Kooperativer Bibliotheksverbund

In: International Journal of Cardiology, Elsevier BV, Vol. 119 ( 2007-6), p. S19-S20

Type of Medium: Online Resource

ISSN: 0167-5273

URL: Article

DOI: 10.1016/j.ijcard.2007.03.050

Language: English

Publisher: Elsevier BV

Publication Date: 2007

detail.hit.zdb_id: 1500478-8

In: Blood Coagulation & Fibrinolysis, Ovid Technologies (Wolters Kluwer Health), Vol. 25, No. 4 ( 2014-06), p. 369-374

Type of Medium: Online Resource

ISSN: 0957-5235

URL: Article

DOI: 10.1097/MBC.0000000000000053

Language: English

Publisher: Ovid Technologies (Wolters Kluwer Health)

Publication Date: 2014

detail.hit.zdb_id: 2035229-3

In: Clinical and Applied Thrombosis/Hemostasis, SAGE Publications, Vol. 13, No. 4 ( 2007-10), p. 416-421

Abstract: the objective of this article was to find out how radiofrequency catheter ablation (RFA) influences platelet aggregation (PA), and the dependence on the total energy (TE) of RFA used and the cause of arrhythmia. We investigated 97 patients. PA was analyzed before, after, and in 24 hours after RFA. ADP- and epinephrine-induced PA significantly decreased after RFA by 5% and 8.9% ( P 〈 .001), respectively, and increased in 24 hours close to baseline. PA induced by ADP and collagen did not radically depend on the TE. Epinephrine-induced PA decreased after RFA by 0%, 8% ( P 〈 .05), and 16.9% ( P 〈 .01) in groups of patients where the TEs used were 〈 4000 J, 4000 to 15 000 J, and 〉 15 000 J, respectively. There were no significant differences in PA between groups based on the cause of arrhythmia. ADP- and epinephrine-induced PA significantly decreased after RFA and returned close to baseline in 24 hours. Epinephrine-induced PA was inversely associated with the TE used for RFA.

Type of Medium: Online Resource

ISSN: 1076-0296 , 1938-2723

URL: Article

DOI: 10.1177/1076029607303612

Language: English

Publisher: SAGE Publications

Publication Date: 2007

detail.hit.zdb_id: 2230591-9

In: Medicina, MDPI AG, Vol. 44, No. 12 ( 2008-12-10), p. 922-

Abstract: Objective. To determine the changes in platelet function, manifesting as deviations of their aggregation intensity, in persons with acute ischemic stroke and transient ischemic attacks, to evaluate the effect of aspirin on platelet aggregation, dependent upon degree of cerebral blood flow disturbances and patient’s gender, and to compare these changes with those in healthy persons. Material and methods. We examined 50 patients aged 33 to 98 years (mean age, 63.7±2.1 years; 20 men and 30 women) with cerebral blood flow disturbances during acute period (18 with transient ischemic attacks and 32 with ischemic stroke). The diagnosis was confirmed by computer tomography and other clinical examinations. Adenosine diphosphate-, epinephrine-, and collagen-induced platelet aggregation was assessed in platelet-rich plasma. Twelve patients used aspirin at prophylactic doses (100–150 mg/d), and 38 patients did not use. The control group consisted of 25 healthy persons aged 31–64 years (mean age, 45.4±1.9 years; 17 men and 8 women). Results. Increased platelet aggregation induced by all three inducers was significantly more frequent in stroke group. Platelet reaction to collagen was more expressed. Aspirin suppressed aggregation, but did not protect against development of ischemic stroke. Higher activity of platelet function during ischemic stroke was observed in platelets from men’s plasma. Conclusions. During acute period, platelet aggregation in platelet-rich plasma statistically significantly increases in the stroke group, independently of the severity of the disease. A part of patients, using recommended dose of prophylactic aspirin, developed ischemic stroke. The effect of aspirin on platelets was more pronounced in women than men.

