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The UK guidelines for the use of desmopressin in patients with von Willebrand's disease. Von Willebrand Working Party of the United Kingdom Haemophilia Centre Director's Organization. 血管性血友病患者使用去氨加压素的英国指南。英国血友病中心主任组织冯·维勒布兰德工作组。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01 DOI: 10.1097/00003643-199703001-00004
S Lethagen, P Flordal, H Van Aken, B J Hunt, M Cattaneo
{"title":"The UK guidelines for the use of desmopressin in patients with von Willebrand's disease. Von Willebrand Working Party of the United Kingdom Haemophilia Centre Director's Organization.","authors":"S Lethagen,&nbsp;P Flordal,&nbsp;H Van Aken,&nbsp;B J Hunt,&nbsp;M Cattaneo","doi":"10.1097/00003643-199703001-00004","DOIUrl":"https://doi.org/10.1097/00003643-199703001-00004","url":null,"abstract":"<p><p>A document entitled Guidelines for the Diagnosis and Management of von Willebrand's Disease was produced by the von Willebrand Working Party of the United Kingdom Haemophilia Centre Directors' Organization. Under the chairmanship of Dr Beverley Hunt, an independent board of haematologists and anaesthesiologists reviewed the use of a synthetic vasopressin analogue, desmopressin (DDAVP), in the management of patients with von Willebrand's disease. The Advisory Board considered that production of the guidelines was to be applauded, but that the contraindications for DDAVP were imprecisely defined and may thus be misleading. This paper summarizes the Advisory Board's discussion of the suggestions.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"14 ","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20040362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Measurement of blood loss in clinical studies. 临床研究中失血量的测量。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01 DOI: 10.1097/00003643-199703001-00007
P A Flordal
{"title":"Measurement of blood loss in clinical studies.","authors":"P A Flordal","doi":"10.1097/00003643-199703001-00007","DOIUrl":"https://doi.org/10.1097/00003643-199703001-00007","url":null,"abstract":"<p><p>Direct measurement of blood loss has poor reliability and poor validity. A formula is proposed for how blood loss may be calculated from pre- and post-operative haemoglobin, taking the influence of any blood transfusions into account.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"14 ","pages":"35-7"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20040365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 29
Desmopressin--a haemostatic drug: state-of-the-art review. 去氨加压素——一种止血药物:最新研究综述。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01
S Lethagen
{"title":"Desmopressin--a haemostatic drug: state-of-the-art review.","authors":"S Lethagen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Desmopressin is a well tolerated and convenient haemostatic drug that can be used in a number of clinical conditions with bleeding diathesis. It has several effects on the haemostatic system, causing endogenous release of coagulation factor VIII, von Willebrand factor, tissue plasminogen activator and also increasing platelet adhesiveness and shortening bleeding time. The effect is virtually immediate and lasts for several hours. Side-effects are few and mostly mild. Desmopressin is suitable for home use in selected patients with bleeding diathesis. The optimal dosage is 0.3 microgram kg-1 intravenously, but the drug may also be administered subcutaneously or intranasally. In addition to the established indications, haemophilia A, von Willebrand's disease and platelet dysfunction, the drug may also be used safely in other patients with unexpected bleeding during or after surgery. The effectiveness of general prophylactic use of desmopressin, in order to diminish surgical blood loss and transfusion requirements, has not been proven, except in patients with known bleeding diathesis caused by congenital or acquired haemostatic disorders, e.g. in those taking aspirin.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"14 ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20040360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacological prophylaxis of bleeding in surgical patients treated with aspirin. 阿司匹林治疗外科病人出血的药理学预防。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01 DOI: 10.1097/00003643-199703001-00008
P A Flordal
{"title":"Pharmacological prophylaxis of bleeding in surgical patients treated with aspirin.","authors":"P A Flordal","doi":"10.1097/00003643-199703001-00008","DOIUrl":"https://doi.org/10.1097/00003643-199703001-00008","url":null,"abstract":"<p><p>A Medline search and subsequent meta-analysis shows that pre-operative aspirin increases blood loss and transfusion requirements in patients undergoing coronary artery bypass grafting. Both aprotinin and desmopressin are effective in counteracting this. There are almost no data on the effects of bleeding of aspirin, aprotinin and desmopressin in other procedures.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"14 ","pages":"38-41"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20040366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 24
Desmopressin and bleeding during invasive surgery. 有创手术中的去氨加压素和出血。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01 DOI: 10.1097/00003643-199703001-00009
B J Hunt
{"title":"Desmopressin and bleeding during invasive surgery.","authors":"B J Hunt","doi":"10.1097/00003643-199703001-00009","DOIUrl":"https://doi.org/10.1097/00003643-199703001-00009","url":null,"abstract":"<p><p>Peri-operative bleeding is associated with invasive surgery and has traditionally been compensated for by blood transfusion. Concerns about the risk of transfusion-transmitted disease have led to an increasing interest in synthetic haemostatic agents. Desmopressin (1-deamino-8-D-arginine vasopressin), a synthetic analogue of vasopressin, has been shown to be of benefit in the peri-operative management of von Willebrand's disease or mild haemophilia A. This paper addresses the role of desmopressin and bleeding during invasive surgery, particularly during cardiopulmonary bypass. Clinical trials using desmopressin in open cardiac surgery indicate that it may reduce blood loss in those with an excessive bleeding tendency. However, it is difficult to identify this group pre-operatively.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"14 ","pages":"42-7; discussion 47-9"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20040367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Guidelines for the diagnosis and management of von Willebrand's disease. 血管性血友病的诊断和治疗指南。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01
