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Low central venous pressure reduces blood loss in hepatectomy

World Journal of Gastroenterology 2006年第6期12卷 935-939页

作者： Wei-Dong Wang Li-Jian Liang Xiong-Qing Huang Xiao-Yu Yin Department of General Surgery The FirstPeople's Hospital of Shun De Fuoshan 528300 GuangdongProvince China Department of Hepatobiliary Surgery The First Affiliated Hospital Sun Yat-Sen University Guangzhou510080 Guangdong Province China Department of Anaesthesia The FirstAffiliated Hospital Sun Yat-Sen University Guangzhou 510080Guangdong Province China

AIM： To investigate the effect of low central venous pressure （LCVP） on blood loss during hepatectomy for hepatocellular carcinoma （HCC）. METHODS： By the method of sealed envelope, 50 HCC patients were randomized into LCVP group （n=25） and control group （n=25）. In LCVP group, CVP was maintained at 2-4 mmHg and systolic blood pressure （SBP） above 90 mmHg by manipulation of the patient＇s posture and administration of drugs during hepatectomy, while in control group hepatectomy was performed routinely without lowering CVP. The patients＇ preoperative conditions, volume of blood loss during hepatectomy, volume of blood transfusion, length of hospital stay, changes in hepatic and renal functions were compared between the two groups. RESULTS： There were no significant differences in patients＇ preoperative conditions, maximal tumor dimension, pattern of hepatectomy, duration of vascular occlusion, operation time, weight of resected liver tissues, incidence of post-operative complications, hepatic and renal functions between the two groups. LCVP group had a markedly lower volume of total intraoperative blood loss and blood loss during hepatectomy than the control group, being 903.9 ± 180.8 mL vs 2 329.4 ±2 538.4 （W=495.5, P〈0.01） and 672.4±429.9 mL vs 1 662.6±1 932.1 （W=543.5, P〈0.01）. There were no remarkable differences in the pre-resection and post-resection blood losses between the two groups. The length of hospital stay was significantly shortened in LCVP group as compared with the control group, being 16.3±6.8 d vs 21.5 ± 8.6 d （W= 532.5, P〈0.05）.CONCLUSION： LCVP is easily achievable in technique. Maintenance of CVP ≤4 mmHg can help reduce blood loss during hepatectomy, shorten the length of hospital stay, and has no detrimental effects on hepatic or renal function.

关键词： Hepatectomy Hepatocellular carcinoma Central venous pressure blood loss

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Controlled low central venous pressure reduces blood loss and transfusion requirements in hepatectomy

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World Journal of Gastroenterology 2014年第1期20卷 303-309页

作者： Zhi Li Yu-Ming Sun Fei-Xiang Wu Li-Qun Yang Zhi-Jie Lu Wei-Feng Yu Department of Anesthesiology Eastern Hepatobiliary Surgery Hospitalthe Second Military Medical University

AIM: To evaluate the effect of low central venous pressure (LCVP) on blood loss and blood transfusion in patients undergoing hepatectomy.

关键词： Low central venous pressure Hepatectomy blood loss blood transfusion

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Efficacy of topical vs intravenous tranexamic acid in reducing blood loss and promoting wound healing in bone surgery:A systematic review and meta-analysis

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World Journal of Clinical Cases 2021年第17期9卷 4210-4220页

作者： Jian-Wen Xu Hong Qiang Ting-Li Li Yi Wang Xiao-Xiao Wei Fei Li Nursing Department Yangpu District Shidong HospitalShanghai 200438China Emergency Services Department Yangpu District Shidong HospitalShanghai 200438China The Second Neurological Department Yangpu District Shidong HospitalShanghai 200438China

BACKGROUND Tranexamic acid(TXA)has been used as an anti-fibrinolytic drug for over half a century and has received much attention in recent *** To evaluate the efficacy of topical vs intravenous TXA in reducing blood loss and promoting wound healing in bone *** From the electronic resources,PubMed,Cochrane Library,Embase,ISI,and Scopus were used to perform a literature search over the last 10 years between 2010 and ***™X8 was used for managing the electronic *** were performed with mesh *** data were retracted blindly by two independent *** effects were used to deal with potential heterogeneity and I2 showed ***-square(I2)tests were used to quantify the extent of heterogeneity(Pblood loss and promoting wound healing in bone surgery was compared with intravenous TXA and *** According to the research design,1360 potentially important research abstracts and titles were discovered in our electronic searches,and 18 papers remained in agreement with our inclusion *** was found that TXA reduced 277.51 mL of blood loss compared to placebo,and there was no significant difference between topical TXA and IV TXA in reducing blood loss in bone *** analyses also showed that TXA significantly reduced blood transfusion compared to placebo and there was no significant difference between topical TXA and IV *** The use of both topical and intravenous TXA are equally effective in reducing blood loss in bone surgery,which might be beneficial for wound healing after surgery.

