Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Exsanguination”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed2001

Evolution in damage control for exsanguinating penetrating abdominal injury.

OBJECTIVE: Damage control (DC) has proven valuable in exsanguinated patients. The purpose of this study was to quantify and qualify the impact of current damage control principles applied in a penetrating abdominal injury (PAI) population. METHODS: Over a 3-year period (June 1997-May 2000), of 271 laparotomies for PAI, 24 patients underwent DC (8.9%). Demographics, injury grade, resuscitative and operative parameters, acid-base status, coagulation profiles, fluid/transfusion requirements, definitive repairs, abdominal closure, complications, and outcomes were reviewed. Data were compared with our DC experience a decade earlier. Fisher's exact test was used for comparisons. RESULTS: Overall survival improved for equivalent Injury Severity Score, Revised Trauma Score, TRISS, admission systolic blood pressure, operating room systolic blood pressure, and Penetrating Abdominal Trauma Index score. Solids (1.2 vs. 1.3), hollow organ (1.5 vs. 1.7), and major vascular injuries (0.5 vs. 0.8) per patient remain unchanged. Currently, there was less hypothermia with equivalent operating room times. In intensive care unit survivors, acid-base status was similar but coagulopathy and hypothermia were less severe. Definitive colon management has shifted from ostomies to anastomoses. Eventual fascial closure occurred in 14 of 19 (74%) compared with 12 of 14 (86%) in the historical group. There were three gastrointestinal fistulae (one pancreatic), one anastomotic leak, and three intra-abdominal abscesses. CONCLUSION: Continued application of DC principles has led to improved survival with PAI. Better control of temperature, experience with the open abdomen, and intensive care unit care may be causative.

Abdominal Injuries↗
PubMed1979

Exsanguination from esophageal rupture of an atherosclerotic aortic aneurysm in a patient with treated tuberculosis.

An elderly man with previous tuberculosis exsanguinated from esophageal rupture of an atherosclerotic thoracic aneurysm. Because the patient refused angiography, the source of bleeding was discovered only at autopsy. Selected clinical and pathologic aspects of the case are discussed in relation to the different causes of thoracic aortic aneurysms. Because these lesions have a grave prognosis, the need for timely diagnostic evaluation and aggressive surgical management is emphasized.

Aorta, Thoracic↗
PubMed1994

Further experience with exsanguination for descending thoracic aneurysms.

Resection and graft replacement of descending thoracic aortic aneurysms is associated with potential ischemic sequelae related to aortic cross-clamping. Such complications are minimized when the ischemic period is shorter than 30 minutes. We have devised a technique in which a single aortic cross-clamp is applied proximal to the lesion, and the distal anastomosis is performed in "open" fashion, with limited distal aortic dissection. This technique depends upon continuous autotransfusion, which allows distal aortic decompression by means of partial exsanguination through the open distal aorta and segmental spinal arteries. In addition, the period of cord ischemia from aortic clamping is minimized. From April 1989 to October 1993, we used this approach in 71 consecutive patients (50 men and 21 women), 8 (11.3%) of whom died during the early postoperative period. Complications included 6 cases of spinal cord dysfunction (8.5%) and 4 cases of renal failure (5.6%). Our success with this approach may contradict more accepted concepts of spinal cord protection from ischemic injury.

Adult↗
PubMed1991

Pulmonary, hepatic and splenic sequestration of technetium-99m labelled autologous rabbit granulocytes: scintigraphic cell distributions after intravenous and intraarterial injections, exsanguination and intraarterial injection of cells passed through an intermediary host.

In man, about half the intravascular granulocytes are not freely circulating, but temporarily sequestered ('marginated'), so that they cannot be retrieved by bleeding. Where and how the sequestration occurs is not settled and is the subject of the present report. Isolated autologous rabbit granulocytes, labelled with two different 99mTc methods, were reinjected and followed with external scintigraphy. Intraarterial as well as intravenous injection led to rapid accumulation of radioactivity over the lungs. This finding was corroborated and extended by similar experiments, where the labelled cells had firstly been passed through an intermediary rabbit host to remove altered cells, i.e. cells damaged, 'primed' (pre-activated), or activated. In the final autologous host about two thirds of the label rapidly localized to the lungs and liver, and a few per cent to the spleen (which is very small in the rabbit). Even though more than half of the intermediary rabbit's calculated blood volume was removed, the blood sample contained only a few per cent of the rabbit's radioactivity; consequently, many of the labelled leucocytes had marginated during the bleeding. The proportional distribution of radioactivity over lungs, spleen, kidneys, and the rest of the intermediary animal was not markedly changed by this exsanguination, but there was a 4-20% decrease over the liver. Taken together, our findings indicate that normal granulocytes marginate in lungs, liver, and spleen--apparently explicable by the effects of cell size, vessel diameter, cell stiffness (visco-elastic properties) and size of the arterio-venous hydrostatic pressure difference. The liver and spleen seemed to play additional roles, since radioactivity over these organs decreased much slower than expected from reported blood half-times of intact and slightly damaged rabbit granulocytes. This led to a suggestion that macrophages exposed to blood normally phagocytose apoptotically dying granulocytes.

