Conjugated estrogen reduces transfusion and coagulation factor requirements in orthotopic liver transplantation.

Abstract:

UNLABELLED:We conducted a prospective, randomized study to determine the efficacy of conjugated estrogen in reducing blood product transfusion during orthotopic liver transplantation (OLT). Patients undergoing OLT were included in the study. Only those having a reaction time of more than 30 mm or 15 min (19 -28 mm) on computed thromboelastography (CTEG) at the beginning of surgery were enrolled in the study. Patients were randomized to receive either conjugated estrogen (CE) or placebo. Every patient received a first dose of CE (100 mg i.v.) (20 mL) or placebo (20 mL of isotonic sodium chloride solution) at the beginning of the procedure and a second dose of CE (100 mg i.v.) or 20 mL of placebo (20 mL of isotonic sodium chloride solution) just after reperfusion of the new graft. The two groups were similar in age, weight, requirement for veno-veno bypass, time on veno-veno bypass, CTEG measurement, and preoperative hemoglobin and platelet values. Blood products were given in relation to hematocrit and coagulation (CTEG) variables, which were measured every hour during the surgery. The amount of transfused blood products did not differ in terms of units of cryoprecipitate, but the intraoperative requirements for red blood cells (6 +/- 3 vs 9 +/- 6 U; P = 0.05), platelets (12 +/- 8 U vs 18 +/- 10 U; P = 0.05) and fresh-frozen plasma (3 +/- 3 U vs 6 +/- 4 U; P = 0.001) was significantly less in the estrogen group than in the control group. We conclude that CE is associated with a significant decrease in use of fresh-frozen plasma, platelets, and red blood cells during OLT. IMPLICATIONS:In this study, we prospectively investigated whether i.v. conjugated estrogen could decrease blood product transfusion during orthotopic liver transplantation. Conjugated estrogen-treated patients received less fresh-frozen plasma, red blood cells, and platelets. In this population of patients, conjugated estrogen can be a useful addition in coagulation management during orthotopic liver transplantation.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Frenette L,Cox J,McArdle P,Eckhoff D,Bynon S

doi

10.1097/00000539-199806000-00008

subject

Has Abstract

pub_date

1998-06-01 00:00:00

pages

1183-6

issue

6

eissn

0003-2999

issn

1526-7598

journal_volume

86

pub_type

临床试验,杂志文章,随机对照试验
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    abstract::Phenomena seen in axons exposed to subblocking doses serve as the basis for interpreting clinical and behavioral observations during onset and recovery of peripheral nerve block. To delineate the changes in excitability and in impulse conduction caused by subblocking concentrations of local anesthetics (LAs) in myelin...

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    doi:10.1213/00000539-199212000-00008

    authors: Raymond SA

    更新日期:1992-12-01 00:00:00

  • Regional cerebral oxygen saturation during electroconvulsive therapy: monitoring by near-infrared spectrophotometry.

    abstract::Electroconvulsive therapy (ECT) increases neuronal energy consumption and alters systemic hemodynamics. We examined the effects of ECT on regional cerebral oxygen saturation (rSo2) using a near-infrared spectro-photometer. Heart rate (HR), mean arterial blood pressure (MAP), and rSo2 were continuously monitored throug...

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    doi:10.1097/00000539-199610000-00011

    authors: Saito S,Miyoshi S,Yoshikawa D,Shimada H,Morita T,Kitani Y

    更新日期:1996-10-01 00:00:00

  • Renal function and proteinuria after cardiopulmonary bypass: the effects of temperature and mannitol.

    abstract::We studied three groups of patients without previous renal impairment, undergoing elective coronary artery bypass surgery. Group H (n = 7) underwent open heart surgery using moderate hypothermia (28 degrees C); Groups N and M (n = 8, each) were managed at normothermia. The extracorporeal circuit was primed with Hartma...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199405000-00004

    authors: Ip-Yam PC,Murphy S,Baines M,Fox MA,Desmond MJ,Innes PA

    更新日期:1994-05-01 00:00:00

  • The inhibitory effect of bupivacaine on prostaglandin E(2) (EP(1)) receptor functioning: mechanism of action.

