Hemostatic and hemorrhagic problems in neurosurgical patients

Gerlach, Ruediger; Krause, Manuela; Seifert, Volker; Goerlinger, Klaus

doi:10.1007/s00701-009-0409-z

Cited by 74 publications

(41 citation statements)

References 296 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, this allows for an early goal-directed therapy of these haemostatic disorders on a rational and calculated basis with specific coagulation factor concentrates and/or haemostatic drugs [15,18,19,21,[26][27][28]51]. This concept enables a 'bleed-to-treat-time' of 20 to 30 min.…”

Section: Poc Test-driven Transfusion and Coagulation Managementmentioning

confidence: 99%

“…The application of 1 IU PCC per kg body weight usually results in an increase of the activity of the corresponding coagulation factors (and the Quick value) by 0.6-1% [80,81]. In case of a clinically relevant diffuse bleeding and a prolongation of the CT in ExTEM > 80 s, a primary dose of about 25 IU PCC per kg body weight (corresponding to 1 ml PCC per kg body weight) should be administered [18,19,26,51,52,55]. The PCC dosage can be enhanced up to 40 IU per kg body weight in case of massive bleeding and a prolongation of the CT in ExTEM > 100 s. …”

Section: Factor XIII Concentratementioning

confidence: 99%

“…In particular, factor XIII administration should be considered in neurosurgical and tumour patients with an activity of factor XIII below 60%, in bleeding patients with increased clot lysis in ROTEM analysis not responding to antifibrinolytics but to in vitro spiking with factor XIII, in ongoing bleeding without pathological findings in ROTEM and Multiplate analysis, and in repeated postoperative diffuse bleeding without detectable surgical source of bleeding [15,18,19,36,51,52,55,62,[83][84][85][86][87][88][89][90][91][92][93].…”

Section: Factor XIII Concentratementioning

confidence: 99%

“…A therapeutic intervention is recommended in bleeding patients with a CT in ExTEM > 80 s [18,19,21,26,28,51,52,55,62].…”

Section: Prothrombin Complex Concentratementioning

confidence: 99%

See 3 more Smart Citations

Reduction of Fresh Frozen Plasma Requirements by Perioperative Point-of-Care Coagulation Management with Early Calculated Goal-Directed Therapy

Görlinger

Fries²,

Dirkmann³

et al. 2012

Transfus Med Hemother

192

107

View full text Add to dashboard Cite

Background: Massive bleeding and transfusion of packed red blood cells (PRBC), fresh frozen plasma (FFP) and platelets are associated with increased morbidity, mortality and costs. Patients and Methods: We analysed the transfusion requirements after implementation of point-of-care (POC) coagulation management algorithms based on early, calculated, goal-directed therapy with fibrinogen concentrate and prothrombin complex concentrate (PCC) in different perioperative settings (trauma surgery, visceral and transplant surgery (VTS), cardiovascular surgery (CVS) and general and surgical intensive care medicine) at 3 different hospitals (AUVA Trauma Centre Salzburg, University Hospital Innsbruck and University Hospital Essen) in 2 different countries (Austria and Germany). Results: In all institutions, the implementation of POC coagulation management algorithms was associated with a reduction in the transfusion requirements for FFP by about 90% (Salzburg 94%, Innsbruck 88% and Essen 93%). Furthermore, PRBC transfusion was reduced by 8.4–62%. The incidence of intraoperative massive transfusion (≧10 U PRBC) could be more than halved in VTS and CVS (2.56 vs. 0.88%; p < 0.0001 and 2.50 vs. 1.06%; p = 0.0007, respectively). Platelet transfusion could be reduced by 21–72%, except in CVS where it increased by 115% due to a 5-fold increase in patients with dual antiplatelet therapy (2.7 vs. 13.7%; p < 0.0001). Conclusions: The implementation of perioperative POC coagulation management algorithms based on early, calculated, goaldirected therapy with fibrinogen concentrate and PCC is associated with a reduction in the transfusion requirements for FFP, PRBC and platelets as well as with a reduced incidence of massive transfusion. Thus, the limited blood resources can be used more efficiently.

show abstract

Section: Poc Test-driven Transfusion and Coagulation Managementmentioning

confidence: 99%

Section: Factor XIII Concentratementioning

confidence: 99%

Section: Factor XIII Concentratementioning

confidence: 99%

“…A therapeutic intervention is recommended in bleeding patients with a CT in ExTEM > 80 s [18,19,21,26,28,51,52,55,62].…”

Section: Prothrombin Complex Concentratementioning

confidence: 99%

See 2 more Smart Citations

Reduction of Fresh Frozen Plasma Requirements by Perioperative Point-of-Care Coagulation Management with Early Calculated Goal-Directed Therapy

Görlinger

Fries²,

Dirkmann³

et al. 2012

Transfus Med Hemother

192

107

View full text Add to dashboard Cite

show abstract

“…hemostaz hayati önem taşır (5,6). Bu nedenle pediatrik hastalarda özellikle vasküler yapılarla yakın komşuluk içinde bulunan patolojilere yönelik akılcıl cerrahi stratejilerin belirlenmesi ve uygulanması güvenli nöroşirurjikal cerrahi ve olumlu cerrahi sonuçlar için önceliklidir.…”

unclassified

Surgical Treatment of Pediatric Patients with Midline Located Primary Calvarial Lesions: Single-center Experience and Surgical Technique

Doğan¹,

Kahiloğulları²,

Ünlü³

2016

Van Med J

View full text Add to dashboard Cite

Neurosurgery

Duval¹

2011

Perioperative Medicine

View full text Add to dashboard Cite

Hemostatic and hemorrhagic problems in neurosurgical patients

Abstract: Perturbations of hemostasis can be multifactorial and maybe encountered in the daily practice of neurosurgery. Early diagnosis and specific treatment is the prerequisite for successful treatment and good patients outcome.

Cited by 74 publications

References 296 publications

Reduction of Fresh Frozen Plasma Requirements by Perioperative Point-of-Care Coagulation Management with Early Calculated Goal-Directed Therapy

Reduction of Fresh Frozen Plasma Requirements by Perioperative Point-of-Care Coagulation Management with Early Calculated Goal-Directed Therapy

Surgical Treatment of Pediatric Patients with Midline Located Primary Calvarial Lesions: Single-center Experience and Surgical Technique

Neurosurgery

Contact Info

Product

Resources

About