Bleeding and Surgery in Children with Glanzmann Thrombasthenia with and without the Use of Recombinant Factor VII a

Hennewig, Ulrike; Hj, Laws; Eisert, S; Göbel, U.

doi:10.1055/s-2005-872523

Cited by 17 publications

(7 citation statements)

References 5 publications

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“…In most cases of mild/moderate mucocutaneous bleeding, antifibrinolytic drugs and local measures were considered sufficiently effective, rendering rFVIIa unnecessary. 620…”

Section: Platelet Defects Recommendationsmentioning

confidence: 99%

Management of severe perioperative bleeding

Kozek‐Langenecker

Ahmed

Afshari

et al. 2017

European Journal of Anaesthesiology

651

299

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: The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline was posted on the European Society of Anaesthesiology website for four weeks for review. All comments were collated and the guidelines were amended as appropriate. This publication reflects the output of this work.

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“…In most cases of mild/moderate mucocutaneous bleeding, antifibrinolytic drugs and local measures were considered sufficiently effective, rendering rFVIIa unnecessary. 620…”

Section: Platelet Defects Recommendationsmentioning

confidence: 99%

Management of severe perioperative bleeding

Kozek‐Langenecker

Ahmed

Afshari

et al. 2017

European Journal of Anaesthesiology

651

299

View full text Add to dashboard Cite

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“…Platelet transfusion for major surgery and antifibrinolytics for minor invasive procedures were reported as effective prophylactic measures for GT. 14 – 16 Surgery-related bleeding, when this occurred, was successfully treated with rFVIIa 17 – 19 or platelet transfusions. 15 Platelet transfusions, alone or in combination with antifibrinolytics 20 – 22 or desmopressin, 22 prevented bleeding in BSS patients, while platelet transfusions, alone 23 or in combination with rFVIIa, 24 were used for HPS patients.…”

Section: Introductionmentioning

confidence: 99%

Bleeding risk of surgery and its prevention in patients with inherited platelet disorders

et al. 2017

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Excessive bleeding at surgery is a feared complication in patients with inherited platelet disorders. However, very few studies have evaluated the frequency of surgical bleeding in these hemorrhagic disorders. We performed a worldwide, multicentric, retrospective study to assess the bleeding complications of surgery, the preventive and therapeutic approaches adopted, and their efficacy in patients with inherited platelet disorders: the Surgery in Platelet disorders And Therapeutic Approach (SPATA) study. We rated the outcome of 829 surgical procedures carried out in 423 patients with well-defined forms of inherited platelet disorders: 238 inherited platelet function disorders and 185 inherited platelet number disorders. Frequency of surgical bleeding was high in patients with inherited platelet disorders (19.7%), with a significantly higher bleeding incidence in inherited platelet function disorders (24.8%) than in inherited platelet number disorders (13.4%). The frequency of bleeding varied according to the type of inherited platelet disorder, with biallelic Bernard Soulier syndrome having the highest occurrence (44.4%). Frequency of bleeding was predicted by a pre-operative World Health Organization bleeding score of 2 or higher. Some types of surgery were associated with a higher bleeding incidence, like cardiovascular and urological surgery. The use of pre-operative pro-hemostatic treatments was associated with a lower bleeding frequency in patients with inherited platelet function disorders but not in inherited platelet number disorders. Desmopressin, alone or with antifibrinolytic agents, was the preventive treatment associated with the lowest bleedings. Platelet transfusions were used more frequently in patients at higher bleeding risk. Surgical bleeding risk in inherited platelet disorders is substantial, especially in inherited platelet function disorders, and bleeding history, type of disorder, type of surgery and female sex are associated with higher bleeding frequency. Prophylactic pre-operative pro-hemostatic treatments appear to be required and are associated with a lower bleeding incidence.

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“…The results may be different from the effect of transfusion on the number of transfusion in patients with different physical conditions. Splenomegaly and hemorrhage will cause platelet consumption and loss, affecting the efficacy of platelet transfusion (28,29). In the results of multivariate logistic regression analysis of this study, however, the above two factors were not considered as risk factors for ineffective transfusion.…”

Section: Discussionmentioning

confidence: 63%

Clinical efficacy of platelet transfusion therapy in patients with leukemia and analysis of risk factors for ineffective transfusion

et al. 2020

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Clinical efficacy of platelet transfusion therapy in patients with leukemia was investigated to analyze risk factors for ineffective transfusion. A total of 105 cases of patients with leukemia admitted to The First Affiliated Hospital of Bengbu Medical College from August 2016 to November 2018 were selected as research subjects. A total of 49 patients received transfusion of apheresis platelet suspension, and were group A. Fifty-six patients who received mixed multi-person platelet suspension were group B. The percentage plate recovery (PPR) and corrected count increment (CCI), interleukin-11 (IL-11) and soluble glycoprotein 130 (sgp130) levels were compared between the two groups, and the correlation of PPR and CCI with serum IL-11 and sgp130 levels was analyzed. Multivariate logistic regression was used to analyze the independent risk factors affecting ineffective transfusion in patients with leukemia. After transfusion, PPR and CCI in both groups were significantly higher than those before transfusion (P<0.05). IL-11 was significantly increased in both groups after transfusion, and sgp130 was significantly decreased in the two groups after transfusion (P<0.05). Serum IL-11 level in leukemia patients was positively correlated with PPR and CCI (r=0.7693, P<0.001), (r=0.7760, P<0.001), and serum sgp130 level in leukemia patients was negatively correlated with PPR and CCI (r=-0.7086, P<0.001), (r=-0.7733, P<0.001). There were differences between the effective group and the ineffective group in transfusion frequency, fever, infection and splenomegaly (P<0.05). Fever (OR, 0.382; 95% CI, 0.183-0.972) and infection (OR, 0.367; 95% CI, 0.140-0.956) were independent risk factors for ineffective transfusion. In conclusion, apheresis platelet or mixed multi-person platelet suspension transfusion can significantly improve the disorder of platelet count in patients with leukemia, and improve the clinical efficacy. Fever and infection are independent risk factors leading to ineffective transfusion.

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Bleeding and Surgery in Children with Glanzmann Thrombasthenia with and without the Use of Recombinant Factor VII a

Cited by 17 publications

References 5 publications

Management of severe perioperative bleeding

Management of severe perioperative bleeding

Bleeding risk of surgery and its prevention in patients with inherited platelet disorders

Clinical efficacy of platelet transfusion therapy in patients with leukemia and analysis of risk factors for ineffective transfusion

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