69 research outputs found
Resuscitation of haemorrhagic shock with normal saline vs. lactated Ringer's: effects on oxygenation, extravascular lung water and haemodynamics
The international normalized ratio overestimates coagulopathy in patients after major hepatectomy
Abstract BACKGROUND: The International Normalized Ratio (INR) is commonly used to guide therapy after hepatectomy. We hypothesized that the use of thrombelastography (TEG) would demonstrate a decreased incidence of hypocoagulability in this patient population. METHODS: Seventy-eight patients were prospectively enrolled before undergoing hepatectomy. INR, TEG, and coagulation factors were drawn before incision, postoperatively, and on postoperative days 1, 3, and 5. RESULTS: Patients demonstrated an elevated INR at all postoperative time points. However, TEG demonstrated a decreased R value postoperatively, with subsequent normalization. Other TEG measurements were equivalent to preoperative values. All procoagulant factors save factor VIII decreased postoperatively, with a simultaneous decrease in protein C. CONCLUSIONS: TEG demonstrated a brief hypercoagulable state after major hepatectomy, with coagulation subsequently normalizing. The INR significantly overestimates hypocoagulability after hepatectomy and these data call into question current practices using the INR to guide therapy in this patient population. Ă 2014 Elsevier Inc. All rights reserved. Partial hepatectomy remains the treatment of choice for a wide range of both benign and malignant diseases of the liver. Following major hepatectomy, derangement of hepatic synthetic function has been well characterized, including impaired synthesis of serum clotting factors and regulatory proteins
Effect of protonation and deprotonation on the gas-phase reactivity of fluorinated 1,2,4-triazines
PO-0646: Adaptive and robust FDG-PET-based dose painting by numbers (DPBN) in head and neck tumors: a methodological approach
SU-E-T-182: Feasibility of Dose Painting by Numbers in Proton Therapy with Contour-Driven Plan Optimization
Vicinal Alkylation of Alkynes - a Short Route Toward Delta-alpha,Beta Butenolides, Furans and Cyclopentenones
- âŠ