    abstract::Prostaglandin E(2) receptors, subtype EP(1) (PGE(2)EP(1)) have been linked to several physiologic responses, such as fever, inflammation, and mechanical hyperalgesia. Local anesthetics modulate these responses, which may be due to direct interaction of local anesthetics with PGE(2)EP(1) receptor signaling. We sought t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200109000-00019

    authors: Hönemann CW,Heyse TJ,Möllhoff T,Hahnenkamp K,Berning S,Hinder F,Linck B,Schmitz W,van Aken H

    更新日期:2001-09-01 00:00:00

  • Factors Associated With Failure of Spinal Anesthetic: An 8-Year Retrospective Analysis of Patients Undergoing Elective Hip and Knee Joint Arthroplasty.

    abstract::The primary outcome of this 8-year retrospective review was the failure of spinal anesthetic (SA) in elective hip and knee joint arthroplasty surgery. Of 3542 SAs, a total of 135 failures were identified (3.8%). Factors associated with increased odds of failure were younger age (odds ratio [OR], 1.03; 95% confidence i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/ANE.0000000000004304

    authors: Colish J,Milne AD,Brousseau P,Uppal V

    更新日期:2020-01-01 00:00:00

  • Propofol inhibits ketamine-induced c-fos expression in the rat posterior cingulate cortex.

    abstract:UNLABELLED:Ketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, has psychotomimetic activity. NMDA receptor antagonists cause morphological damage in the posterior cingulate cortex, which may be the brain region responsible for their psychotomimetic effects. Benzodiazepines are effective in preve...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199812000-00040

    authors: Nagata A,Nakao S,Miyamoto E,Inada T,Tooyama I,Kimura H,Shingu K

    更新日期:1998-12-01 00:00:00

  • Lack of CNS depression from large doses of trimethaphan in sheep.

    abstract::It is not uncommon to observe prolonged CNS depression for several hours following controlled hypotension and halothane anesthesia for neurosurgery. The present study evaluates possible contribution of large doses of trimethaphan to CNS depression. Four adult sheep were placed on transapical left ventricular bypass (T...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197701000-00005

    authors: Wong KC,Peters JL,Roberts TS,McRea JC,Fukumasu H

    更新日期:1977-01-01 00:00:00

  • Leg warming minimizes core hypothermia during abdominal surgery.

    abstract::The efficacy of leg skin warming in preventing hypothermia and shivering was evaluated in two separate prospective, randomized trials in patients undergoing abdominal surgery. In the first trial, 22 patients were randomized to receive no hypothermia prevention (control group) or active warming with an electric warming...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199311000-00021

    authors: Camus Y,Delva E,Just B,Lienhart A

    更新日期:1993-11-01 00:00:00

  • Pathogenic Link Between Postextubation Pneumonia and Ventilator-Associated Pneumonia: An Experimental Study.

    abstract:BACKGROUND:The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001899

    authors: Rezoagli E,Zanella A,Cressoni M,De Marchi L,Kolobow T,Berra L

    更新日期:2017-04-01 00:00:00

  • Thromboelastography for monitoring prolonged hypercoagulability after major abdominal surgery.

    abstract:UNLABELLED:Despite clinical and laboratory evidence of perioperative hypercoagulability, there are no consistent data evaluating the extent, duration, and specific contribution of platelets and procoagulatory proteins by in vitro testing. We tested the hypothesis that the parallel use of standard and abciximab-cytochal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200103000-00004

    authors: Mahla E,Lang T,Vicenzi MN,Werkgartner G,Maier R,Probst C,Metzler H

    更新日期:2001-03-01 00:00:00

  • Solubility of I-653, sevoflurane, isoflurane, and halothane in plastics and rubber composing a conventional anesthetic circuit.

    abstract::This study defines some characteristics of a standard anesthetic circuit that may impede anesthetic induction and recovery with I-653, sevoflurane, isoflurane, and halothane. Partition coefficients for anesthetic circuit components (masks, bellows, bags, airways, and circuit tubes) consistently ranked halothane greate...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Targ AG,Yasuda N,Eger EI 2nd

    更新日期:1989-08-01 00:00:00

  • Anesthetic considerations for cerebral computer tomography.

    abstract::Cerebral computer tomography is a recently introduced neuroradiologic procedure involving tomographic x-rays of horizontal brain sections. Although most adults undergo the procedure without anesthesia, children and uncooperative adults must be given general anesthesia for absolute immobility. Of 84 procedures under ge...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197705000-00005

    authors: Ferrer-Brechner T,Winter J

    更新日期:1977-05-01 00:00:00

  • Special article: airway management in reconstructive surgery for noma (cancrum oris).