Animals↗
PubMed1984

Exsanguination of animals at slaughter and the residual blood content of meat.

About 40 to 60 per cent of the total blood volume is lost at exsanguination. The loss can be influenced slightly by differences in traditional slaughter techniques and is considerably reduced after cardiac arrest in sheep and cattle. Blood not lost at sticking is probably largely retained in the viscera rather than the carcase. The residual blood content of lean meat is 2 to 9 ml/kg muscle. There is no evidence that this amount is affected by different slaughter methods or that large amounts of residual blood influence the microbiology of meat.

Abattoirs↗
PubMed1998

Effect of magnetite on the hematocrit value in exsanguinated rats.

Magnetite prepared by an enzyme-dependent reaction gradually released iron ion into the acidic-to-neutral buffer solution. A preparatory experiment was performed to examine the efficiency of magnetite as an iron supplement. Feeding exsanguinated rats with being magnetite resulted in the hematocrit value being recovered without any serious adverse effect on the digestive organs.

Animals↗
PubMed1994

[Resection of intra-atrial tumor thrombi from renal malignant tumors with the use of cardiopulmonary bypass and temporary exsanguination. An experience based on 4 cases].

We report 4 patients, 1 female and 3 males aged 26-74 years, who underwent surgical treatment for renal malignant tumors with supradiaphragmatic extension into the vena cava. All of their tumor thrombi extended to the right atrium as confirmed by magnetic resonance imaging. The distinctive symptom was liver dysfunction caused by disturbance of the hepatic vein drainage in two patients. However, there was no common symptom in these 4 patients. Preoperative metastasis was found only in the female, whose metastasis was solitary in the lung and seemed to be able to be removed easily after radical nephrectomy. All of these 4 patients had radical nephrectomy and removal of the tumor thrombi with the use of cardiopulmonary bypass and temporary exsanguination. In 3 of these patients, the liver was mobilized to expose the retrohepatic vena cava by incision of the falciform, triangular and coronary ligaments. Two patients with vena caval wall invasion had vena cavectomy and an artificial vascular graft was then sutured to replace the caval wall in one of them. Preoperative liver dysfunction was gradually improved after operation and completely recovered about 1 week later. A postoperative complication, wound infection, occurred in only one patient. Pathological examination revealed renal cell carcinoma in 3 patients and nephroblastoma in the remaining one. In renal cell carcinoma, both patients without distant metastasis were alive about 15 months postoperatively. However, the one with lung metastasis died with newly appeared multiple metastases 9 months postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1999

Lower limb exsanguination and embolism.

We report a case of fatal pulmonary embolism during lower limb exsanguination in orthopaedic surgery. A 76-year-old woman underwent an open fixation of an external femoral condyle fracture one day after injury. Subarachnoidal anaesthesia was performed and Esmarch compression bandages were applied in preparation for tourniquet ischaemia. At this time, the patient lost consciousness, became apneic and collapsed. Resuscitation procedures were instituted and transoesophageal echocardiography revealed pulmonary embolism. In spite of haemodynamic support and thrombolytic therapy, the patient died. Postmortem examination revealed multiple thromboemboli of recent origin in the right heart cavities, in the pulmonary arteries and in the popliteal and tibial veins of the injured leg. Preventive, diagnostic and therapeutic options of this catastrophic event and indications of pulmonary embolectomy are discussed.

Aged↗
PubMed1991

Haemostasis by angiographic embolisation in exsanguinating haemorrhage from facial arteries. A report of 2 cases.

Life-threatening exsanguinating haemorrhage from arteries of the face following trauma is uncommon. When it occurs it is often located in the relatively inaccessible parts of the vessels and requires deep face or neck exploration and ligation of the main feeding vessel. The procedure requires expert head and neck vascular surgery performed under general anaesthesia, which is often not suitable in these haemodynamically unstable patients. In addition, surgery is often rendered more difficult by the associated post-traumatic swelling and disfigurement. Because of these considerations, angiographic embolisation of the bleeding vessels was performed as an alternative to surgical exploration. This report illustrates its use in achieving haemostasis in 2 patients.

