Abstract:
:Disseminated intravascular coagulation (DIC) is reported in neurosurgical patients; however, the incidence of DIC after craniotomy procedures is unknown. Using a surgical database, we identified 3164 patients who underwent primary craniotomy at Mayo Clinic Rochester between January 1, 2000 and December 31, 2004. Potential cases of DIC in this population were identified using 3 search triggers, patients: (1) in whom the diagnosis of DIC was noted on their hospital discharge summary, (2) who received red blood cell-free blood products, or (3) in whom a blood fibrinogen or d-dimer concentration was assessed. Using criteria based on laboratory values, we estimated the incidence of DIC developing within 72 hours of primary craniotomy to be between 13 and 44 per 10,000 patients. Despite a low incidence of DIC, the associated mortality rate was 43% to 75%. Traumatic head injury was a significant risk factor for the development of DIC [odds ratio of trauma was in the range of 16 (95% confidence interval (CI)=5.3-49) to 29 (CI=4.0-204)]. Autologous salvaged blood was administered intraoperatively to 44 patients, and 1 of these developed DIC. Although this small sample of patients receiving salvaged blood requires caution in interpreting the results, the risk of DIC seemed to be greater with salvaged blood than without [odds ratio 24 (CI=2.5-237)]. In children, 2 of 3 patients who developed DIC had congenital malformations of the brain. Findings from this study suggest that DIC is rare after craniotomy, but is often associated with mortality.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Pasternak JJ,Hertzfeldt DN,Stanger SR,Walter KR,Werts TD,Marienau ME,Lanier WLdoi
10.1097/ANA.0b013e318155b1c4subject
Has Abstractpub_date
2008-01-01 00:00:00pages
15-20issue
1eissn
0898-4921issn
1537-1921pii
00008506-200801000-00003journal_volume
20pub_type
杂志文章abstract::Patients receiving anticonvulsants such as phenytoin or carbamazepine may be resistant to neuromuscular blocking agents. The authors report the response to rapacuronium bromide (1.5 mg/kg) in two adult patients; one receiving phenytoin and the other receiving carbamazepine. In both patients, there was a delay in achie...
journal_title:Journal of neurosurgical anesthesiology
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abstract:INTRODUCTION:The exposure of anesthesiologists to organ recovery procedures and the anesthetic technique used during organ recovery has not been systematically studied in the United States. METHODS:A retrospective cohort study was conducted on all adult and pediatric patients who were declared brain dead between Janua...
journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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pub_type: 临床试验,杂志文章
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3182a43ed8
更新日期:2014-07-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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pub_type: 杂志文章,随机对照试验
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