Management of Hemostasis and Coagulopathies for Surgical and Critically Ill Patients

An Evidence-Based Approach
 
 
Elsevier (Verlag)
  • 1. Auflage
  • |
  • erschienen am 18. April 2016
  • |
  • 174 Seiten
 
E-Book | ePUB mit Adobe DRM | Systemvoraussetzungen
978-0-12-803569-6 (ISBN)
 

Management of Hemostasis and Coagulopathies for Surgical and Critically Ill Patients: An Evidence-Based Approach offers a concise guide to a sub-specialty of transfusion medicine from the clinical laboratory perspective. It focuses on the clinical tests that may be done during preoperative assessment, intraoperative, and postoperative assessment and management of surgical or critically ill patients. Management of hemostasis and coagulopathies is approached from an evidence-based perspective-the coagulation status of a patient according to the laboratory test results. Algorithms and decision-support software, designed by the authors, guide clinicians with an additional tool to base transfusion dosage on specific laboratory results, including the use of an artificial neural network for predicting more accurate blood use.

Chapters reflect the experience of all three authors who have successfully applied the algorithm for better patient management as well as decreased wastage of expensive blood products, from both the clinical laboratory/pathology and clinical medicine perspective. This book will appeal to a broad section of clinical laboratory and medical practitioners from hematopathology, to internal medicine, surgery, and anesthesiology. For hematopathologists and pathologists who are involved in laboratory medicine and transfusion medicine, this book will help them understand the proper utilization of blood products and how to avoid unnecessary waste and costs for the hospital. For general surgery practitioners, this book will provide practical guidelines on how to use blood products rationally for best medical practice. Internists will also gain insight from this book, learning which patients are at higher risk of bleeding during surgery so that they can alert their clinical colleagues.


  • Focuses on the clinical tests that may be done during preoperative assessment, intraoperative, and postoperative assessment and management
  • Explains new decision-support software developed by the authors as a tool for the management of bleeding patients
  • Reviews common coagulation based tests (indication and interpretation) that are used to assist in the management of bleeding patients
  • Provides an overview of various blood products, pharmacotherapeutic agents, antiplatelets, and anticoagulants, their usage strategy, indications, and therapy goals