Adult↗
PubMed1991

Transfusion in the exsanguinating Jehovah's Witness patient--the attitude of intensive-care doctors.

The attitude of a Jehovah's Witness patient refusing a blood transfusion during an exsanguinating episode can raise important ethical problems. Various ethical principles, including the patient's autonomy, the sanctity of life and the dignity of the medical profession can be confronted. A total of 242 doctors, members of the European Society of Intensive Care Medicine, answered a questionnaire indicating that 63% would transfuse in those circumstances. However, 26% would never inform the patient about this. Only 45% considered the blood transfusion as appropriate, of whom 25% were unable to define the best option. Doctors from France and Italy more commonly transfuse while those from The Netherlands, the United Kingdom and Scandinavia more commonly withhold transfusion. These data stress the need for a definition of the appropriate medical attitudes towards the patient refusing blood transfusion.

Attitude↗
PubMedDate not supplied

Hypothermia and exsanguination in emergency cardiovascular surgery in children.

Emergency cardiac surgery in children can be successfully carried out even when cardiopulmonary bypass is either not feasible or not available quickly enough. Hypothermia induced with ice-water bags, complete circulatory arrest, near-total body exsanguination, and rewarming with a heating blanket and heating lamps, were used twice successfully in the repair of a ruptured aneurysm of the ascending aorta.

Aortic Rupture↗
PubMed1986

Life salvage with fibrin glue in three cases of exsanguinating hemorrhage.

Fibrin glue, although widely used in Europe for a decade, has not been commercially available in North America because its fibrinogen component is obtained from multiple, pooled, human blood donors with the subsequent increased risk of blood transmissible diseases. Techniques developed recently to isolate fibrinogen from single-donor plasma will circumvent these potential hazards. In Canada the use of fibrin glue has not been widespread even though biologic fibrin glue can be made from components readily available within most hospitals. Equal amounts of cryoprecipitate from fresh frozen plasma and bovine thrombin will combine within 2 minutes to form the fibrin glue. Simultaneous injections of each component at bleeding sites form a film of the glue that will effectively control even small arterial bleeding. The authors present three case reports to illustrate how use of the glue can save lives in cases of exsanguinating hemorrhage. They discuss the multiple applications of the fibrin glue which they believe will soon be part of the armamentarium of all Canadian surgeons.

Aged↗
PubMed1985

The Rhys-Davies exsanguinator.

A simple device for limb exsanguination is described. It is quick and easy to use, effective and safe, and appropriate to a wide range of circumstances. Strain-gauge plethysmography has been used to measure its efficacy and shows that it is better than limb elevation alone and comparable to use of the Esmarch bandage.

Arm↗
PubMed1984

Equine plasma banking: collection by exsanguination.

A procedure was developed for the collection, preparation, storage, and administration of equine plasma. The technique involved exsanguination of anesthetized donor horses via carotid artery catheterization with a large-bore cannula. Blood was collected into plastic bags, allowed to settle by gravity, then transferred into storage bags and frozen. These were quickly thawed when needed.

Animals↗
PubMed1993

Dieulafoy-like lesion of the rectum presenting with exsanguinating hemorrhage: successful endoscopic sclerotherapy.

The classic Dieulafoy lesion is a minute gastric mucosal defect that bleeds massively from an exposed artery. Similar lesions have been identified in the small intestine, colon, and rectum. In this report, we describe a patient who presented with an exsanguinating hemorrhage from a small rectal ulcer with a visible vessel. Control of the bleeding was achieved with endoscopic sclerotherapy using absolute alcohol and 1.5% sodium tetradocyl sulfate, with eventual complete healing of the site.

Adult↗
PubMed1993

Technical note: a quick and simple method of obtaining venous access in traumatic exsanguination.

The procedure described here for rapid venous access is simple, involves minimal dissection, and is highly reliable. Difficulty in defining the saphenous vein in the groin is alleviated by the forceful separation of the subcutaneous tissues, which invariably reveals the vein at the base of the wound. The only materials required are a scalpel, surgical ties, and IV tubing. In cases of traumatic exsanguination surgical residents were able to achieve IV access within a minute or less. The disadvantage of this technique is that it requires a long incision.

Hemorrhage↗