M Cattaneo, B J Hunt, H Van Aken, P A Flordal, S Lethagen
{"title":"Guidelines for the diagnosis and management of von Willebrand's disease.","authors":"M Cattaneo,&nbsp;B J Hunt,&nbsp;H Van Aken,&nbsp;P A Flordal,&nbsp;S Lethagen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"14 ","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20040363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Strategies to reduce the need for peri-operative blood transfusion. 减少围手术期输血需求的策略。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01 DOI: 10.1097/00003643-199703001-00006
N Mertes, M Booke, H Van Aken
{"title":"Strategies to reduce the need for peri-operative blood transfusion.","authors":"N Mertes,&nbsp;M Booke,&nbsp;H Van Aken","doi":"10.1097/00003643-199703001-00006","DOIUrl":"https://doi.org/10.1097/00003643-199703001-00006","url":null,"abstract":"<p><p>Therapeutic regimens involving the transfusion of blood components are a matter of debate, not only with regard to patients' safety, but also with regard to cost-effectiveness. The following different measures to reduce the use of blood components and their efficacy are discussed: autologous transfusion, including predonation, isovolaemic haemodilution and peri-operative retransfusion; toleration of a lower haematocrit; and measures to reduce blood loss. In particular, a combination of these methods may be most effective at reducing transfusion needs.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"14 ","pages":"24-32; discussion 33-4"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20040364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Desmopressin--a haemostatic drug: state-of-the-art review. 去氨加压素——一种止血药物:最新研究综述。
European journal of anaesthesiology. Supplement Pub Date : 1997-03-01 DOI: 10.1097/00003643-199703001-00002
S. Lethagen
{"title":"Desmopressin--a haemostatic drug: state-of-the-art review.","authors":"S. Lethagen","doi":"10.1097/00003643-199703001-00002","DOIUrl":"https://doi.org/10.1097/00003643-199703001-00002","url":null,"abstract":"Desmopressin is a well tolerated and convenient haemostatic drug that can be used in a number of clinical conditions with bleeding diathesis. It has several effects on the haemostatic system, causing endogenous release of coagulation factor VIII, von Willebrand factor, tissue plasminogen activator and also increasing platelet adhesiveness and shortening bleeding time. The effect is virtually immediate and lasts for several hours. Side-effects are few and mostly mild. Desmopressin is suitable for home use in selected patients with bleeding diathesis. The optimal dosage is 0.3 microgram kg-1 intravenously, but the drug may also be administered subcutaneously or intranasally. In addition to the established indications, haemophilia A, von Willebrand's disease and platelet dysfunction, the drug may also be used safely in other patients with unexpected bleeding during or after surgery. The effectiveness of general prophylactic use of desmopressin, in order to diminish surgical blood loss and transfusion requirements, has not been proven, except in patients with known bleeding diathesis caused by congenital or acquired haemostatic disorders, e.g. in those taking aspirin.","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"1 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89008910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 81
Patient sedation: technical problems and developments. 患者镇静:技术问题和进展。
European journal of anaesthesiology. Supplement Pub Date : 1996-07-01 DOI: 10.1097/00003643-199607001-00005
G N Kenny
{"title":"Patient sedation: technical problems and developments.","authors":"G N Kenny","doi":"10.1097/00003643-199607001-00005","DOIUrl":"https://doi.org/10.1097/00003643-199607001-00005","url":null,"abstract":"<p><p>Target-controlled infusion (TCI) systems have dramatically simplified the technique of total intravenous infusion. Systems have been used successfully to provide patient sedation during a variety of surgical procedures. Initial studies indicate that sedation for surgery is achieved rapidly without undue oversedation, and is easily maintained at a constant level. TCI systems have also been used successfully for patient-controlled analgesia (PCA). Using the analgesic alfentanil, good quality post-operative analgesia can be achieved without under- or overdosing. The recent development of using effector-site drug concentrations as a guide to the extent of sedation should allow fine control of patient sedation with TCI systems.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"13 ","pages":"18-21; discussion 22-5"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19809927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
Sedation during regional anaesthesia: indications, advantages and methods. 区域麻醉中的镇静:适应证、优点和方法。
European journal of anaesthesiology. Supplement Pub Date : 1996-07-01 DOI: 10.1097/00003643-199607001-00002
N Mackenzie
{"title":"Sedation during regional anaesthesia: indications, advantages and methods.","authors":"N Mackenzie","doi":"10.1097/00003643-199607001-00002","DOIUrl":"https://doi.org/10.1097/00003643-199607001-00002","url":null,"abstract":"<p><p>Patient management is a vital component of regional anaesthesia, and the appropriate method and level of sedation must be chosen for each patient on an individual basis. This may range from simple distraction through pharmacologically induced anxiolysis or hypnosis, to light general anaesthesia by the inhalational or intravenous routes. Intravenous sedation is most widely used and suitable agents include the benzodiazepines, the intravenous induction agents and the opioids. Currently, midazolam and propofol are considered to be the most suitable drugs. Patient safety must never be compromised and pharmacological sedation must be administered by a trained practitioner, with appropriate patient monitoring and provision of supplementary oxygen.</p>","PeriodicalId":11873,"journal":{"name":"European journal of anaesthesiology. Supplement","volume":"13 ","pages":"2-7; discussion 22-5"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19809924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
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