关键词： Tranexamic acid blood loss Wound healing Bone surgery Meta-analysis

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Association between tourniquet use and intraoperative blood loss during below-knee amputation

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World Journal of Orthopedics 2022年第7期13卷 644-651页

作者： Alden E Wyland Erik Woelber Liam H Wong Jordan Arakawa Zachary M Working James Meeker School of Medicine Oregon Health and Sciences UniversityPortlandOR 97239United States Department of Orthopaedics and Rehabilitation Oregon Health and Sciences UniversityPortlandOR 97239United States

BACKGROUND Despite over 150000 amputations of lower limbs annually,there remains a wide variation in tourniquet practice patterns and no consensus on their necessity,especially among orthopedic patient *** purpose of this study was to determine whether tourniquet use in orthopedic patients undergoing below knee amputation(BKA) was associated with a difference in calculated blood loss relative to no tourniquet *** To determine if tourniquet use in orthopedic patients undergoing BKA was associated with a difference in calculated blood loss relative to no tourniquet *** We performed a retrospective review of consecutive patients undergoing BKA by orthopedic surgeons at a tertiary care hospital from 2008 through *** loss was calculated using a combination of the Nadler equation for preoperative blood volume and a novel formula utilizing preoperative and postoperative hemoglobin levels and *** and forwards step-wise multivariate linear regressions were performed to determine the association between tourniquet use and blood loss.A Wilcoxon was used to determine the univariate relationship between tourniquet use and blood loss for in the restricted subgroups of patients who underwent BKA for trauma,tumor,and *** Of 97 eligible patients identified,67 underwent surgery with a tourniquet and 30 did *** multivariate regression,tourniquet use was associated with a 488 mL decrease in calculated blood loss(CI 119-857,P = 0.01).In subgroup analysis,no individual group showed a statistically significant decrease in blood loss with tourniquet *** was no significant association between tourniquet use and either postoperative transfusions or reoperation at one *** We found that tourniquet use during BKA is associated with decreased calculated intraoperative blood *** recommend that surgeons performing this procedure use a tourniquet to minimize blood loss.

关键词： Amputation Tourniquet blood loss Hemostasis

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Effect of warm bladder irrigation fluid for benign prostatic hyperplasia patients on perioperative hypothermia, blood loss and shiver: A meta-analysis

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Asian Journal of Urology 2019年第2期6卷 183-191页

作者： Jie Cao Xia Sheng Yan Ding Lingjuan Zhang Xiaoying Lu Department of Urology Changhai HospitalSecond Military Medical UniversityShanghaiChina Department of Robotic Urology Operating Theatre Changhai HospitalSecond Military Medical UniversityShanghaiChina Nursing Department Changhai HospitalSecond Military Medical UniversityShanghaiChina

Objective:To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia,blood loss and shiver in patients treated with benign prostatic hyperplasia(BPH).Method:A comprehensive literature review and meta-analysis that included randomized controlled trials(RCTs)related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by *** relevant literature were searched in Chinese database,such as Retrieval Chinese Journal Full-text Database,VIP Journal Database,Wanfang database,as well as in English search engine and database,including Embase,Cochrane and Medline till January *** study quality was assessed by recommended standards from Cochrane Handbook(version 5.1.0).Results:A total of 28 RCTs and 3858 patients were *** results showed that the incidences of shiver(risk ratio[RR]Z 0.32,95%confidence interval[CI]:0.28e0.36,p<0.001,I^2 Z 0%)and hypothermia(RR Z 0.36,95%CI:0.21e0.59,p<0.001,I^2 Z 67%)in the group of warm irrigation fluid were lower than the group having room-temperature ***-temperature irrigation fluid group caused a greater drop in body temperature compared to warm irrigation fluid group(p<0.001,I^2 Z 96%).We performed a narrative descriptive statistics only because of substantial ***:Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for *** irrigation fluid should be considered as a standard practice in BPH surgeries.

关键词： Irrigation fluid Temperature Bladder fluid Benign prostatic hyperplasia Hypothermia blood loss Shiver

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Can bone mineral density affect intra-operative blood loss of mini-invasive posterior lumbar interbody fusion?

