Subject(s)
Blood Coagulation Disorders/blood , Cardiopulmonary Bypass/adverse effects , Extracorporeal Circulation/adverse effects , Hemostasis , Blood Cell Count , Blood Platelets , Fibrin Fibrinogen Degradation Products/blood , Fibrinogen/analysis , Fibrinolysin/analysis , Hematocrit , Humans , Plasminogen/analysis , Platelet Adhesiveness , Protamines/pharmacology , Prothrombin Time , Thrombin/analysis , Time FactorsABSTRACT
The effects of aspirin on well-standardized commercially produced platelet adhesiveness devices and template bleeding times were simultaneously studied in 19 normal volunteers. As expected, there was significant prolongation of the bleeding time after aspirin, but there was no change in platelet adhesion. Reason for the different effects of aspirin on the two tests are discussed. In addition, the normal range of platelet adhesion was further defined utilizing commercially prepared glass-bead columns.
Subject(s)
Aspirin/pharmacology , Blood Coagulation/drug effects , Platelet Adhesiveness/drug effects , Adult , Female , Humans , MaleABSTRACT
A prothrombin complex concentrate was used in attempts to control life-threatening hemorrhage in 4 patients with chronic liver disease. The population manifested profuse bleeding from varices and/or hemorrhagic gastritis; 3 had Laennec's cirrhosis and 1 had postnecrotic cirrhosis from childhood hepatitis. In all patients the complex was given in amounts needed to raise the prothrombin (factor II) level to approximately 100% of normal. In all 4 cases the prothrombin time and prothrombin complex factors approached normal within 1-2 hr after beginning the infusion. In all patients bleeding ceased with correction of the clotting status. One patient rebled several hours after completing the infusion. In several patients, increases in factors V and VIII were noted following infusion of the concentrate. A further unexpected finding was a spontaneous increase in factors II and IX at 3 days postinfusion. Prothrombin complex concentrate appears to be useful in controlling the hemorrhage of chronic liver disease when used alone or in combination with other modalities to correct specific hemostatic defects; however, patients may be expected to rebleed when the effect of the concentrate wears off. Its use, therefore, should probably be restricted to those patients who are to undergo corrective surgery of the bleeding point once hemostasis is achieved.
Subject(s)
Fatty Liver/complications , Gastrointestinal Hemorrhage/prevention & control , Hemorrhagic Disorders/prevention & control , Liver Cirrhosis/complications , Liver Diseases/complications , Prothrombin/therapeutic use , Adult , Alcoholism/blood , Alcoholism/complications , Blood Coagulation Tests , Chronic Disease , Factor IX/metabolism , Factor V/metabolism , Factor VII/metabolism , Factor VIII/metabolism , Fatty Liver/blood , Female , Gastrointestinal Hemorrhage/blood , Half-Life , Hemorrhagic Disorders/blood , Hemorrhagic Disorders/etiology , Humans , Kinetics , Liver Cirrhosis/blood , Liver Diseases/blood , Male , Middle Aged , Necrosis , Prothrombin/metabolism , Prothrombin Time , Syndrome , Time FactorsSubject(s)
Hemorrhage/etiology , Tracheotomy/adverse effects , Adult , Brachiocephalic Trunk , Female , Fistula/complications , Fistula/etiology , Humans , Methods , Postoperative Complications/surgery , Suture Techniques , Sutures , Time Factors , Tracheal Diseases/complications , Tracheal Diseases/etiology , Tracheoesophageal Fistula/complications , Tracheoesophageal Fistula/etiology , Ventilators, MechanicalABSTRACT
Left atrial myxomas may present with signs of mitral valve obstruction, embolic phenomena or systemic disease. The diagnosis is suspected on clinical grounds and confirmed by angiocardiography. However, the tumor may be unexpectedly discovered on surgical exploration. Once the diagnosis is established, operation, using cardiopulmonary bypass, should be done promptly. A coexisting valvular lesion should be looked for. Complete cure may be expected, especially if the involved atrial septum is excised and repaired by patch replacement.