Type of Medium: Online Resource

ISSN: 1648-9144

URL: Article

DOI: 10.3390/medicina44120115

Language: English

Publisher: MDPI AG

Publication Date: 2008

detail.hit.zdb_id: 2088820-X

In: Medicina, MDPI AG, Vol. 45, No. 9 ( 2009-09-08), p. 706-

Abstract: Objective. To determine an influence of radiofrequency ablation on changes in coagulation system. Material and methods. We investigated 30 patients with cardiac arrhythmias. Platelet aggregation, fibrinogen and D-dimer level were analyzed before, right after, 24 and 72 h after radiofrequency ablation. Platelet aggregation was explored in whole blood and platelet-rich plasma using adenosine diphosphate (ADP), epinephrine, and collagen for induction. Results. Platelet aggregation induced by ADP and collagen in whole blood plasma increased significantly (P 〈 0.01) (by 45% and 43%, respectively) in 24 h after radiofrequency ablation and remained increased in 72 h after radiofrequency ablation (by 11% and 35%, respectively) (P 〈 0.01) as compared with baseline results. Spontaneous aggregation of platelet-rich plasma as well as ADP- and collagen-induced platelet aggregation tended to decrease right after radiofrequency ablation. Epinephrine-induced platelet aggregation significantly decreased by 17.5% after radiofrequency ablation (P 〈 0.01) and started to increase in 24 h after radiofrequency ablation. In 72 h after radiofrequency ablation, platelet aggregation induced by different agonists increased by 7–45% significantly (P 〈 0.05), and values were higher than baseline ones. Fibrinogen level after radiofrequency ablation did not differ from that of the baseline (3.08±0.7 g/L), but D-dimer level increased significantly (from 0.39±0.3 to 1.29±2.4 mg/L, P 〈 0.01). In 24 h after radiofrequency ablation, an increase in fibrinogen level and a decrease in D-dimer level were found. Fibrinogen level increased to 3.32±0.6 g/L significantly in 72 h after radiofrequency ablation (P 〈 0.05). Meanwhile, D-dimer concentration decreased to 0.78±0.8 mg/L, but it was still significantly higher (P 〈 0.05) than the baseline value. Conclusion. Despite diminished platelet aggregation and increased D-dimer level right after radiofrequency ablation, a risk of thrombosis increased in the next few days after radiofrequency ablation.

Type of Medium: Online Resource

ISSN: 1648-9144

URL: Article

DOI: 10.3390/medicina45090092

Language: English

Publisher: MDPI AG

Publication Date: 2009

detail.hit.zdb_id: 2088820-X

In: Journal of Thrombosis and Thrombolysis, Springer Science and Business Media LLC, Vol. 37, No. 2 ( 2014-2), p. 177-185

Type of Medium: Online Resource

ISSN: 0929-5305 , 1573-742X

URL: Article

DOI: 10.1007/s11239-013-0940-x

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2014

detail.hit.zdb_id: 2017305-2

In: Perfusion, SAGE Publications, Vol. 22, No. 5 ( 2007-09), p. 345-352

Abstract: Various strategies have been proposed to decrease allogeneic blood transfusion requirements after cardiac surgery. The aim of the study was to evaluate the efficacy of collected and re-infused autologous shed mediastinal blood on a patient's postoperative course. Ninety patients who underwent heart surgery with cardiopulmonary bypass (CPB) were studied. The patients were divided into two groups: Group 1 ( n = 41) received the centrifuged autologous shed mediastinal blood collected from the cardiotomy reservoir 4 hours after surgery; in Group 2 ( n = 49) all shed mediastinal blood was discarded (control group). Haemoglobin (Hb), haematocrit (Hct), C-reactive protein values, and leucocyte count were compared before surgery, at 4 h and 20 h after surgery, and on the fifth postoperative day. We have measured serum procalcitonin (PCT) concentration at 4 h and 20 h after CPB. We assessed drained blood loss within 20 postoperative hours. Leucocyte count, Hb, Hct values, C-reactive protein, and procalcitonin concentration did not differ between the groups before and at 4 h after surgery. Hb, Hct level, and leucocyte count were similar at 20 hours and on the fifth day after surgery. At 20 hours after surgery, an increase of serum PCT concentration ( 〉 0.5—2 ng/mL) was more frequent in Group 2 (58.3% vs. 33.3%; p = 0.03). On the fifth postoperative day, C-reactive protein concentration was lower in Group 1 (71.74 ± 15.23; p 〈 0.01) compared to Group 2 (93.53 ± 20.3). Postoperative blood loss did not differ between the groups. Requirement for allogeneic blood transfusion was significantly lower in Group 1 (14.6% vs. 38.8%; p 〈 0.02). Patients in Group 1 developed less infective complications compared with Group 2 (2.4% and 16.3%, respectively; p 〈 0.05). The length of postoperative in-hospital stay was shorter in Group 1 compared with Group 2 (9.32 ± 2.55 and 16.45 ± 6.5, respectively; p 〈 0.05). We conclude that postoperative re-infusion of autologous red blood cells processed from shed mediastinal blood did not increase bleeding tendency and systemic inflammatory response and was effective in reducing the requirement for allogeneic transfusion, the rate of infective complications and the length of postoperative in-hospital stay. Perfusion (2007) 22, 345—352.

