Thrombelastography guides transfusion strategy.

During surgery for an abdominal aortic aneurysm, coagulation may be impaired and the use of thrombelastography (TEG) is described in six patients with a perioperative blood loss of 3L. During surgery blood products were infused but not platelets. When the patients were admitted to the intensive care unit, the TEG report demonstrated a lowered MA value indicating impaired function of platelets.

Effect of perioperative insulin infusion on surgical morbidity and mortality: systematic review and meta-analysis of randomized trials.7.

Objective: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients.

Patients And Methods: We used 6 search strategies including an electronic database search of MEDLINE, EMBASE, and Cochrane CENTRAL, from their inception up to May 1, 2006, and included RCTs of perioperative insulin infusion (with or without glucose targets) measuring outcomes in patients undergoing any surgery. Pairs of reviewers working independently assessed the methodological quality and characteristics of included trials and abstracted data on perioperative outcomes (ie, outcomes that occurred during hospitalization or within 30 days of surgery).

Advanced quantitative echocardiography in arrhythmogenic right ventricular cardiomyopathy.

Background: Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a regional disease of the RV myocardium with variable degrees of left ventricular involvement. Three-dimensional echocardiography and Doppler tissue imaging (DTI) are new echocardiographic modalities for the evaluation of global and regional function, but the diagnostic potential remains to be assessed.

Methods: Twenty patients with previously established ARVC were evaluated by 3-dimensional echocardiography and DTI, and compared with 32 age- and sex-matched control subjects.

Maintained cerebral and skeletal muscle oxygenation during maximal exercise in patients with liver cirrhosis.

Background/aims: In cirrhotic patients, insufficient redistribution of blood from splanchnic organs to the central circulation could limit blood supply to skeletal muscles and the brain during exercise.

Methods: Eight cirrhotic patients performed incremental cycling to exhaustion (74 (49-123) W; median with range).

Results: Heart rate increased from 68 (62-88)beats/min at rest to 142 (116-163)beats/min, cardiac output from 5.

Regional myocardial oxygenation during surgical revascularisation.

The aim of the study was to assess changes in myocardial oxygenation in patients with ischaemic heart disease during surgical revascularisation. In 20 patients, regional oxygen saturation, oxyhaemoglobin and total haemoglobin concentrations were examined by near-infrared spectroscopy in the myocardium and in a non-ischaemic skeletal muscle, which served as a control. Pre-revascularisation values of all spectroscopy parameters were 40-50% lower in the myocardium than in the control.