scholarly journals Cardiopulmonary Arrest with Airway Obstruction due to Postoperative Bleeding

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Kenichi Sato ◽  
Mami Chikuda ◽  
Yoshihisa Miyamae ◽  
Miwako Kan
Keyword(s):  
Soft Palate ◽  
Cardiopulmonary Arrest ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Skin Grafting ◽  
Spontaneous Circulation ◽  
Bypass Grafting ◽  
Medical Doctors ◽  
Intravenous Heparin ◽  
Warfarin Potassium

An 84-year-old woman underwent soft palate resection and skin grafting with tie-over under general anesthesia. Fourteen years previously, she had undergone aortic valve replacement and coronary artery bypass grafting followed by lifelong warfarin and aspirin anticoagulation. We terminated the two drugs 8 and 6 days, respectively, before the present surgery and substituted intravenous heparin (10,000 units/day), which was terminated 6 h preoperatively. The surgery was uneventful. Heparin was restarted 2 days postoperatively but without warfarin potassium or aspirin because of postoperative soft palate bleeding, which continued for 10 days despite compression hemostasis. On day 10, she exhibited a suffocating large hemorrhagic mass, leading to cardiopulmonary arrest. Emergency consultation with medical doctors and dental anesthetists resulted in pulmonary resuscitation and tracheal intubation. After confirming spontaneous circulation/respiration, she was transferred to the intensive care unit. We now consider it essential that all medical/surgical/anesthesia specialists managing patients under anticoagulant therapy collaborate perioperatively.

Abstract 17348: Clinical Outcomes in Acute Coronary Syndrome Patients Following Coronary Artery Bypass Grafting in Relation to Timing of Ticagrelor Discontinuation: Insights From the CAPITAL Registry

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Juan J Russo ◽  
Tyler E James ◽  
Nikita Malhotra ◽  
Daniel Goubran ◽  
Fraser D Rubens ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Significant Proportion ◽  
Timing Of Surgery ◽  
Blood Transfusions ◽  
Bypass Grafting ◽  
Coronary Syndrome ◽  
Icu Stay ◽  
Prolonged Icu Stay

Background: We sought to assess in-hospital clinical outcomes in ACS patients undergoing CABG in relation to the duration of ticagrelor discontinuation prior to surgery. Methods: We identified consecutive ACS patients who underwent CABG after having received ticagrelor. Patients were divided into 3 groups based on the timing of surgery after discontinuation of ticagrelor (<48 hours, 48 hours to <5 days, 5 days or more). We then compared clinical outcomes following CABG in relation to the duration of ticagrelor discontinuation prior to surgery. Clinical variables evaluated included postoperative bleeding, need for surgical reopening or blood transfusions, and length of stay in the intensive care unit (ICU). Results: Of 664 ACS patients undergoing CABG between January 2012 and March 2015, 53 received ticagrelor prior to CABG. Ticagrelor had been discontinued <48 hours prior to CABG in 22 patients (41%); 48 hours to <5 days in 19 (36%); and 5 days or more in 12 (23%). Patients who underwent CABG <48 hours after ticagrelor discontinuation were more likely to require blood transfusions and a prolonged ICU stay (defined as >3 days). In addition, they had numerically higher, but non-statistically significant, rates of postoperative bleeding. Patients who underwent CABG 48 hours to <5 days after ticagrelor discontinuation had similar rates of postoperative bleeding and duration of ICU stay compared to patients who waited at least 5 days. Conclusions: A significant proportion of ACS patients (77%) who require CABG undergo surgery before the guideline recommended ticagrelor discontinuation period of 5 days. Patients who undergo CABG <48 hours after ticagrelor discontinuation are more likely to require postoperative blood transfusions and a prolonged ICU stay. Notably, patients who undergo CABG 48 hours to <5 days after ticagrelor discontinuation have similar postoperative outcomes compared to patients who undergo CABG after 5 days of ticagrelor discontinuation.

scholarly journals 158 Effect of Preoperative Continuation of Aspirin on Postoperative Bleeding After Off-Pump Coronary Artery Bypass Grafting (OPCABG)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M I S Al-Manzo ◽  
S Biswas ◽  
S Das Gupta ◽  
Md.Z Rahman ◽  
B Basak ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Chest Tube ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Bypass Grafting ◽  
Off Pump ◽  
Significant Difference ◽  
Pump Coronary Artery Bypass

Abstract Background Despite ample evidence of continued preoperative aspirin to improve outcomes in coronary artery bypass surgery, practice for routine continued preoperative aspirin use is still inconsistent due to concern for increased postoperative bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on postoperative bleeding after off-pump coronary artery bypass grafting (OPCABG). Method This cohort study involved patients (n = 74) who underwent OPCABG at a single center between August 2017 to January 2018. After considering the inclusion and exclusion criteria, they were divided into two groups: one (n = 37) received tablet Aspirin 75mg till the day of surgery and for the other group (n = 37) aspirin was stopped 5 days before surgery. Postoperative bleeding was recorded in both groups. After considering preoperative, intraoperative, and postoperative variables statistical analysis was done. Results There was no significant difference between the two groups concerning preoperative and peroperative variables. No significant difference was also observed between the two groups in chest tube drainage at 1sthour, 2ndhour, 3rdhour, 24thhour, next 24 hours (at 48th hour), and next 24 hours (at 72nd hour) (p = 0.845, 0.126, 0.568, 0.478, 0.342 and 0.717 respectively). No significant difference was seen in the transfusion requirement of blood and fresh frozen plasma (FFP). Conclusions Continuation of preoperative aspirin till the day of surgery is not associated with an increase in chest tube drainage, re-operation for bleeding complications, or transfusion of blood and FFP.

scholarly journals Can Higher Body Mass Index Patients Save Blood Following On-pump Coronary Artery Bypass Grafting?

2019 ◽  
Vol 22 (5) ◽  
pp. E352-E356
Author(s):  
Wenyuan Zhang ◽  
Shibiao Chen ◽  
Xiaojie Liu ◽  
Lijuan Wang ◽  
Sudena Wang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Body Mass ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Bypass Grafting ◽  
Bleeding Volume ◽  
Pump Cabg

Background: The association of obesity with postoperative bleeding volume and transfusions after coronary artery bypass grafting (CABG) is not clear. We evaluated the effects of body mass index (BMI) on bleeding volume and transfusions in patients undergoing on-pump CABG. Methods: We investigated 1,050 patients, aged 24 years to 83 years, who underwent isolated, primary CABG with cardiopulmonary bypass (CPB) at Fuwai Hospital, Chinese Academy of Medical Sciences, from September 2017 to July 2018. We recorded preoperative medical and laboratory coagulation parameters, intraoperative data, and postoperative bleeding volume for 24 hours following surgery. Primary endpoint was bleeding volume within 24 hours and transfusions after surgery. We analyzed the correlation between bleeding volume within 24 hours and transfusions after surgery and preoperative data with univariate and multivariate linear regression and logistic regression. Results: Old age significantly increased postoperative transfusions (OR = 1.035 95% CI 1.013-1.058, P = .002), whereas higher BMI (OR = 0.897 95% CI 0.848-0.949, P < .001) and higher hemoglobin (HGB) (OR = 0.966 95% CI 0.954-0.978, P < 0.001) decreased postoperative transfusions. And, BMI independently was correlated with bleeding volume after multivariate regression analysis (B = -0.257, P < .001). Conclusions: Our findings suggest higher BMI may reduce postoperative bleeding volume and transfusion rate, thus such patients may save blood products during on-pump CABG.

Sign in / Sign up

Export Citation Format

Share Document