A5008947273- Blood transfusion and management
- Cardiac and Coronary Surgery Techniques
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Cardiac, Anesthesia and Surgical Outcomes
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Venous Thromboembolism Diagnosis and Management
- Mechanical Circulatory Support Devices
- Anesthesia and Sedative Agents
- Cardiac Arrest and Resuscitation
- Antiplatelet Therapy and Cardiovascular Diseases
- Blood donation and transfusion practices
- Nausea and vomiting management
- Anesthesia and Pain Management
- Heparin-Induced Thrombocytopenia and Thrombosis
- Hemodynamic Monitoring and Therapy
- Sepsis Diagnosis and Treatment
- Coronary Interventions and Diagnostics
- Cardiac Valve Diseases and Treatments
- Cardiac Structural Anomalies and Repair
- Hemostasis and retained surgical items
- Atrial Fibrillation Management and Outcomes
- Intensive Care Unit Cognitive Disorders
- Central Venous Catheters and Hemodialysis
- Hemophilia Treatment and Research
- Acute Myocardial Infarction Research
Mayo Clinic
2015-2024
Mayo Clinic in Arizona
2003-2024
Mayo Clinic Hospital
2023
WinnMed
1996-2019
Arthur B. McDonald-Canadian Astroparticle Physics Research Institute
2019
Baylor College of Medicine
2019
Icahn School of Medicine at Mount Sinai
2013
University of Minnesota Rochester
2002-2011
Mayo Clinic in Florida
2007
Foundation for Medical Research
2006
Background: It is not known whether rigorous intraoperative glycemic control reduces death and morbidity in cardiac surgery patients. Objective: To compare outcomes of intensive insulin therapy during with those conventional glucose management. Design: A randomized, open-label, controlled trial blinded end point assessment. Setting: Tertiary care center. Patients: Adults without diabetes who were undergoing on-pump surgery. Measurements: The primary outcome was a composite death, sternal...
Some observational studies have reported that transfusion of red-cell units been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoing cardiac surgery may be especially vulnerable the effects transfusion.We conducted a randomized trial at multiple sites from 2010 2014. Participants 12 years age or older who were complex and likely undergo red cells randomly assigned receive leukocyte-reduced 10 days less (shorter-term storage group) 21...
Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products resulting in increased morbidity mortality. Despite the publication numerous guidelines consensus statements for patient management surgery, research has revealed that adherence these poor, as result, significant variability practices among practitioners still remains. In addition, although utilization point-of-care (POC) coagulation monitors use novel therapeutic strategies...
Background Abnormal bleeding after cardiopulmonary bypass (CPB) is a common complication of cardiac surgery, with important health and economic consequences. Coagulation test-based algorithms may reduce transfusion non-erythrocyte allogeneic blood in patients abnormal bleeding. Methods The authors performed randomized prospective trial comparing practices 92 adult CPB. Patients were to one two groups: control group following individual anesthesiologist's protocol using algorithm guided by...
A retrospective review of 244 adult spine instrumentation and fusion surgery cases (1994-1995) from one institution.To ascertain the predictors blood transfusions for patients undergoing different types multilevel surgery.Blood loss transfusion requirements during after surgeries have always been perceived as great. Identifying with this type may aid in reducing amount requirements.The charts who underwent January 1994 to July 1995 were retrospectively reviewed.A large percentage required...
The American College of Cardiology released a scientific advisory that included recommendation to delay elective noncardiac surgery (NCS) for 1 yr after percutaneous coronary intervention (PCI) with drug-eluting stent (DES).This single-center, retrospective study examined the risk complications NCS performed within 2 DES placement and whether this changed based on time between procedures. primary endpoint was major adverse cardiac events (MACEs) during hospitalization NCS. Bleeding were...
The duration of time that elective noncardiac surgery (NCS) should be delayed after percutaneous coronary intervention (PCI) with bare metal stents (BMSs) is unknown.This large, single-center, retrospective study examined the relation between complication rate in patients BMSs undergoing NCS and PCI NCS. Primary endpoints included in-hospital major adverse cardiac events (death, myocardial infarction, stent thrombosis, or repeat revascularization either artery bypass grafting target vessel)...
Prior research has provided inconsistent data regarding the risk factors associated with complications from arterial cannulation. The goal of this study was to clearly define incidence and risks cannulation complications.After obtaining institutional review board approval, all patients requiring line placement documentation were included in retrospective between January 1, 2006, December 31, 2012. Leveraging two robust warehouses, Perioperative DataMart Mayo Clinic Life Silences System,...