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    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182908e6f

    authors: Coupe MH,Johnson D,Seigne P,Hamlin B

    更新日期:2013-07-01 00:00:00

  • The mechanism of helium-induced preconditioning: a direct role for nitric oxide in rabbits.

    abstract:BACKGROUND:Helium produces preconditioning against myocardial infarction by activating prosurvival signaling, but whether nitric oxide (NO) generated by endothelial NO synthase plays a role in this phenomenon is unknown. We tested the hypothesis that NO mediates helium-induced cardioprotection in vivo. METHODS:Rabbits...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181815995

    authors: Pagel PS,Krolikowski JG,Pratt PF Jr,Shim YH,Amour J,Warltier DC,Weihrauch D

    更新日期:2008-09-01 00:00:00

  • A simple technique to reduce epistaxis and nasopharyngeal trauma during nasotracheal intubation in a child with factor IX deficiency having dental restoration.

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    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000133914.26066.99

    authors: Delgado AV,Sanders JC

    更新日期:2004-10-01 00:00:00

  • Hemodynamic response to caudal epidural clonidine in a pediatric cardiac patient.

    abstract:IMPLICATIONS:Postoperative management of sedation and analgesia in pediatric cardiac patients presents many challenges. This case report describes a child who experienced dramatic clinical improvement with the postoperative use of caudal morphine and clonidine after conventional therapy had failed. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200301000-00019

    authors: Diaz LK,Cantu F

    更新日期:2003-01-01 00:00:00

  • Exhaled Propofol Concentrations Correlate With Plasma and Brain Tissue Concentrations in Rats.

    abstract:BACKGROUND:Propofol can be measured in exhaled gas. Exhaled and plasma propofol concentrations correlate well, but the relationship with tissue concentrations remains unknown. We thus evaluated the relationship between exhaled, plasma, and various tissue propofol concentrations. Because the drug acts in the brain, we f...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004701

    authors: Müller-Wirtz LM,Maurer F,Brausch T,Kiefer D,Floss M,Doneit J,Volk T,Sessler DI,Fink T,Lehr T,Kreuer S

    更新日期:2021-01-01 00:00:00

  • Influence of Remifentanil on the Control Performance of the Bispectral Index Controlled Bayesian-Based Closed-Loop System for Propofol Administration.

    abstract:BACKGROUND:This study investigated the clinical performance of a model-based, patient-individualized closed-loop (CL) control system for propofol administration using the bispectral index (BIS) as a controlled variable during the induction and maintenance of anesthesia with propofol and remifentanil and studied the inf...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004208

    authors: Neckebroek M,Boldingh JHL,De Smet T,Struys MMRF

    更新日期:2020-06-01 00:00:00

  • Kinetics of anesthetic onset measured with a direct index of neural activity.

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    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182549490

    authors: Drummond GB,Bleach L,Thomson AJ,Kennedy RR

    更新日期:2012-09-01 00:00:00

  • Long-term pain vulnerability after surgery in rats: prevention by nefopam, an analgesic with antihyperalgesic properties.

    abstract:BACKGROUND:Tissue damage associated with surgery often produces peripheral and central sensitization that may outlast the stimuli, leading to exaggerated postoperative pain. Paradoxically, the use of opioid analgesia, which is essential for surgical pain management may induce pain sensitization leading to enhanced post...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181aa956b

    authors: Laboureyras E,Chateauraynaud J,Richebé P,Simonnet G

    更新日期:2009-08-01 00:00:00

  • Perioperative Management of the Patient With a Left Ventricular Assist Device for Noncardiac Surgery.

    abstract::The pandemic of heart failure and the limited options for treatment of end-stage disease have resulted in an increase in the utilization of left ventricular assist devices (LVADs). Improvements in device technology and patient survival have led to an expanding population of patients requiring noncardiac surgery while ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000002669

    authors: Chung M

    更新日期:2018-06-01 00:00:00

  • Subhypnotic doses of propofol possess direct antiemetic properties.

