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- BookCarlo Enrique Marcucci, Patrick Schoettker, editors.Summary: All anesthesiologists are confronted with patients who show bleeding disorders, whether congenital, acquired, or pharmacologically induced. Although many studies, meta-analyses, guidelines, and textbooks have been published on the subject, they mostly cover specific aspects or require a thorough knowledge of hemostasis. The goal of this book is to provide the anesthetist with an overview of hemostasis and the mechanisms underlying bleeding and coagulation in general and to assist in the understanding of specific coagulation disorders as they may occur in the various anesthetic subspecialties. It is hoped that, through the provision of practical information and tools, the book will help residents and trained anesthetists to manage one of the most frustrating challenges that they face: the bleeding patient. A full understanding of coagulation requires a lifelong career, and this book is not intended to replace the consulting hematologist, whose expert opinion should always be sought. The available procoagulant blood products and drugs all have potentially dangerous side-effects; furthermore, in bleeding disorders pitfalls are frequent and a misdiagnosis can have potentially catastrophic consequences. The aim of the editors is thus instead to enhance the collaboration between the disciplines of Anesthesiology and Hematology.
Contents:
Part I: Pre-operative haemostasis: Cell based coagulation model
Laboratory testing of hemostasis
Viscoelastic tests of hemostasis
Point of care platelet function tests
Hemostasis assessment and evaluation
Hereditary coagulopathies
Acquired coagulopathies
Drug induced
Antiplatelet drugs
Intravenous fluids and coagulation
Split blood products
Isolated coagulation products
Pro-coagulant drugs
Patient blood management. Part II: Per-operative haemostasis: In cardiac surgery
In Hepatic Surgery
In Pediatric Surgery
In Obstetrics Surgery
In Trauma
In Neurosurgery
In Orthopedic Surgery
In Neuraxial and Peripheral Nerve blocks. Part III: Post-Operative: Intensive Care
Anti-Coagulation. Part IV: Economic aspects and organization. - ArticleFraser GM.Clin Radiol. 1978 Nov;29(6):625-34.One hundred and seven patients admitted to a small general hospital with acute upper gastrointestinal bleeding have been examined by the double contrast barium meal technique. The presumed bleeding site was identified in 75 cases (70%). Twenty-eight patients showed radiological evidence of recent or active bleeding. These were all examined within 24 h of the bleed and 18 (64%) continued to bleed or had a further bleed whereas of 79 patients who did not show radiological signs of recent or active bleeding only 10(13%) continued to bleed or had a further bleed. The radiological features of recent or active bleeding seen on the double contrast barium meal are: 1, Blood clot in an ulcer or adherent to a recently bleeding lesion. 2. An artery in the base of an ulcer. 3. Active bleeding during the course of the examination seen as a dynamic alteration or disturbance in the barium as it flows over the bleeding site.