Fulminant intraoperative right heart and pulmonary artery thrombosis following prothrombin complex concentrate infusion after complex open heart surgery with cardiopulmonary bypass.

Prothrombin complex concentrates are increasingly used during complex cardiac surgery with cardiopulmonary bypass. Reports describing massive thromboembolism after administration of prothrombin complex concentrates are rare. We report a case of a patient developing massive intracardiac and pulmonary artery thrombus formations during infusion of a moderate dose of prothrombin complex concentrate after separation from cardiopulmonary bypass for complex open heart surgery.

Fulminate heparin-induced thrombocytopenia and surgery with deep hypothermic circulatory arrest using bivalirudin.

After on-pump coronary artery bypass graft surgery, a patient had acute heparin-induced thrombocytopenia with thoracic arterial and venous thrombus formations. Complex emergency surgery with cardiopulmonary bypass and deep hypothermic circulatory arrest using bivalirudin anticoagulation was performed.

[Realisation of material costs in anaesthesia. Alternatives to the reimbursement via diagnosis-related groups].

Background And Goal: For reimbursement via diagnosis-related groups (DRG), lump compensation-based payment of medical cases in German hospitals requires a case-related measuring and billing of resources that has to be consistent with DRG guidelines. Only through this, can the real costs be compared with the standard costs as calculated by the hospital reimbursment system (InEK) on a case-related basis and the DRG-specific break-even level be identified.

Methods: In the present paper the authors introduce and validate two newly created alternative methods for case-related allocation of material costs in the field of anaesthesia.