitation of postmyocardial infarction patients.

Adult↗
PubMed2006

[Choice of a hemostasis method in injury and focal lesions of the spleen].

Methods of hemostasis in injury and focal lesions of the spleen were studied in experiments and applied in clinical practice. Technique of spleen resection, suturing of cut and perforating wounds is described. Autotransplantation of spleen tissue was used as alternative to splenectomy. In cases of small focal lesions (cysts, abscesses) minimally invasive methods of treatment were preferred.

Animals↗
PubMed1965

Hemostasis as a total physiological function.

The hemostasis is due to the combined action of several systems, blood composition, blood flow and vessels. The author reviews the factors which determine the vessel integrity and promote the repair after trauma.

Blood Circulation↗
PubMed2006

[Hemostasis and bleeding control in thyroid surgery using electrothermal system (Ligasure): our experience in 317 patients].

BACKGROUND: Intraoperative bleeding during thyroidectomy can cause hemodynamic shock and even death. Efforts to control bleeding may prolong the operation and put at risk adjacent organs. Postoperative bleeding sometimes requires reoperation, and may prolong the hospitalization and the recovery period. There are different ways of achieving hemostasis-ligations, sutures, clips and coagulation methods. Ligasure is an electrothermal sealer, which seals vessels using physical pressure and electric bipolar coagulation. The device has been used in thyroid surgery in recent years. AIM: To describe the advantages and disadvantages in the use of Ligasure in the light of our experience and in the literature. METHODS: (1) Retrospective review of 317 patients who underwent thyroidectomy, using Ligasure, in the period 2002-2005. (2) Summary of research results in which Ligasure was used. RESULTS: In the 317 operations there were no bleeding events nor was there any thermal damage to the recurrent laryngeal nerve. The use of Ligasure did not extend the operative duration or the rate of complications of recurrent laryngeal nerve palsy or hypo-parathyroidism. CONCLUSION: The use of Ligasure is effective in the prevention of operative bleeding in thyroid surgery, and it does not prolong the operative time nor raise the rate of complications. In comparison with other sealing methods we found Ligasure to be the most effective. The main disadvantage of Ligasure is its cost. We recommend the use of Ligasure in thyroid surgery.

Adult↗
PubMed2006

Gamma testing experience with the ACL TOP hemostasis testing system.

As a gamma testing site or a limited early release site for the ACL TOP, St. Michael's Hematology Laboratory evaluated the ACL TOP for its ability to fit into a laboratory whose workflow includes large volumes of routine and specialty hemostasis assays. This evaluation included the determination of the ACL TOP's precision, normal ranges, and reagent sensitivities. Analytical correlation studies for the ACL TOP were performed in comparison to the ACL ADVANCE. The ACL TOP was also tested for its ability to handle large volumes of not only routine assays but also more specialized coagulation assays. Instrument precision, normal reference range assignment, and factor sensitivities met the requirements of this laboratory. The ACL TOP correlated favorably to the ACL ADVANCE, and in a workup for thrombophilia its throughput was twice what was seen with the ACL ADVANCE. The speed of the ACL TOP was impressive, generating results at a rate of almost 5 results/min. In this gamma testing study, the ACL TOP has demonstrated suitability as a precise coagulation analyzer for use in the settings of a high-volume, fast-paced, specialized coagulation laboratory faced with demanding turnaround times.

Autoanalysis↗
PubMed1991

[Effect of lidocaine-epinephrine-dextran solution on the plasma epinephrine concentration during spinal surgery--how to avoid circulatory complications due to the use of epinephrine for hemostasis].

Epinephrine infiltrated for hemostasis may cause adverse effect on the circulatory system and the effect can be potentiated by surgical stimulation. Local infiltration of lidocaine-epinephrine-dextran solution (LED) at the surgical site is advantageous for this purpose since nerve blocking action of lidocaine attenuates surgical stimulation and dextran suppresses the transfer of injected epinephrine to the blood stream, thereby reducing the adverse effect of epinephrine. LED, however, could be injected accidentally into vessels. This is one of the important causes of raising the plasma epinephrine concentration to a dangerous level. The author believes that the following maneuvers are helpful to avoid the rise of plasma epinephrine concentration to a dangerous level; 1) injecting not more than 0.05 ml.kg-1 at a time, 2) monitoring the arterial pressure waves and ECG during the injection by use of a continuous recording device, and 3) halting the injection immediately whenever sudden changes in the arterial pressure and in the height of the T wave in ECG were observed. More importantly, surgeon's cooperation is essential for anesthesiologists to execute these maneuvers.

Adult↗
PubMed1990

Hemostasis of the thyroid carcinoma invading the skin and trachea. Conservative treatment.

