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Showing papers in "National Medical Journal of China in 1974"


Journal Article

14 citations


Journal Article
TL;DR: It is suggested that a supraceliac AXCT of less than 60 minutes and infusion of platelets and fresh frozen plasma prior to unclamping may be critical in preventing massive bleeding that so frequently occurs during thoracoabdominal aneurysm repair.
Abstract: Massive coagulopathy and bleeding continues to play a major role in the operative mortality and perioperative multi-system failure of patients requiring elective thoracoabdorninal aneurysm repair. It was the purpose of this study to determine the coagulation defect that occurs wi th supraceliac aortic clamping and the effects of increasing aortic cross-clamp time (AXCT) on the coagulation system and its recovery. Through a standard thoracoabdominal incision, 16 mongrel dogs had their aortas cross-clamped simultaneously just above the diaphragm and at the aortic bifurcation. Animals were divided into four groups of four animals each ; sham operation, 30 minute AXCT, 60 minute AXCT, and 90 minute AXCT. Central venous blood was sampled prior to aortic cross clamping (AXC), during AXC and 1 hour, 2 hours, 5 hours, 7 hours, 12 hours, and 24 hours after the clamp was removed. All samples were assayed for platelets, fibrinogen, fibrin split products, prothrombin time (PT) and partial thromboplastin time (PTT). Platelets and fibrinogen decreased as PT and PTT increased with increasing AXCT consistent with disseminated intravascular coagulation (DIC) (P < .OOl). Fibrin split products were positive in the 90 minute AXCT group only. The drop in platelets was greater for increasing AXCT and continued to fall in the 30, 60 and 90 minute AXCT groups at 24 hours (p < .OOl). Fibrinogen dropped to the lowest levels between two and twelve hours after AXC and returned to normal at twenty-four hours in the 60 and 90 minute AXCT groups (p < .05). PT was maximally prolonged between five and seven hours post AXC in the 60 and 90 minute AXC groups. PTT remained prolonged at 24 hours in all three experimental groups with a profound abnormality in the 90 minute AXC group (p< .OOl). These data suggest that increasing supraceliac AXCT from 0 to 90 minutes increases the degree of DIC which progressively improves within 24 hours for shorter clamp times. A supraceliac AXCT of less than 60 minutes and infusion of platelets and fresh frozen plasma prior to unclamping may be critical in preventing massive bleeding that so frequently occurs during thoracoabdominal aneurysm repair. (Ann Vasc Surg, 1987, 1,552-557).

13 citations




Journal Article
Fang Cc, Lin M, Sun Cm, Hong Liu, Lang Hy 

9 citations




Journal Article
Chin Cp, Meng H, Tung Hh, Ou-yang Y, Yuan C 

3 citations