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Laparoscopic, Endoscopic and Robotic Surgery 2020年第3期3卷 66-69页

作者： Yong He Chao Liu Yue Huang Department of Orthopaedics Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province Hangzhou 310016China

Objective:Many factors affect intraoperative blood loss(BL)in mini-invasive posterior lumbar interbody fusion(PLIF)procedures,but only few has ***,the impact of bone mineral density(BMD)levels on intraoperative *** study aims to examine the correlation between these two ***:Retrospective review of 120 patients with low back disorders who were scheduled to undergo mini-invasive PLIF from October 2018 to October 2019 was *** were divided into two groups based on BMD of the lumbar spine:normal group and abnormal group(osteoporosis and osteopenia).Comparison of age,gender,BMD,BL,BMI,prothrombin time,activated partial thromboplastin time,haemoglobin concentration,intraoperative mean arterial pressure,platelet count,and operative time(OT)between the two groups,and correlation analysis of BMD and BL were ***:The mean BL of patients in the abnormal group was remarkably higher than that in the normal group:357.22±152.55 ml and 259.37±125.90 ml respectively(p<0.001).The partial correlation coefficient between BL and BMD was0.45(p<0.001).The results of univariate regression analysis demonstrated that only BMD,gender,and OT were related to BL(BMD,r=0.427,p<0.001;gender,r=0.211,p=0.024;OT,r=0.318,p=0.001).While multivariate linear regression analysis demonstrated that patients with lower BMD and longer OT had a higher amount of intraoperative BL(p<0.001).Conclusions:BMD is an important factor influencing intraoperative BL in mini-invasive *** should be assessed routinely as a part of the preoperative examination to improve preoperative assessment and ensure patient safety.

关键词： Bone mineral density blood loss Mini-invasive posterior lumbar interbody fusion

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Peking University Third Hospital score:a comprehensive system to predict intra-operative blood loss in radical nephrectomy and thrombectomy

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Chinese Medical Journal 2020年第10期133卷 1166-1174页

作者： Zhuo Liu Xun Zhao Hong-Xian Zhang Run-Zhuo Ma Li-Wei Li Shi-Ying Tang Guo-Liang Wang Shu-Dong Zhang Shu-Min Wang Xiao-Jun Tian Lu-Lin Ma departm ent of Urology Peking University Third HospitalBeijing 100191China Health Science Center Peking UniversityBeijing 100191China Department of Ultrasound Peking University Third HospitalBeijing 100191China.

Background:Radical nephrectomy and thrombectomy is the standard surgical procedure for the treatment of renal cell carcinoma (RCC) with tumor thrombus (TT). But the estimation of intra-operative blood loss is only based on the surgeon’s experience. Therefore, our study aimed to develop Peking University Third Hospital score (PKUTH score) for the prediction of intra-operative blood loss volume in radical nephrectomy and ***: The clinical data of 153 cases of renal mass with renal vein (RV) or inferior vena cava tumor thrombus admitted to Department of Urology, Peking University Third Hospital from January 2015 to May 2018 were retrospectively analyzed. The total amount of blood loss during operation is equal to the amount of blood sucked out by the aspirator plus the amount of blood in the blood-soaked gauze. Univariate linear analysis was used to analyze risk factors for intra-operative blood loss, then significant factors were included in subsequent multivariable linear regression ***: The final multivariable model included the following three factors: open operative approach (P blood loss was noticed along with higher risk score. The estimated median blood loss from PKUTH score 0 to 3 was 280 mL (interquartile range [IQR] 100-600 mL), 1250 mL (IQR 575-2700 mL), 2000 mL (IQR 1250-2900 mL), and 5000 mL (IQR 4250-8000 mL), respectively. Meanwhile, the higher PKUTH score was, the more chance of post-operative complications (P = 0.004) occurred. A tendency but not significant overall survival difference was found between PKUTH risk score 0vs. 1 to 3 (P = 0.098).Conclusion: We present a structured and quantitative scoring system, PKUTH score, to predict intra-operative blood loss volume in radical nephrectomy and thrombectomy.

关键词： Renal cell carcinoma Venous thrombosis blood loss Inferior vena cava

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Correlation between the coverage percentage of prosthesis and postoperative hidden blood loss in primary total knee arthroplasty

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Chinese Medical Journal 2014年第12期127卷 2265-2269页

作者： Gao Fuqiang Guo Wanshou Sun Wei Li Zirong Wang Weiguo Wang Bailiang Cheng Liming Kush Nepali Osteonecrosis and Joint-Preserving and Reconstruction Center Department of Orthopedic SurgeryChina-Japan Friendship HospitalBeijing 100029China