In most instances, the prognosis of well-differentiated thyroid carcinoma is generally favorable and adequately controlled by surgery alone. In some cases, however, in which the tumor has remained or in recurrent cases, infiltrates surrounding the skin or trachea can result in uncontrollable hemorrhage which cannot be treated with conventional medical or surgical therapy. We present our attempts at hemostatic procedures in such cases. When a thyroid cancer for which radical surgery is not indicated invades the skin with hemorrhage, we remove the ulcerated skin area with as much of underlying cancerous tissue as possible, and cover the defect skin area with a Bakamjian's deltopectoral flap or a musculocutaneous flap. In the 4 cases we have experienced, there had been no ulceration of the flap skin or recurrent. When a thyroid cancer invades the tracheal wall resulting in an intratracheal tumor accompanied by hemoptysis, we attempt to perform bronchoscopic cauterization using Nd-YAG Laser. Cauterization is repeatedly performed weekly, up to five times in one series. In all cases, radioiodine therapy is used before or after treatment. In all 4 cases we have experienced, hemostasis and shrinkage of the tumor was achieved. No complication such as ulcer formation or perforation was noted.

Aged↗
PubMed2006

[Influence of extracorporeal circuits surface on hemostasis system during off-pump surgeries].

It is demonstrated that special surface of extracorporeal circuit promotes reduction of artificial circulation negative influence on hemostasis system. During artificial circulation coating "duraflo" gradually loses its protective characteristics due to washout of heparin molecules from the surface of extracorporeal circuit, whereas chemical link between heparin and protein in "safe-line" coating is more stable. The results of the study demonstrate no advantages of heparin coating of extracorporeal circuits over protein one. Finally, all the advantages of extracorporeal circuits with "safe-line" coating lead to a decrease of postoperative blood loss.

Assisted Circulation↗
PubMed1992

A modified technique for hemostasis during myomectomy.

By using a rubber shod Bainbridge type vascular clamp during myomectomy, the uterine blood supply coming from the ovarian artery can be interrupted medial to the ovary, allowing for adnexal perfusion. The gap in its clamp jaws provides a space for the fallopian tube to pass through undamaged. When used in conjunction with a tourniquet on the uterine arteries, excellent hemostasis is obtained. This simple and effective technique should prove to be a useful addition to the armamentarium of the gynecologic surgeon.

Female↗
PubMed1991

The effect of flow on hemostasis and thrombosis.

While dilution of procoagulants has generally been proposed as the mechanism by which flow reduces coagulation at surfaces, such a mechanism has never been verified experimentally and, in fact, there are theoretical grounds for suspecting the validity of such a hypothesis (29). It is quite plausible that flow may have direct effects on certain enzyme or polymerization kinetics involved in thrombosis, in addition to the well-defined effect that flow has an enhancing transport of reactants and products to and from the vessel wall. Such effects of flow on immobilized enzymes have occasionally been observed, but never studied with respect to coagulative processes (30). The study of the effects of flow on hemostasis and thrombosis, while numerous, are still in their infancy. As noted above, increasing shear increases the rate of formation of factor Xa in a tubular reactor. In the presence of factors VIII and IX, there is also a shear-induced enhancement of Xa production (31). These studies indicate that at least some coagulation reactions are accelerated in the presence of high shear. However, it has been observed that fibrin formation is diminished at increasing shear rates (20). This implies that at least one step of the coagulation cascade is being inhibited by high shear. One possibility is that fibrin monomer is being removed by the high local flow conditions, although the concomitant reduction in fibrinopeptide A argues against this interpretation. Another possibility, not yet tested, is that thrombin itself is removed by flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Coagulation↗
PubMed1991

[Studies on molecular markers for hemostasis and thrombosis in various renal diseases].

In order to clarify the abnormalities of blood coagulation and fibrinolysis in patients with various renal diseases, some molecular markers for hemostasis and thrombosis were examined in comparison with those of the patients with disseminated intravascular coagulation. The results were as follows: 1) PIC was significantly higher in the patients with CGN, NS, SLE, HD and DIC than normal subjects. 2) TAT was significantly higher in the patients with CGN, NS, HD and DIC. 3) SFMC was significantly higher only in the patients of DIC. 4) FDP and FDP-E were significantly higher in the patients with HD and DIC. 5) D-dimer was significantly higher in the patients with CGN, CRF, HD and DIC. These results suggested that the abnormalities of blood coagulation and fibrinolysis in patients with various renal diseases are relatively mild, and situated between the normal subjects and patients with DIC.

Adult↗
PubMed1991

Hemostasis in the perinatal period: approach to the diagnosis of coagulation disorders.

A wide range of hemostatic disorders may complicate the clinical course of the mother or fetus during pregnancy and the perinatal period. Given the potentially life-threatening implications of hemorrhage or thrombosis, it is important to evaluate these clinical emergencies with an organized approach to the diagnosis of the pertinent derangement and its etiology in order to institute corrective action promptly. Therapeutic interventions are outside the scope of this presentation; however, it is evident that an efficient and precise diagnosis is the first step toward effective, corrective action. The three elements of the hemostatic system that have been presented, blood vessels, platelets, and plasma proteins, provide a logical framework for initiating the hemostatic evaluation and interpreting screening hemostasis tests. Optimum patient management is rewarding, since many of the disorders discussed in this article are of brief duration, improving after the peripuerium. In contrast, the manifestations of hemorrhage may lead to life-long complications.

Blood Coagulation Disorders↗