Massive bleeding with coagulopathy and hemorrhagic shock poses a potential threat to life in numerous clinical settings. Optimal treatment including the prevention of exsanguination necessitates a standardized and interdisciplinary approach. Several studies have shown the importance of massive transfusion protocols and standardized coagulation algorithms to improve survival of severely bleeding patients and to avoid secondary complications. Thus, the Helsinki declaration for patient safety in anesthesiology demands the implementation of clinical practice guidelines for the treatment of patients requiring massive transfusion. This paper introduces a standardized algorithm for the treatment of patients with massive bleeding which was developed in consensus with the German Society of Anaesthesiology and Intensive Care Medicine (DGAI).
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http://dx.doi.org/10.1007/s00101-012-2136-8 | DOI Listing |
J Neurosurg Case Lessons
January 2025
The Trauma and Neuroscience Institutes, St. John's Hospital and Medical Center, Tulsa, Oklahoma.
Background: Direct carotid-cavernous fistulas (CCFs) are relatively rare but dangerous complications of penetrating traumatic brain injury or maxillofacial trauma. A variety of clinical signs have been described, including ophthalmological and neurological ones. In some cases, severely altered cerebral blood flow can present as massive life-threatening bleeding through the nose, subarachnoid hemorrhage, and/or intraparenchymal hemorrhage.
View Article and Find Full Text PDFHerein, we report the cases of two patients with hemolysis, elevated liver enzymes, and low platelets syndrome who underwent emergent Cesarean sections that were complicated by massive hemorrhage due to undiagnosed hepatic rupture. Intraoperative General Surgery team intervention, early activation of massive transfusion protocol, hemostatic resuscitation, and transfer to ICU resulted in the survival of both patients.
View Article and Find Full Text PDFGynecol Oncol Rep
February 2025
Department of Obstetrics and Gynecology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Introduction: Musculocontractural Ehlers-Danlos syndrome (mcEDS) is a rare autosomal recessive connective tissue disorder caused by systemic depletion of dermatan sulfate. Symptoms characteristic of mcEDS include multiple contractures, fragile skin with subcutaneous bleeding, and hypermobile joints, which suggest difficulty in perioperative management. However, safe surgical techniques and perioperative management of this disorder remain unknown because of its rarity.
View Article and Find Full Text PDFSAGE Open Med Case Rep
January 2025
Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Uterine leiomyoma, also referred to as fibroid or myoma, is a prevalent benign tumor that can present with a range of clinical manifestations. The symptoms, which vary based on the tumor's location, size, and number, include pain, constipation, urinary disturbances, and abnormal menstrual bleeding. Certain types of uterine leiomyomas, such as pedunculated subserosal myomas or large degenerating cystic myomas, may closely mimic ovarian tumors, leading to significant diagnostic and management challenges.
View Article and Find Full Text PDFNeurol Res
January 2025
Department of Radiology, Bursa Uludag University, Bursa, Turkey.
Objectives: To evaluate success, complications and efficacy for endovascular management for carotid blowout syndrome.
Methods: Images were evaluated for contrast extravasation, vessel wall irregularity, pseudoaneurysm/aneurysm formation. Hemostatic results in the immediate postprocedural period and procedure related infarcts were assessed.
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