Background The aim of this study was to determine the relationship between prosthesis coverage and postoperative hidden blood loss （HBL） in primary total knee arthroplasty （TKA）.Methods A total of 120 patients who had undergone unilateral TKA from August 2012 to May 2013 were retrospectively *** Gross formula was used to calculate the amount of *** standard anteroposterior （AP） and lateral x-ray films of the knee joint were taken postoperatively and used to measure the percentages of coronal femoral and of coronal and sagittal tibial prosthetic *** Pearson＇s correlation analysis was performed to assess the correlations between the percentages of prosthetic coverage for each AP and lateral position and HBL on the first and third postoperative *** The volumes of HBL on the first and third postoperative days after TKA were （786.5±191.6） ml and （1 256.6±205.1） ml,respectively,and lateral x-ray film measurements of percentages of coronal femoral,tibial coronal,and sagittal prosthetic coverage were （87.9±2.5）％,（88.5±2.2）％,and （89.1±2.3）％,***＇s correlation analysis showed statistically significant correlations between percentages of total knee prosthetic coverage for each AP and lateral position and volumes of HBL on the first and third postoperative days （P ＜0.05）.Conclusions HBL after TKA correlates with degree of prosthetic *** some extent,the size of the surfaces exposed by osteotomy determines the amount of *** of the appropriate prosthesis can significantly reduce postoperative *** individualized prostheses would be a worthwhile development in joint replacement surgery.

关键词： arthroplasty replacement, knee prosthetic coverage blood loss hidden

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Effect of Desmopressin on Platelet Aggregation and blood loss in Patients Undergoing Valvular Heart Surgery

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Chinese Medical Journal 2015年第5期128卷 644-647页

作者： Lei Jin Hong-Wen Ji Department of Anesthesiology Fuwai Hospital Chinese Academy of Medical Sciences Beijing 100037 China

Background：blood loss after cardiac surgery can be caused by impaired platelet （PLT） function after cardiopulmonary *** or 1-deamino-8-D-arginine vasopressin （DDAVP） is a synthetic analog of *** can increase the level of von Willebrand factor and coagulation factor Ⅷ,thus it may enhance PLT function and improve *** this study,we assessed the effects of DDAVP on PLT aggregation and blood loss in patients undergoing cardiac ***：A total of 102 patients undergoing valvular heart surgery （from October 2010 to June 2011） were divided into DDAVP group （n =52） and control group （n =50）.A dose of DDAVP （0.3 μtg/kg） was administered to the patients intravenously when they were being *** the same time,an equal volume of saline was given to the patients in the control *** aggregation rate was measured with the AggRAM four-way PLT aggregation measurement *** blood loss and transfusion,hemoglobin levels,PLT counts,and urine outputs at different time were recorded and ***：The postoperative blood loss in the first 6 h was significantly reduced in DDAVP group （202 ± 119 ml vs.258 ± 143 ml,P =0.023）.The incidence of fresh frozen plasma （FFP） transfusion was decreased postoperatively in DDAVP group （3.8% vs.12%,P =0.015）.There was no significant difference in the PLT aggregation,urine volumes,red blood cell transfusions and blood loss after 24 h between two ***：A single dose of DDAVP can reduce the first 6 h blood loss and FFP transfusion postoperatively in patients undergoing valvular heart surgery,but has no effect on PLT aggregation.

关键词： blood loss blood Transfusion Cardiac Surgery Desmopressin Platelet Aggregation

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Clinical effects of applying a tourniquet in total knee arthroplasty on blood loss

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Chinese Medical Journal 2010年第21期123卷 3030-3033页

作者： ZHANG Fu-jiang XIAO Yu LIU Ya-bin TIAN Xu GAO Zhi-guo Department of Orthopaedics Tianjin Hospital Tianjin 300211China

Background Tourniquets used during total knee arthroplasty may lead to many complications. The aim of this study was to determine perioperative blood loss and its clinical relevance in total knee replacement surgery after applying a *** From June 2009 to October 2009, 60 consecutive patients who underwent routine total knee arthroplasty were randomly divided into two groups and were treated with or without a tourniquet （30 patients/group）. There were no significant differences in patient baseline characteristics between the two groups. We compared the two groups of patients in terms of intra- and postoperative bleeding, invisible or visible bleeding, and total blood *** None of the patients showed poor wound healing, lower extremity deep venous thrombosis or other complications. The amount of blood loss during surgery was lower in the tourniquet group than in the control group （P〈0.01）. However, postoperative visible bleeding （P 〈0.05） and occult bleeding （P 〈0.05） were significantly greater in the toumiquet group than in the control group. There was no significant difference in the total amount of blood loss between the two groups （P 〉0.05）.Conclusions Tourniquet can reduce bleeding during total knee replacement surgery, but is associated with greater visible and invisible blood loss.

关键词： blood loss total knee arthroplasty tourniquet

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