Type of Medium: Online Resource

ISSN: 0267-6591 , 1477-111X

URL: Article

DOI: 10.1177/0267659107088450

Language: English

Publisher: SAGE Publications

Publication Date: 2007

detail.hit.zdb_id: 2029611-3

In: Perfusion, SAGE Publications, Vol. 21, No. 1 ( 2006-01), p. 61-66

Abstract: The aim of the study was to assess the effect of aspirin or heparin pretreatment on platelet function and bleeding in the early postoperative period after coronary artery bypass grafting (CABG) surgery. Seventy-five male patients with coronary artery disease who underwent CABG with cardiopulmonary bypass (CPB) were studied. The patients were divided into three groups: Group 1 ( n = 25) included patients receiving aspirin pretreatment, Group 2 ( n = 22) received heparin pretreatment, and Group 3 ( n = 28) included patients who received no antiplatelet or anticoagulant pretreatment. Twenty-four hours after surgery, all patients were administered aspirin therapy that was continued throughout their hospitalization period. We assessed the following preoperative blood coagulation indices: activated partial thromboplastin time (aPTT), international normalized ratio (INR), and fibrinogen. We compared platelet count and platelet aggregation induced by adenosinediphosphate (ADP) before surgery, 1 h after surgery, 20 h after surgery and on the seventh postoperative day. We assessed drained blood loss within 20 postoperative hours. Preoperative blood coagulation indices did not differ among the groups. Platelet count was also similar. One hour after surgery, platelet count significantly decreased in all groups ( p 〈 0.001), after 20 postoperative hours it did not undergo any marked changes, and on the seventh postoperative day, it significantly increased in all groups ( p 〈 0.001). Before surgery, the lowest index of ADP-induced platelet aggregation was found in Group 1 ( p 〈 0.05). One hour after surgery, platelet aggregation significantly decreased in all groups, most markedly in Group 3 ( p 〈 0.001), yet after 20 h, its restitution tendency and a significant increase in all groups was noted. On the seventh day, a further increase in the statistical mean platelet aggregation value was noted in Groups 2 and 3. Comparison of platelet aggregation after 20 postoperative hours and on the seventh day after surgery revealed a significantly higher than 10% increase of the index in 32% of patients in Group 1 ( p 〈 0.05), 27.3% of patients in Group 2 ( p 〈 0.05) and in 35.7% of patients in Group 3 ( p 〈 0.001). The lowest statistically significant value of postoperative blood loss was noted in Group 2 ( p 〈 0.01). Our study has shown that aspirin or heparin pretreatment had no impact on the dynamics of platelet function in the early postoperative period after CABG. The lowest postoperative blood loss was noted in patients pretreated with heparin.

Type of Medium: Online Resource

ISSN: 0267-6591 , 1477-111X

URL: Article

DOI: 10.1191/0267659106pf845oa

Language: English

Publisher: SAGE Publications

Publication Date: 2006

detail.hit.zdb_id: 2029611-3

In: Lietuvos chirurgija, Vilnius University Press, Vol. 5, No. 3 ( 2007-01-01), p. 0-0