Andy Nguyen received his BS and MS degrees in Mechanical Engineering from the University of Houston. He had been working as a mechanical engineer for 5 years prior to enrolling in medical school. He obtained his MD degree from the University of Texas Medical Branch-Galveston and received his pathology residency training from the Pathology and Laboratory Medicine Department of the University of Texas Health Sciences Center located at the Texas Medical Center at Houston. After completing his residency, he stayed on as a faculty member and is currently a Full Professor of Pathology and Laboratory Medicine. He has clinical and research interests in hematopathology, coagulopathy, and pathology informatics. Dr. Nguyen has published numerous scientific papers, written many invited review articles, and contributed to several textbooks. He has also received multiple teaching awards from the Pathology Department and from the Office of the Dean.
  • Englisch
  • San Diego
  • |
  • USA
Elsevier Science
  • 4,67 MB
978-0-12-803569-6 (9780128035696)
0128035692 (0128035692)
weitere Ausgaben werden ermittelt
  • Front Cover
  • Management of Hemostasis and Coagulopathies for Surgical and Critically Ill Patients
  • Copyright Page
  • Contents
  • Preface
  • 1 Coagulation-Based Tests and Their Interpretation
  • 1.1 Introduction
  • 1.2 Complete Blood Count
  • 1.3 Tests for Platelet Function
  • 1.3.1 PFA-100
  • 1.3.2 VerifyNow
  • 1.3.3 Plateletworks
  • 1.3.4 Platelet Aggregation
  • 1.4 Prothrombin Time
  • 1.5 Partial Thromboplastin Time
  • 1.6 Thrombin Time
  • 1.7 Fibrinogen Level
  • 1.7.1 D-Dimer
  • 1.7.2 Antithrombin III Level
  • 1.7.3 Mixing Study
  • 1.8 Thromboelastography
  • 1.8.1 Platelet Mapping
  • 1.8.2 Anti-Xa Assay
  • 1.8.3 Plasma-Diluted Thrombin Time
  • 1.9 Heparin-Induced Thrombocytopenia
  • 1.9.1 Bleeding Patient With Normal Coagulation Tests
  • 1.10 Conclusions
  • References
  • 2 Blood Bank Testing and Blood Products
  • 2.1 Introduction
  • 2.2 Blood Collection and Testings
  • 2.2.1 ABO/Rh(D) Typing
  • 2.2.2 Antibody Screen
  • 2.2.3 Antibody Identification by Extended (Panel) Testing
  • 2.2.4 Implications of the Presence of Antibodies
  • 2.2.5 Crossmatch
  • 2.3 Blood Components
  • 2.3.1 Whole Blood
  • 2.3.2 Packed Red Blood Cells
  • 2.3.3 Fresh Frozen Plasma
  • 2.3.4 Plasma Variants
  • 2.3.5 Platelets
  • 2.3.6 Cryoprecipitate
  • 2.4 Release of Blood Products
  • 2.4.1 Autologous Blood
  • 2.4.2 Transfusion Reactions
  • 2.4.3 Transfusion-Related Acute Lung Injury
  • 2.4.4 Transfusion-Related Graft-Versus-Host Disease
  • 2.5 Transfusion Reaction Workup
  • 2.5.1 RhIg
  • 2.6 Conclusions
  • References
  • 3 Pharmacotherapy With Antiplatelet, Anticoagulant, and Their Reversing Agents
  • 3.1 Introduction
  • 3.2 Antiplatelet and Anticoagulant Agents: An Overview
  • 3.3 Reversing Agents: An Overview
  • 3.4 Aspirin
  • 3.4.1 Monitoring Aspirin Therapy
  • 3.5 Adenosine Diphosphate Receptor Blockers
  • 3.5.1 Ticlopidine and Clopidogrel
  • 3.5.2 Prasugrel
  • 3.5.3 Ticagrelor
  • 3.5.4 Cangrelor
  • 3.5.4.1 Monitoring Therapy with ADP Receptor-Blocking Agents
  • 3.6 Glycoprotein IIB/IIIA Inhibitors
  • 3.7 Phosphodiesterase Inhibitors
  • 3.8 Thrombin Receptor Antagonist
  • 3.9 Warfarin
  • 3.9.1 Reversal of Warfarin Therapy
  • 3.10 Heparin and Low-Molecular-Weight Heparin
  • 3.10.1 Low-Molecular-Weight Heparin
  • 3.10.2 Reversible Agents for Heparin
  • 3.11 Direct Thrombin Inhibitors
  • 3.11.1 Parenterally Administered Direct Thrombin Inhibitors
  • 3.11.2 Orally Administered Direct Thrombin Inhibitors
  • 3.12 Factor XA Inhibitors
  • 3.13 Conclusions
  • References
  • 4 Antiplatelets and Anticoagulants
  • 4.1 Introduction
  • 4.2 Monitoring and Reversal for Coumadin
  • 4.2.1 Reversal of Coumadin With Supratherapeutic INR
  • 4.3 Monitoring and Reversal for Unfractionated Heparin
  • 4.3.1 Reversal of UFH
  • 4.4 Monitoring and Reversal for Bivalirudin (Angiomax)
  • 4.5 Monitoring and Reversal for Dabigatran
  • 4.6 Monitoring and Reversal for Rivaroxaban (Xarelto) and Apixaban
  • 4.7 Monitoring for Aspirin and P2Y12 Platelet Inhibitors
  • 4.8 Bridging Anticoagulants for Surgery
  • 4.9 Conclusions
  • References
  • 5 Preoperative Assessment of Patients
  • 5.1 Introduction
  • 5.2 History
  • 5.2.1 Medical History
  • 5.2.2 Surgical History
  • 5.2.3 Medication History
  • 5.2.4 Transfusion History
  • 5.3 Physical Examination
  • 5.4 Laboratory Testing
  • 5.4.1 Blood Bank Testing
  • 5.5 Antiplatelets and Anticoagulants: Impact on Surgery
  • 5.6 Commonly Used Antiplatelets and Anticoagulants
  • 5.6.1 Warfarin
  • 5.6.2 Heparin: Unfractionated and Low-Molecular-Weight Heparin
  • 5.6.3 Antiplatelet Drugs
  • 5.6.4 Bivalirudin (Angiomax) and Dabigatran
  • 5.6.5 Rivaroxaban (Xarelto) and Apixaban
  • 5.7 Conclusions
  • References
  • 6 Intraoperative and Postoperative Assessment and Management of Coagulopathy
  • 6.1 Introduction
  • 6.2 Intraoperative Assessment and Management of Coagulopathy
  • 6.2.1 Major Mechanisms of Bleeding Associated With Cardiopulmonary Bypass
  • 6.2.2 Coagulation-Based Hemotherapy Service
  • 6.2.3 Establishment of Almost Real-Time Coagulation Parameters
  • 6.2.4 Intraoperative Management
  • 6.3 Miscellaneous Information on Intraoperative Management of Coagulopathy
  • 6.4 Postoperative Assessment and Management of Coagulopathy
  • 6.5 Conclusions
  • References
  • 7 Specific Clinical Situations
  • 7.1 Introduction
  • 7.2 Typical Anticoagulant and Antiplatelet Protocols for Specific Situations
  • 7.2.1 Patients With Left Ventricular Assist Device
  • 7.2.2 TandemHeart System
  • 7.2.3 Intra-Aortic Balloon Pump (IABP)
  • 7.2.4 Post Coronary Artery Bypass Graft
  • 7.2.5 Percutaneous Coronary Intervention
  • 7.2.6 Extracorporeal Membrane Oxygenation
  • 7.2.7 Total Artificial Heart (SynCardia): Anticoagulation and Antiplatelet Therapy
  • 7.2.7.1 Postoperative Period (Immediate)
  • 7.2.7.2 Postoperative (Chest Tubes Pulled)
  • 7.2.7.3 Transfusion Threshold (Nonbleeding Patients)
  • 7.2.8 Cardiopulmonary Bypass and Anticoagulation With UFH for Patients With Heparin-Induced Thrombocytopenia
  • 7.2.9 Anticoagulation With Bivalirudin (Angiomax) During Cardiopulmonary Bypass for Patients With Heparin-Induced Thrombocy...
  • 7.2.10 Anticoagulation Following Bioprosthetic Valve Implantation
  • 7.3 Difficult Problems in Coagulopathy Management
  • 7.3.1 Anticoagulant for Patients With Thrombotic Complications and Hypocoagulopathy Without Active Bleeding
  • 7.3.2 HLA Antibody Workup for Refractory Thrombocytopenia Due to HLA Alloantibodies
  • 7.3.3 Management of Transfusion-Dependent Patients on ECMO
  • 7.3.4 Thrombophilia Workup
  • 7.3.5 Modifying Anticoagulant Protocol for Patients With Risk of Both Bleeding and Thrombosis
  • 7.3.6 Management of HITT in Bleeding Patients
  • 7.3.7 Monitoring Anticoagulant in Patients With Lupus Anticoagulant and Severe Liver Disease
  • 7.3.8 Modifying Anticoagulant Protocol for Patients With Severe Thrombophilia Despite Therapeutic PTT for UFH
  • 7.3.9 Transfusion Support for DIC
  • 7.4 Conclusions
  • References
  • 8 Decision Support Software for Coagulopathy
  • 8.1 Introduction
  • 8.2 Mobile Computing Platform With Decision Support Modules for Hemotherapy
  • 8.3 Postoperative Bleeding Risk Stratification in Cardiac Pulmonary Bypass Patients Using Artificial Neural Network
  • 8.4 Conclusions
  • References
  • Index
  • Back Cover

