Study of Blood Coagulation Parameters of One Hundred Serious Patients Admitted to the Intensive and Critical Care Service of Nuestra Senora Del Mar Hospital in Barcelona for Two Years

Bellon, J L; J, Garces; Nolla, M.

doi:10.1097/00003246-198103000-00273

Critical Care Medicine

1981

DOI: 10.1097/00003246-198103000-00273

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Study of Blood Coagulation Parameters of One Hundred Serious Patients Admitted to the Intensive and Critical Care Service of Nuestra Senora Del Mar Hospital in Barcelona for Two Years

J L Bellon¹,

Garces J²,

M. Nolla³

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1995

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Control and Treatment of Hemostasis in Cardiovascular Surgery.

Szefner

1995

Int J Artif Organs

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The hemostasis protocol applied at the Cardiovascular Surgery Dept. of La Pitié Hospital has greatly reduced thromboembolic accidents and excessive bleeding, with consequent benefits for patients as well as cost reduction. Protocol also has been adopted for patients implanted with a circulatory assist device or a TAH. This paper presents our criteria on supervision and treatment of coagulation with such patients, who reflect all the acquired pathology in clinical hemostasis. From 04/86 to 07/94, 82 patients underwent TAH as a bridge to transplantation. Mean age: 38. Overall duration of mechanical support: 1930 days (mean: 23), of which 137 and 603 for 2 patients. Average duration of CPB: 150 min. Systematic approach to complex TAH-blood interaction and pre-operative multiple organ dysfunction used to control bleeding and/or thromboembolism after CPB. In addition to routine tests, specific regular testing was carried out at least once a day for platelet functions, for thrombin formation and its regulatory pathways, and for the fibrinolytic system. Patients were treated with small doses of Heparin, large doses of Dypyridamole, small doses of Aspirin, modulated doses of Aprotinin, Ticlopidine, Pentoxifylline, FFP, as well as Fibrinogen and AT III concentrates. Dosage was adapted to patient's clinical profile as well as to test interpretation criteria to provide personalized treatment. DIC, widely present in its different phases, was thus diagnosed and treated. All DIC bleeding was controlled, making it possible to detect other causes of post-operatory bleeding and use blood derivates rationally. There were no thromboembolic complications and no iatrogenic bleeding. TAH explanation shows no evidence of macroscopic clots in high risk sites, confirmed by microscopic analysis.

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Control and Treatment of Hemostasis in Cardiovascular Surgery.

Szefner

1995

Int J Artif Organs

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Study of Blood Coagulation Parameters of One Hundred Serious Patients Admitted to the Intensive and Critical Care Service of Nuestra Senora Del Mar Hospital in Barcelona for Two Years

Cited by 1 publication

References 0 publications

Control and Treatment of Hemostasis in Cardiovascular Surgery.

Control and Treatment of Hemostasis in Cardiovascular Surgery.

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