“…Blood pressure was tightly controlled during the postoperative period with intravenous agent and patients monitored carefully for complications in particular for potential neck haematoma using the “SHOUT” protocol (Figure 1). 13 Figure 1.The SHOUT Protocol used to alert the ward staff to the possibility of a post-carotid endarterectomy neck haematoma. 13 …”
Section: Methodsmentioning
confidence: 99%
“…13 Figure 1.The SHOUT Protocol used to alert the ward staff to the possibility of a post-carotid endarterectomy neck haematoma. 13 …”
Section: Methodsmentioning
confidence: 99%
“…Blood pressure was tightly controlled during the postoperative period with intravenous agent and patients monitored carefully for complications in particular for potential neck haematoma using the "SHOUT" protocol (Figure 1). 13…”
Introduction Carotid endarterectomy (CEA) for symptomatic stenosis reduces further stroke risk. Post-CEA haematoma increases the risk of complications including stroke. There are few studies considering protocols aimed at reducing post-CEA haematoma rates. Presented are the outcomes of a protocol developed to reduce this surgical complication. Method The protocol was implemented in 112 consecutive CEA. It involves stepwise additional measures to ensure haemostasis before wound closure. Attention to bleeding points is followed by light compression for 10 min. Protamine is then given if haemostasis has not been achieved. If after 20 min the problem persists Tranexamic acid is given. Following a further 20 min if haemostasis is not yet achieved a platelet transfusion is undertaken. Haematoma rates, return to theatre for post-operative haematoma and other complications were compared with 100 consecutive pre-protocol introduction CEA cases. Results Of 112 CEA patients, 19 received protamine, 8 protamine and tranexamic acid. One case required platelet transfusion. Neck haematoma rate fell from 10 to 3 cases ( P = .02, OR: 0.25 [95% CI .07-.94]), of which returned to theatre for haematoma evacuation fell from 6 to 1 case ( P = .03, OR: 0.14 [95% CI .02-1.19]). 30 day stroke and death rate reduced from 5% to 1.8% ( P = .11, OR: 0.35 [95% CI .07-1.82]). Conclusion The stepwise haemostasis intraoperative protocol can reduce post-CEA haematoma rates.
“…Blood pressure was tightly controlled during the postoperative period with intravenous agent and patients monitored carefully for complications in particular for potential neck haematoma using the “SHOUT” protocol (Figure 1). 13 Figure 1.The SHOUT Protocol used to alert the ward staff to the possibility of a post-carotid endarterectomy neck haematoma. 13 …”
Section: Methodsmentioning
confidence: 99%
“…13 Figure 1.The SHOUT Protocol used to alert the ward staff to the possibility of a post-carotid endarterectomy neck haematoma. 13 …”
Section: Methodsmentioning
confidence: 99%
“…Blood pressure was tightly controlled during the postoperative period with intravenous agent and patients monitored carefully for complications in particular for potential neck haematoma using the "SHOUT" protocol (Figure 1). 13…”
Introduction Carotid endarterectomy (CEA) for symptomatic stenosis reduces further stroke risk. Post-CEA haematoma increases the risk of complications including stroke. There are few studies considering protocols aimed at reducing post-CEA haematoma rates. Presented are the outcomes of a protocol developed to reduce this surgical complication. Method The protocol was implemented in 112 consecutive CEA. It involves stepwise additional measures to ensure haemostasis before wound closure. Attention to bleeding points is followed by light compression for 10 min. Protamine is then given if haemostasis has not been achieved. If after 20 min the problem persists Tranexamic acid is given. Following a further 20 min if haemostasis is not yet achieved a platelet transfusion is undertaken. Haematoma rates, return to theatre for post-operative haematoma and other complications were compared with 100 consecutive pre-protocol introduction CEA cases. Results Of 112 CEA patients, 19 received protamine, 8 protamine and tranexamic acid. One case required platelet transfusion. Neck haematoma rate fell from 10 to 3 cases ( P = .02, OR: 0.25 [95% CI .07-.94]), of which returned to theatre for haematoma evacuation fell from 6 to 1 case ( P = .03, OR: 0.14 [95% CI .02-1.19]). 30 day stroke and death rate reduced from 5% to 1.8% ( P = .11, OR: 0.35 [95% CI .07-1.82]). Conclusion The stepwise haemostasis intraoperative protocol can reduce post-CEA haematoma rates.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