Abstract: Audronė Veikutienė1, Rimantas Benetis1, Edmundas Širvinskas2, Pranas Grybauskas3, Judita Andrejaitienė2, Vincentas Veikutis2, Jonas Šurkus41 Kauno medicinos universiteto klinikų Širdies,krūtinės ir kraujagyslių chirurgijos klinika, Eivenių g. 2, LT-50009 Kaunas2 Kauno medicinos universiteto Biomedicininių tyrimų institutas, Eivenių g. 2, LT-50009 Kaunas3 Kauno medicinos universiteto Kardiologijos institutas, Eivenių g. 2, LT-50009 Kaunas4 Kauno medicinos universiteto klinikų Nefrologijos klinika, Eivenių g. 2, LT-50009 KaunasEl paštas: aveikutiene@gmail.com Įvadas / tikslas Įvairūs metodai yra siūlomi alogeninio kraujo poreikiui po širdies operacijų sumažinti. Šio darbo tikslas – nustatyti, ar tikslinga naudoti reinfuzijai autologinį kraują, ištekėjusį ankstyvuoju pooperaciniu laikotarpiu, atsižvelgiant į reinfuzijos įtaką ligos pooperacinei eigai. Ligoniai ir metodai Ištirta 90 ligonių, kuriems atliktos širdies operacijos naudojant dirbtinę kraujo apytaką. Tiriamieji suskirstyti į dvi grupes. Pirmą grupę (n = 41) sudarė ligoniai, kuriems po operacijos per 4 valandas į kardiotominį rezervuarą išsiskyręs kraujas buvo surenkamas į sterilius plastikinius maišelius, centrifuguojamas, o gauti autologiniai eritrocitai grąžinami ligoniui. Antros grupės (n = 49) ligoniams išsiskyręs autologinis kraujas nebuvo grąžinamas. Palyginome hemoglobino, hematokrito, leukocitų, C reaktyviojo baltymo vertes prieš operaciją, po operacijos praėjus 4 val., 20 val. ir penktą parą. Tyrėme prokalcitonino koncentraciją serume praėjus 4 val. ir 20 val. po operacijos. Įvertinome netekto kraujo kiekį per 20 val. laikotarpį. Rezultatai Grupių demografiniai, intraoperaciniai duomenys, kairiojo skilvelio išstūmimo frakcija, NYHA funkcinė klasė nesiskyrė. Prieš operaciją ir praėjus 4 val. po operacijos hemoglobino, hematokrito, leukocitų, C reaktyviojo baltymo, prokalcitonino vertės grupėse buvo panašios. Hemoglobino, hematokrito vertės, leukocitų skaičius tarp grupių reikšmingai nesiskyrė ir po 20 val. bei penktą parą. Praėjus 20 val. po operacijos, prokalcitonino koncentracijos padidėjimas ( 〉 0,5–2 ng/ml) dažniau pasitaikė II grupės ligoniams (58,3% / 33,3%). Penktą parą C reaktyviojo baltymo vertė buvo mažesnė I grupėje (70,63 ± 34,23), palyginti su II grupe (93,53 ± 45,48; p 〈 0,05). Pooperacinis kraujo netekimas per pirmąsias 20 val. tarp grupių reikšmingai nesiskyrė. Alogeninio kraujo transfuzijų poreikis buvo reikšmingai mažesnis I grupės ligoniams: 14,6% / 38,8% (p 〈 0,05). Infekcinės komplikacijos registruotos I grupės 2,4% ligonių ir II grupės 10,2% ligonių (p 〈 0,05) Pooperacinio hospitalizavimo trukmė 35,19% buvo trumpesnė I grupės tiriamųjų (p 〈 0,05). Išvada Ankstyva po širdies operacijos ištekėjusio autologinio, centrifuguoto kraujo reinfuzija nedidino kraujavimo bei sisteminio uždegiminio atsako. Autologinių eritrocitų ankstyvos reinfuzijos grupėje mažėjo alogeninio kraujo transfuzijų poreikis, infekcinių komplikacijų rizika, buvo trumpesnė pooperacinio hospitalizavimo trukmė. Pagrindiniai žodžiai: autologinis kraujas, alogeninis kraujas, dirbtinė kraujo apytaka Benefit of early reinfusion of autologous shed mediastinal blood after cardiac surgery Audronė Veikutienė1, Rimantas Benetis1, Edmundas Širvinskas2, Pranas Grybauskas3, Judita Andrejaitienė2, Vincentas Veikutis2, Jonas Šurkus41 Kaunas University of Medicine Hospital, Department of Cardiothoracic and Vascular Surgery,Eivenių str. 2, LT-50009 Kaunas, Lithuania2 Kaunas University of Medicine, Institute for Biomedical Research,Eivenių str. 2, LT-50009 Kaunas, Lithuania3 Kaunas University of Medicine, Institute of Cardiology,Eivenių str. 2, LT-50009 Kaunas, Lithuania4 Kaunas University of Medicine Hospital, Department of Nefrology,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: aveikutiene@gmail.com Background / objective Various strategies have been proposed to decrease allogeneic transfusion requirements after cardiac surgery. The aim of the study was to evaluate the efficacy of collected and reinfused autologous shed mediastinal blood on the postoperative cource. Patients and methods We investigated 90 patients who underwent cardiac surgery with cardiopulmonary bypass. The patients were divided into two groups: group I (n = 41) received the centrifuged autologous shed mediastinal blood collected from the cardiotomy reservoir following 4 hours after surgery; in group II (n = 49) all shed mediastinal blood was discarded (control group). Haemoglobin, haematocrit, C-reactive protein values, leucocyte count were compared before surgery, 4 h, 20 h after surgery and on the fifth postoperative day. We have measured serum procalcitonin concentration at 4 h and 20 h after cardiopulmonary bypass. We assessed drained blood loss within 20 postoperative hours. Results There were no significant differences in patients’ demographic, operative data, left ventricle ejection fraction, NYHA functional class between the two groups. C-reactive protein, procalcitonin concentration, haemoglobin, haematocrit values, leucocyte count did not differ between the groups before and at 4 hours after surgery. Haemoglobin, haematocrit level, leucocyte count were similar at 20 hours and on the fifth day after surgery. At 20 hours after surgery, an increase of serum procalcitonin concentration ( 〉 0.5–2 ng/ml) was more frequent in group II (58.3% vs 33.3%). On the fifth postoperative day, the C-reactive protein value was lower in group I (70.63 ± 34.23; p 〈 0.05), compared to group II (93.53 ± 45.48). Postoperative blood loss did not differ between the groups. Requirement for allogeneic transfusion was significantly lower in group I (14.6% vs 38.8%; p 〈 0.05). Patients in group I developed less infective complications as compared with the group II (2.4% and 10.2%, respectively; p 〈 0.05). The length of postoperative in-hospital stay was shorter by 35.19% in group I (p 〈 0.05) as compared with group II. Conclusions Reinfusion of centrifuged autologous shed mediastinal blood did not increase bleeding tendency and systemic inflammatory response. Requirement for allogeneic transfusion, the risk of postoperative infection and the length of postoperative in-hospital stay was lower in autotransfused patients (group I). The estimation of serum procalcitonin concentration is a usable and rather informative test for evaluating inflammatory response activity after cardiac surgery. Key words: autologous blood, allogeneic blood, cardiopulmonary bypass

