Intra-Operative Hemorrhage: A Review of Literature

Kathariya, Rahul

doi:10.4172/2168-9784.1000146

Cited by 17 publications

(14 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IAEs were defined as any iatrogenic harmful event occurring during the operation, which had not derived from standard course of operation. Intraoperative blood loss ≥500 mL was considered to be a hemorrhage because losing less than one unit of blood (≈500 mL) usually does not negatively condition of patient and does not lead to hypovolemia and hemorrhagic shock [9,10]. Indications for transfusion were hemorrhagic shock, hemoglobin ≤6 g % or 6–8 g % in the case of evidence for limited compensation and risk factors (e.g., coronary heart disease, systolic heart failure, insufficient cerebral vascular flow) or presence of the following symptoms: tachycardia, hypotension, acute coronary ischemia in electrocardiography (ECG), and acidosis [11].…”

Section: Methodsmentioning

confidence: 99%

Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases

Wysocki

Radkowiak

Zychowicz

et al. 2018

JCM

View full text Add to dashboard Cite

Prediction of intraoperative difficulties may be helpful in planning surgery; however, few studies explored this issue in laparoscopic splenectomy (LS). We performed retrospective analysis of consecutive 468 patients undergoing LS from 1998 to 2017 (295 women; median age 47 years). The patients were divided into difficult LS and control groups. The inclusion criteria for difficult LS were operative time ≥mean + 2SD; intraoperative blood loss ≥500 mL, intraoperative adverse events (IAE), conversion. Primary outcomes were risk factors for difficult splenectomy and secondary outcomes for perioperative morbidity. Fifty-six patients were included in the difficult LS group (12%). Spleens ≥19 cm and higher participation of younger surgeons in consecutive years were predictive for difficult splenectomy. Age ≥53 years and diagnosis other than idiopathic thrombocytopenic purpura (ITP) were independent risk factors of spleen ≥19 cm. The perioperative morbidity was 8.33%; its OR was increased only by blood loss and IAEs. Only blood loss significantly increased serious morbidity. Male sex, spleens ≥19 cm, and IAEs were independent risk factors for intraoperative hemorrhage. Spleen length ≥19 cm was a risk factor for difficult LS and intraoperative hemorrhage. Diagnoses other than ITP in patients aged ≥53 years with ≥19 cm spleens are predictive for intraoperative difficulties and perioperative complications.

show abstract

Section: Methodsmentioning

confidence: 99%

Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases

Wysocki

Radkowiak

Zychowicz

et al. 2018

JCM

View full text Add to dashboard Cite

show abstract

“…Intraoperative adverse events/complications were defined as any iatrogenic harmful event occurring during the operation, which had not derived from the standard technique. Intraoperative blood loss equal to or greater than 500 ml was considered to be a hemorrhage and was included as an intraoperative complication, because losing less than one unit of blood (≈500 ml) usually does not negatively affect the condition of the patient and does not lead to hypovolemia and hemorrhagic shock [ 5 , 6 ]. Indications for transfusion were: hemorrhagic shock, hemoglobin ≤ 6 g% or 6–8 g% in case of evidence for limited compensation and risk factors (e.g.…”

Section: Methodsmentioning

confidence: 99%

Quest for the optimal technique of laparoscopic splenectomy - vessels first or hilar transection?

Radkowiak

Zychowicz

Wysocki

et al. 2018

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

IntroductionThroughout our 20 years of experience, we have used several different techniques for laparoscopic splenectomy (LS). However, two methods have been used most frequently: “vessels first” and “hilar transection”.AimTo evaluate the outcomes of LS performed with these two different approaches.Material and methodsIt was an observational study based on retrospective analysis of consecutive patients undergoing LS in a tertiary referral surgical center in the period 1998–2017. We excluded patients with splenic trauma, initially submitted to open surgery, stapled transection of splenic hilum, partial resections of the spleen and other spleen-preserving procedures. Patients were divided into two groups: group 1 (“vessels first”) with 188 patients, and group 2 (“hilar transection”) with 287 patients.ResultsMean operative time was shorter (p < 0.001) and blood loss was lower (p < 0.001) in group 2. The need for blood transfusions and the conversion rate were higher in group 1 (p = 0.044 and p = 0.003 respectively). There was no difference in intraoperative adverse events (p = 0.179). Overall postoperative morbidity did not differ between groups (p = 0.081) and we noted mortality of 0.21% (1 patient of group 2). The morbidity rate associated with accidental injury of the pancreatic parenchyma was significantly higher in group 1 (p = 0.028). Median length of hospital stay was 4 days (range: 1–99) and did not differ between groups (p = 0.175).ConclusionsThe “vessels first” technique is associated with longer operative time, higher blood loss and increased risk of conversion. “Hilar transection” is associated with lower incidence of local complications related most likely to accidental injury of the pancreatic tail. In the case of a large caliber of splenic vessels the “vessels first” approach remains the technique of choice.

show abstract

“…The intraoperative blood loss (IBL) [30] = (the weight of the gauze pads and compresses with bloodthe dry weight of the gauze pads and compresses) + (the volume collected by the aspiratorsthe volume used to wash the surgical area).…”

Section: Primary Outcomes Perioperative Blood Lossmentioning

confidence: 99%

Effectiveness of preemptive antifibrinolysis with tranexamic acid in rheumatoid arthritis patients undergoing total knee arthroplasty: a study protocol for a randomized controlled trial

Lei

Liu

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: Patients with rheumatoid arthritis (RA) who have undergone total knee arthroplasty are at increased risk of requiring a blood transfusion. This study is designed to compare the effects of preemptive antifibrinolysis of single-dose and repeat-dose tranexamic acid (TXA) in in RA patients undergoing total knee arthroplasty (TKA). Methods/design: The study will be a double-blind randomized controlled trial with two parallel groups of RA patients. Group A will be given 100 ml normal saline twice daily starting from 3 days before the operation, Group B will be given TXA 1.5 g twice daily starting from 3 days before the operation. All patients will be given TXA 1.5 g 30 min before the operation. The primary outcomes will be evaluated with total blood loss and hidden blood loss. Other outcome measurements such as, fibrinolysis parameters, inflammatory factors, visual analogue scale for postoperative pain, analgesia usage, coagulation parameters, transfusion, the length of stay (LOS), total hospitalization costs, the incidence of thromboembolic events and other complications will be recorded and compared. Recruitment is scheduled to begin on 1 August 2020, and the study will continue until 31 May 2021. Discussion: In current literature there is a lack of evidence with regard to the efficacy of TXA in RA patients. The findings of this study, whether positive or negative, will contribute to the formulation of further recommendations on the use of TXA in RA patients undergoing TKA.

show abstract

Intra-Operative Hemorrhage: A Review of Literature

Cited by 17 publications

References 24 publications

Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases

Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases

Quest for the optimal technique of laparoscopic splenectomy - vessels first or hilar transection?

Effectiveness of preemptive antifibrinolysis with tranexamic acid in rheumatoid arthritis patients undergoing total knee arthroplasty: a study protocol for a randomized controlled trial

Contact Info

Product

Resources

About