Dateiformat: EPUB
Kopierschutz: Adobe-DRM (Digital Rights Management)

Systemvoraussetzungen:

Computer (Windows; MacOS X; Linux): Installieren Sie bereits vor dem Download die kostenlose Software Adobe Digital Editions (siehe E-Book Hilfe).

Tablet/Smartphone (Android; iOS): Installieren Sie bereits vor dem Download die kostenlose App Adobe Digital Editions (siehe E-Book Hilfe).

E-Book-Reader: Bookeen, Kobo, Pocketbook, Sony, Tolino u.v.a.m. (nicht Kindle)

Das Dateiformat EPUB ist sehr gut für Romane und Sachbücher geeignet - also für "fließenden" Text ohne komplexes Layout. Bei E-Readern oder Smartphones passt sich der Zeilen- und Seitenumbruch automatisch den kleinen Displays an. Mit Adobe-DRM wird hier ein "harter" Kopierschutz verwendet. Wenn die notwendigen Voraussetzungen nicht vorliegen, können Sie das E-Book leider nicht öffnen. Daher müssen Sie bereits vor dem Download Ihre Lese-Hardware vorbereiten.

Weitere Informationen finden Sie in unserer E-Book Hilfe.


Download (sofort verfügbar)

85,62 €
inkl. 19% MwSt.
Download / Einzel-Lizenz
ePUB mit Adobe DRM
siehe Systemvoraussetzungen
E-Book bestellen

Unsere Web-Seiten verwenden Cookies. Mit der Nutzung dieser Web-Seiten erklären Sie sich damit einverstanden. Mehr Informationen finden Sie in unserem Datenschutzhinweis. Ok