Pulmonary Dysfunction and Massive Transfusion1

Author(s):  
John A. Collins
1985 ◽  
Vol 54 (04) ◽  
pp. 849-852 ◽  
Author(s):  
O Naesh ◽  
J T Friis ◽  
I Hindberg ◽  
K Winther

SummaryTen patients for elective cholecystectomy were studied pre-, per- and postoperatively. All had neurolept anesthesia. Plasma concentrations of β-TG, TXB2 and 5-HT and intraplatelet 5-HT were measured. Aggregation to ADP was recorded.Serum cortisol concentration was used as index of the stress response, showing peroperative increase and postoperative decrease. Closely related to this we observed a significant increase in P-β-TG and P-TXB2 with postoperative normalization in 6 patients without complications. P-5-HT had a peak peropera-tively and remained elevated postoperatively. A negative correlation between P--5-HT and decreasing intraplatelet 5-HT postoperatively was observed.High postoperative levels of P--5-HT seem to be related to low arterial Po2 and pulmonary dysfunction. In 3 patients with complications a second increase in P-β-TG, P-TXB2 and partly in P--5-HT was found. Platelets were temporarily refractory to ADP immediately following surgery and showed increased aggregabil-ity postoperatively. We conclude that platelets are activated in surgical stress.


1991 ◽  
Vol 19 (7) ◽  
pp. 926-933 ◽  
Author(s):  
DON K. NAKAYAMA ◽  
REBECCA MUTICH ◽  
ETSURO K. MOTOYAMA

Author(s):  
Christina Schindera ◽  
Jakob Usemann ◽  
Simeon Joel Zuercher ◽  
Ruedi Jung ◽  
Rahel Kasteler ◽  
...  

Surgery ◽  
1996 ◽  
Vol 119 (3) ◽  
pp. 302-315 ◽  
Author(s):  
Timothy C. Fabian ◽  
Matthew J. Fabian ◽  
Jennifer M. Yockey ◽  
Kenneth G. Proctor

2002 ◽  
Vol 52 (4) ◽  
pp. 545-553 ◽  
Author(s):  
Per Arne Tølløfsrud ◽  
Sverre Medbø ◽  
Anne Beate SolÅs ◽  
Christian A Drevon ◽  
Ola Didrik Saugstad

1996 ◽  
Vol 9 (2) ◽  
pp. 334-339 ◽  
Author(s):  
R.K. Brown ◽  
H. Wyatt ◽  
J.F. Price ◽  
F.J. Kelly

2021 ◽  
pp. 000313482110604
Author(s):  
Takahiro Yoshikawa ◽  
Daisuke Hokuto ◽  
Satoshi Yasuda ◽  
Naoki Kamitani ◽  
Yasuko Matsuo ◽  
...  

Background Restrictive pulmonary dysfunction (RPD) is a risk factor for perioperative complications during gastrointestinal surgery. We hypothesized that high airway pressure due to RPD results in increased intraoperative blood loss during liver surgery. Thus, we investigated the effects of RPD on perioperative outcomes for liver resection. Methods This study included 496 patients who underwent curative liver resection at our hospital between April 2009 and April 2020. Perioperative outcomes for the RPD and control groups were compared. Restrictive pulmonary dysfunction was defined as % vital capacity <80%. Results Forty-one patients (8.3%) had RPD. No significant differences were observed in intraoperative blood losses (440 mL vs 320 mL, P = .340), overall complication rates (29.3% vs 31.2%, P = .797), or pulmonary complication rates (4.9% vs 9.0%, P = .286) between the RPD and control groups. In the 256 patients who underwent anatomical liver resection, 18 patients (7.0%) had RPD. The intraoperative blood loss was significantly higher in the RPD group (925 mL vs 456 mL, P = .013), but no differences in the overall complication rates (44.4% vs 37.3%, P = .528) or pulmonary complication rates (11.1% vs 10.5%, P = .589) between the two groups were detected. A multivariate analysis showed that RPD was an independent risk factor for intraoperative blood loss ≥500 mL during anatomical liver resection (odds ratio 4.132; 95% confidence interval 1.135-15.045; P = .031). Discussion Restrictive pulmonary dysfunction may be a risk factor for intraoperative blood loss during anatomical liver resection, which requires exposure of the main hepatic vein.


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