3 research outputs found
Relationship between Polymorphonuclear Leukocyte Count in Bronchoalveolar Lavage Fluid and Bacterial Content in Gramās Stain and Bacterial Content in Final Microbiological Report
Eighty samples of bronchoalveolar lavage fluid (BALF) were obtained from the total of 48 patients (22 females and 26 males) and analyzed. Eighteen of those patients were organ transplant recipients.The relationship between polymorphonuclear leukocyte (PMN) count in direct sample and semi quantitative Gram-positive and Gram-negative bacterial content were analyzed in BALF samples. PMN count in direct sample and Gram-positive and Gram-negative bacterial content of the final microbiological report was compared as well. On the total number of samples PMN count in direct samples of BALF was statistically significant regarding the presence of Gram-positive bacteria in the same sample; it was nearly significant regarding the presence of Gram-negative bacteria; and it was statistically significant for the total bacterial content. If BALF samples are divided into those obtained from organ-transplant and those obtained from non- -organ-transplant patients, positive, statistically significant relationship is found in the organ-transplant group, more specifically for the relationship between PMNs and total bacterial content. When PMN count in direct microbiological sample was compared with the results of the final microbiological report, statistically significant relationship was found neither with respect to all BALF samples, nor after dividing them into Ā»organ-transplantĀ« and Ā»non-organ-transplantĀ« group. We did not find differences caused by gender
Viscoelastic hemostatic tests during liver transplantation ā have we changed blood transfusion therapy?
Uvod: Transplantacija ili presaÄivanje jetre jest priznata metoda lijeÄenja kojom se terminalno bolesna jetra zamjenjuje sa zdravom jetrom darivatelja. Standardni laboratorijski testovi (protrombinsko vrijeme, aktivirano parcijalno tromboplastinsko vrijeme, fibrinogen, antitrombin), premda koreliraju s težinom jetrene bolesti, pokazali su inferiornost u odnosu na viskolelastiÄne testove (trombelastogram ā TEG i rotacijska trombelastometrija ā ROTEM) u procjeni funkcije koagulacijskog sustava u terminalnoj fazi jetrene bolesti. Cilj ovog istraživanja bio je utvrditi na koji je naÄin intraoperacijska upotreba viskolestiÄnih testova u procjeni hemostaze tijekom transplantacije jetre utjecala na transfuzijsko lijeÄenje u KliniÄkoj bolnici Merkur. Metode: Ovom retrospektivnom, opservacijskom studijom analizirane su slijedeÄe varijable za 76 pacijenta iz 2010. (bez ROTEM-a) te 82 pacijenta iz 2021. (s ROTEM-om) kojima je u KB Merkuru transplantirana jetra : intraoperacijska nadoknada tekuÄinama (kristaloidne, koloidne otopine); transfuzijsko lijeÄenje krvnim derivatima (deplazmatizirani koncentrati eritrocita, svježe smrznuta plazma, trombociti, krioprecipitat); ukupni intraoperacijski gubitci (krv, diureza, meÄustaniÄni prostor); ukupna nadoknada tekuÄinama i krvnim derivatima. Rezultati: Tijekom 2010. prosjeÄna ukupna nadoknada tekuÄinama i krvnim derivatima bila je 18 433 ml dok je za 2021. bila 9838 ml (p<0,0001). ProsjeÄni volumen kristaloidnih otopina ordiniranih 2010. tijekom transplantacije jetre bio je 5674 ml dok je 2021. bio 4734 ml (p=0,0015); koloidnih 2010. godine 2244 ml, a koloidnih 2021. godine 1949 ml (p=0,07). ProsjeÄna koliÄina deplazmatiziranih eritrocita ordinirana 2010. bila je 2927 ml dok je 2021. bila 1266 ml (p<0,0001). ProsjeÄna koliÄina svježe smrznute plazme, trombocita i krioprecipitata ordiniranih 2010. bila je 5428, 426, 266 ml dok je 2021. bila 823 (p<0,0001), 137 (p<0,0001), 366 ml (p<0,03). ZakljuÄak: Uporabom viskoelastiÄnih testova za praÄenje hemostaze tijekom transplantacije jetre znaÄajno je smanjeno davanje svih krvnih derivata, osim krioprecipitata Äija potroÅ”nja je poveÄana, a nije utjecala na koliÄinu ordiniranih koloidnih otopina. Smanjenje koliÄine krvnih derivata je od iznimnog znaÄaja s obzirom na rizike koje nosi transfuzijsko lijeÄenje.Introduction: Liver transplantation is a viable treatment for end stage liver desease in which a terminally ill liver is replaced with a healthy donor liver. Standard laboratory tests (prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin), although correlates with the severity of liver disease, showed inferiority to viscolelastic tests (thrombelastogram ā TEG, rotational thrombelastometry ā ROTEM) in the assessment of coagulation in the end stage liver desease. The aim of this study was to determine if the intraoperative use of viscolastical tests during liver transplantation have influenced amount of administered blood products. Methods: This retrospective, observational study analyzed the following variables for 76 patients in 2010. (without ROTEM) and 82 patients in 2021. (with ROTEM) who underwent liver transplantation at University Hospital
Merkur: intraoperative fluid replacement (crystalloid, colloid); blood products (deplasmatized erythrocytes, fresh frozen plasma, platelets, cryoprecipitate); total intraoperative fluide losses (blood, diuresis, intercellular space); total compensation of fluids and blood products. Results: In 2010. the average total compensation of fluids and blood products was 18,433 ml, while in 2021. it was 9,838 ml (p <0.0001). Volume of crystalloids administered in 2010. was 5674 ml, in 2021. 4734 ml (p = 0.0015); colloids in 2010. 2244 ml, in 2021. 1949 ml (p = 0.07). Deplasmated erythrocytes administered in 2010. were 2927 ml while in 2021. 1266 ml (p <0.0001). Fresh frozen plasma, platelets and cryoprecipitates administered in 2010. were 5428, 426, 266 ml, in 2021. it was 823 (p <0.0001), 137 (p <0.0001), 366 ml (p <0, 03). Conclusion: The use of viscoelastic tests to monitor hemostasis during liver transplantation significantly reduced the administration of all blood products, except cryoprecipitates whose consumption was increased and did not affect the amount of administered colloids. Reducing the amount of blood products is important given the risks related to transfusion of blood products