Type of Medium: Online Resource

ISSN: 1648-9942 , 1392-0995

URL: Article

DOI: 10.15388/LietChirur.2007.3.2201

Language: Unknown

Publisher: Vilnius University Press

Publication Date: 2007

In: Medicina, MDPI AG, Vol. 43, No. 9 ( 2007-09-08), p. 708-

Abstract: Background. Left ventricular remodeling is a complex pathologic process of progressive left ventricular dilatation, leading to dysfunction and heart failure in patients after myocardial infarction. Objective. To evaluate biochemical markers, reflecting cardiac remodeling process after first myocardial infarction and compare those markers with clinical characteristics of left ventricular remodeling. Material and methods. Brain natriuretic peptide, troponin I, creatine kinase, creatine kinase MB mass, lactate dehydrogenase levels were measured in 30 patients with acute myocardial infarction on days 1, 2, 3–7 . Brain natriuretic peptide was measured at 3 months, 6 months, and 2 years after myocardial infarction. Echocardiographic parameters of left ventricular remodeling were determined in acute phase (day 1–3), at 3 months, 6 months, and 2 years after MI. Results. In acute phase, brain natriuretic peptide level progressively increased according to worsening of left ventricular geometry: in normal left ventricle geometry group, brain natriuretic peptide level was 84.1 (58.7–121) pg/mL, in concentric remodeling group – 125 (69.2–165) pg/mL, in concentric hypertrophy group – 128 (74–368) pg/mL, and in eccentric hypertrophy group – 470 (459–494) pg/mL, P=0.02. Patients who had increased left ventricular end diastolic diameter index during 2-year period had higher brain natriuretic peptide level in the acute phase (584 (249–865) pg/mL vs. 120 (67–202) pg/mL, P=0.04) and also higher peak lactate dehydrogenase and troponin I levels. Conclusions. Brain natriuretic peptide level in acute phase of myocardial infarction is strongly associated with the markers of myocardial injury and related to left ventricular geometry changes and remodeling. Brain natriuretic peptide together with troponin I levels in acute phase of myocardial infarction might be useful in predicting subsequent cardiac function.

Type of Medium: Online Resource

ISSN: 1648-9144

URL: Article

DOI: 10.3390/medicina43090092

Language: English

Publisher: MDPI AG

Publication Date: 2007

detail.hit.zdb_id: 2088820-X