Examens de ľhémostase périopératoire réalisés en laboratoire et au lit du patient

Sié, Pièrre; Steib, A.

doi:10.1007/bf03022248

Cited by 30 publications

(11 citation statements)

References 33 publications

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“…However, their turnaround time makes laboratory-based methods impractical for concurrent coagulation management of patients during surgery [2]. Point-of-care (POC) tests enable contemporary and targeted therapy of coagulation disorders [3,4]. Coupled with algorithms for coagulation management, the use of POC tests may be able to reduce transfusion requirements, re-exploration rates and costs [1,5,6].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Görlinger

Jámbor²,

Hanke

et al. 2007

Transfus Med Hemother

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About one third of all blood components transfused intraoperatively is used in cardiac surgery, whereas mortality of cardiosurgical patients correlates nearly linear with the number of transfused units of packed red blood cells. Acquired platelet function disorders play a major role in perioperative bleeding in cardiac surgery. Therefore, the use of point-of-care-suitable platelet function analyzers seems to be reasonable in this field. Methods: Platelet function analyzer PFA-100®, rotational thrombelastometry (ROTEM®), and multiple platelet function analyzer (Multiplate®) are in principle applicable for point-of-care testing. Since these three analyzers monitor different aspects of platelet function and have different limitations, the selection of the right test system depends on the right question. Results: Perioperative use of platelet function analyzers is helpful in prediction of blood loss in cardiac surgery. Perioperative usage of blood components and their respective costs can be reduced by an appropriate coagulation management. Conclusion: Algorithms for perioperative coagulation management based on point-of-care testing permit a fast diagnostic and goal-directed therapy of coagulation and functional platelet disorders. The possibility to reduce the mortality of patients and the overall cost for hospital stay is subject of further studies.

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Section: Introductionmentioning

confidence: 99%

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Görlinger

Jámbor²,

Hanke

et al. 2007

Transfus Med Hemother

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“…La relación entre un resultado anormal y el riesgo de hemorragia perioperatoria parece ser bastante baja, especialmente en aquellos que se cree que tienen un bajo 45 riesgo de hemorragia sobre la base de la historia y examen físico .…”

Section: Exámenes Laboratorialesunclassified

Efectividad de los estudios preoperatorios en pacientes sanos sometidos a cirugías de bajo-moderado riesgo

Estigarribia¹

2015

Rev. virtual Soc. Parag. Med. Int

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Efectividad de los estudios preoperatorios en pacientes sanos sometidos a cirugías de bajo-moderado riesgo Effectiveness of pre-operative studies in healthy patients subjected to low and moderate risk surgeries ResumenIntroducción: los exámenes preoperatorios están indicados según los hallazgos obtenidos en la historia clínica y el examen físico. Se realizan con el propósito de optimizar las condiciones clínicas previas a la cirugía y disminuir las complicaciones perioperatorias. Objetivos: determinar los resultados de exámenes realizados en la evaluación preoperatoria de pacientes sanos sometidos a cirugías de bajo-moderado riesgo y la relación de dichos resultados con las complicaciones perioperatorias. Materiales y métodos: fueron reclutados 113 varones y mujeres menores a 50 años, sanos, admitidos en las salas de Cirugía y de Traumatología del Hospital Nacional (Itauguá) y sometidos a evaluación preoperatoria por la autora en el período de enero a noviembre de 2014. Los estudios evaluados fueron todos solicitados por los médicos tratantes como parte de su rutina. Resultados: los procedimientos quirúrgicos más frecuentes fueron la colecistectomía crónica calculosa y la hernioplastia. El examen laboratorial que reveló más alteraciones fue el hepatograma (15,79%), seguido del hematocrito y la glicemia. En cuanto a la radiografía de tórax y el electrocardiograma, no hubo hallazgos anormales significativos relevantes. Se constató un porcentaje mínimo de complicaciones perioperatorias (5,31%). Conclusión: de todos los estudios realizados en el preoperatorio, se observó por lo menos un resultado anormal en 18,58%. Ningún resultado anormal modificó el manejo perioperatorio ni se relacionó con las complicaciones ocurridas. Palabras claves: evaluación preoperatoria, estudios preoperatorios AbstractIntroduction: The pre-operatory studies are indicated according to the clinical history and clinical examination. They are performed in order to optimize the clinical conditions before a surgery and decrease peri-operative complications. peri-operative complications. Objectives: To determine the results of the studies performed in the pre-operative evaluation of healthy patients subjected to low and moderate risk surgeries and the relationship of these results with the perioperatory complications. Materials and methods: One hundred thirteen healthy men and women younger than 50 years old admitted into the rooms of Surgery and Traumatology of the National Hospital (Itauguá) were subjected to pre-operative evaluation from January to November 2014. The evaluated studies were requested by the treating medical doctors as part of the routine procedure. Results: The most frequent surgical procedures were the chronic calculous cholecystectomy and the hernioplasty. The laboratory exam that revealed most alterations was the hepatogram (15.79%), followed by the hematocrit and the glycemia. In relation to the chest radiograph and the electrocardiogram, there were not significant relevant abnormal findings. A minimum percentage of peri-...

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“…Furthermore, preoperative laboratory evaluations, including platelet count, prothrombin time, and activated prothrombrin time, are helpful to confirm a suspected diagnosis and for the preoperative planning. However, systematic screening is inefficient and should be confined to patients at high risk [2]. Bleeding time is purported to evaluate platelet function, but it is associated with poor accuracy due to operator technique and patient variation (e.g., skin thickness, skin temperature, and vascular pattern) [3, 4].…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Control of Bleeding in Endoscopic Skull Base Surgery: Current Concepts to Improve Hemostasis

et al. 2013

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Hemostasis is critical for adequate anatomical visualization during endoscopic endonasal skull base surgery. Reduction of intraoperative bleeding should be considered during the treatment planning and continued throughout the perioperative period. Preoperative preparations include the optimization of comorbidities and cessation of drugs that may inhibit coagulation. Intraoperative considerations comprise anesthetic and surgical aspects. Controlled hypotension is the main anesthetic technique to reduce bleeding; however, there is controversy regarding its effectiveness; what the appropriate mean arterial pressure is and how to maintain it. In extradural cases, we advocate a mean arterial pressure of 65–70 mm Hg to reduce bleeding while preventing ischemic complications. For dealing intradural lesion, controlled hypotension should be cautious. We do not advocate a marked blood pressure reduction, as this often affects the perfusion of neural structures. Further reduction could lead to stroke or loss of cranial nerve function. From the surgical perspective, there are novel technologies and techniques that reduce bleeding, thus, improving the visualization of the surgical field.

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Examens de ľhémostase périopératoire réalisés en laboratoire et au lit du patient

Cited by 30 publications

References 33 publications

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Efectividad de los estudios preoperatorios en pacientes sanos sometidos a cirugías de bajo-moderado riesgo

Control of Bleeding in Endoscopic Skull Base Surgery: Current Concepts to Improve Hemostasis

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