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    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199204000-00013

    authors: Borgeat A,Wilder-Smith OH,Saiah M,Rifat K

    更新日期:1992-04-01 00:00:00

  • Dolasetron versus ondansetron for the treatment of postoperative nausea and vomiting.

    abstract::The management of postoperative nausea and vomiting (PONV) remains a persistent problem. Despite the use of prophylactic antiemetics, breakthrough nausea and vomiting still frequently occur. There have been no published studies comparing dolasetron and ondansetron for the treatment of PONV. This was a prospective, ran...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000144421.96275.D1

    authors: Meyer TA,Roberson CR,Rajab MH,Davis J,McLeskey CH

    更新日期:2005-02-01 00:00:00

  • 2,6 di-tert-butylphenol, a nonanesthetic propofol analog, modulates alpha1beta glycine receptor function in a manner distinct from propofol.

    abstract::The anesthetic propofol (2,6 diisopropylphenol) mediates some of its effects by activating inhibitory chloride currents in the lower brainstem and spinal cord. The effects comprise direct activation of gamma-aminobutyric acid-A and glycine receptors in the absence of the natural agonist, as well as potentiation of the...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000120083.10269.54

    authors: Ahrens J,Haeseler G,Leuwer M,Mohammadi B,Krampfl K,Dengler R,Bufler J

    更新日期:2004-07-01 00:00:00

  • GABA(A) receptor blockade antagonizes the immobilizing action of propofol but not ketamine or isoflurane in a dose-related manner.

    abstract:UNLABELLED:The enhancing action of propofol on gamma-amino-n-butyric acid subtype A (GABA(A)) receptors purportedly underlies its anesthetic effects. However, a recent study found that a GABA(A) antagonist did not alter the capacity of propofol to depress the righting reflex. We examined whether the noncompetitive GABA...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

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    authors: Sonner JM,Zhang Y,Stabernack C,Abaigar W,Xing Y,Laster MJ

    更新日期:2003-03-01 00:00:00

  • Intracranial hypotension caused by cervical cerebrospinal fluid leak: treatment with epidural blood patch.

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    journal_title:Anesthesia and analgesia

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    doi:10.1213/01.ane.0000117225.31416.36

    authors: Cousins MJ,Brazier D,Cook R

    更新日期:2004-06-01 00:00:00

  • The anesthetic and recovery profile of two doses (60 and 80 mg) of plain mepivacaine for ambulatory spinal anesthesia.

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    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

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    authors: Pawlowski J,Sukhani R,Pappas AL,Kim KM,Lurie J,Gunnerson H,Corsino A,Frey K,Tonino P

    更新日期:2000-09-01 00:00:00

  • The effect of universal leukodepletion of packed red blood cells on postoperative infections in high-risk patients undergoing abdominal aortic surgery.

    abstract:UNLABELLED:We evaluated, by using a before-and-after study, the influence of leukoreduction by filtration on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery. From January 1995 to October 2000, all patients who underwent elective abdominal aortic surgery were included i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200203000-00010

    authors: Baron JF,Gourdin M,Bertrand M,Mercadier A,Delort J,Kieffer E,Coriat P

    更新日期:2002-03-01 00:00:00

  • Total Joint Replacement Perioperative Surgical Home Program: 2-Year Follow-Up.

    abstract:BACKGROUND:Previously, our group successfully established one of the nation's first Perioperative Surgical Homes (PSHs) aimed at coordinating services to patients undergoing primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). As we now focus on extending the PSH to other service lines within...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001308

    authors: Cyriac J,Garson L,Schwarzkopf R,Ahn K,Rinehart J,Vakharia S,Cannesson M,Kain Z

    更新日期:2016-07-01 00:00:00

  • Local GABA(A) receptor blockade reverses isoflurane's suppressive effects on thalamic neurons in vivo.

    abstract::Many in vitro effects of volatile anesthetics are known, but the mechanisms of action are still under debate. Because suppression of sensory perception is one of the major goals of general anesthesia, we studied the effects of isoflurane on the processing of somatosensory information in anesthetized rats. Local iontop...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200106000-00046

    authors: Vahle-Hinz C,Detsch O,Siemers M,Kochs E,Bromm B

    更新日期:2001-06-01 00:00:00