Post-cardiopulmonary bypass (CPB) coagulopathy and bleeding are among the most common reasons for blood product transfusion in surgical practices. Current retrospective data suggest lower rates loss patients receiving prothrombin complex concentrate (PCC) compared with plasma after cardiac surgery.To analyze perioperative outcomes undergoing surgery who develop microvascular receive treatment either PCC or plasma.A single-institution, prospective, randomized clinical trial performed at a...
Although tranexamic acid is used to reduce bleeding after cardiac surgery, there large variation in the recommended dose, and few studies of plasma concentrations drug during cardiopulmonary bypass (CPB) have been performed. The concentration reported inhibit fibrinolysis vitro 10 microg/mL. Twenty-one patients received an initial dose mg/kg given over 20 min followed by infusion 1 mg. kg(-1). h(-1) via a central venous catheter. Two were removed from study secondary protocol violation....
Most blood crossmatched in a hospital bank is for surgical patients, and the majority never transfused. The maximal standard order schedule used to promote efficient ordering practices patients.To ascertain predictors of red cell transfusions patients undergoing total hip arthroplasty, charts 299 adult primary revision arthroplasty were reviewed. A equation was developed calculating number units cells that should be ordered. Stepwise regression analysis determine which...
Visual loss (acuity or field) secondary to ischemic optic neuropathy (ION) is a rare but devastating complication of cardiac surgery involving cardiopulmonary bypass (CPB). We determined clinical features and risk factors for ION by retrospective time-matched, case-control study. was identified in 17 (0.06%) patients out 27,915 who underwent CPB between January 1, 1976, December 31, 1994. For each patient, two exactly 2 wk before the patient were selected as controls. Data analyzed using...
The US Food and Drug Administration issued a black box warning regarding the use of droperidol potential for torsade de pointes (TdP).The primary objective this retrospective study was to determine whether low-dose administration increased incidence TdP in general surgical population during 3-yr time period before after warning. A random sample 150 patients each interval selected estimate period.During (July 1, 1998 June 30, 2001), 2,321/139,932 (1.66%) had QT prolongation, TdP, or death...
There are a few large studies of the morbidity and mortality electroconvulsive therapy (ECT). To add data to this literature, we performed retrospective review all patients who underwent ECT at our institution between January 1, 1988, through December 31, 2001. We identified 2,279 were given 17,394 treatments during their first series. The median number received per patient was 7. Twenty-one (0.92%) experienced complication some time series treatments. Cardiac complications, mostly...
Intravenous insulin protocols are increasingly common in the intensive care unit to maintain normoglycemia. Little is known about accuracy of point-of-care glucometers for measuring glucose this patient population or impact sample source (capillary, arterial, venous whole blood) on glucometer results. We compared capillary, and blood values with laboratory plasma 20 patients after cardiac surgery. All 4 samples glucose) were analyzed hourly first 5 hours during intravenous therapy unit....
The implementation of evidence-based practice poses a significant challenge in the intensive care unit. In this quality improvement intervention we assessed effect an institutional protocol and computerized decision support for red cell transfusion critically ill.We compared processes outcomes during two 3-month periods before after introduction multidisciplinary intervention.Multidisciplinary units--medical, surgical, mixed--in tertiary academic center.Consecutive ill patients with anemia...
OBJECTIVE Adequate hemostasis is extremely important in neurosurgery, commonly requiring the use of topical hemostatic agents. Apart from variable efficacy, residual presence these agents may cause foreign body reaction, infection, and delayed bone growth. This study compares safety efficacy used with a newly approved agent, Arista (microporous polysaccharide hemospheres; Medafor, Inc., Minneapolis, MN). METHODS A brain tissue defect was created 228 Wistar outbred rats, either no agent...
<h3>Objective</h3> The aim of this prospective, randomized, double-blind, placebo controlled trial was to evaluate the safety and efficacy continuous ropivacaine infusion into sternal wound. <h3>Methods</h3> We planned enroll 200 patients scheduled for various cardiac surgical procedures study. Patients, in a double-blind randomized fashion, were given either normal saline or 0.3% through 2 subcutaneous multiport catheters placed on side split at an rate 4 mL/h 64 hours. outcomes measured...
Hetastarch is used for intravascular volume expansion in cardiac surgery. Studies show conflicting effects of intraoperative hetastarch administration on postoperative bleeding. was routinely during cardiovascular surgeries at our institution until its use discontinued intraoperatively. We performed a retrospective chart review patients undergoing primary coronary artery bypass grafting, valve repair or replacement requiring cardiopulmonary (n = 444), 234 which received and 210 did not....