• Title/Summary/Keyword: Bleeding

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Effect of Cardiopulmonary Bypass on Platelet (체외순환이 혈소판에 미치는 영향)

  • Choe, Jun-Yeong;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.26-35
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    • 1988
  • The effect of cardiopulmonary bypass on platelet count, platelet function, and bleeding time was studied in 60 patients. Platelet count was significantly reduced during and after cardiopulmonary bypass. Platelet function also had a reduced aggregation response to adenosine diphosphate. Bleeding time was prolonged to over 30 minutes during cardiopulmonary bypass and not returned to normal level until postbypass 1 hour. The amount of postoperative bleeding was proportional to the degree of decrease in platelet count and function, degree of decrease in platelet count and function. There was no significant correlation between duration of cardiopulmonary bypass and platelet count, platelet function, bleeding time, or amount of postoperative bleeding. Patients with cyanotic congenital heart disease showed a larger amount of postoperative bleeding than patients with acyanotic congenital heart disease [P<0.01], and this difference was due to the fact that platelet function was more significantly affected by cardiopulmonary bypass in cyanotic group. Patients using membrane oxygenator showed a less amount of postoperative bleeding than patients using bubble oxygenator [p<0.005] reflecting better preservation of platelet count and function by membrane oxygenator.

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Mach 6 Tests of Scramjet Engine with Boundary-Layer Bleeding and Two-Staged Injection

  • Kodera, Masatoshi;Tomioka, Sadatake;Kobayashi, Kan;Kanda, Takeshi;Mitani, Tohru
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2004.03a
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    • pp.26-33
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    • 2004
  • In this study, a boundary-layer bleeding and a two-staged fuel injection were applied to a scramjet engine for suppressing unstart transition and improving the thrust performance under Mach 6 flight conditions. With the boundary-layer bleeding, the engine could operate without unstart transition around at the fuel equivalence ratio of unity ($\Phi$ = 1). The thrust increment from the no fuel condition (dF) increased to 2460 N, which was about 1.4 times as large as that of the case without the bleeding and maximum in our Mach 6 tests. It was confirmed that the boundary-layer bleeding suppressed the separation during the engine operation. The two-staged fuel injection was less effective for improving the thrust performance com-pared with the single-staged one with the bleeding at Mach 6.

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Comprehensive understanding of vascular anatomy for endovascular treatment of intractable oronasal bleeding

  • Moon, Sungjun
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.7-16
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    • 2018
  • Oronasal bleeding that continues despite oronasal packs or recurs after removal of the oronasal packs is referred to as intractable oronasal bleeding, which is refractory to conventional treatments. Severe craniofacial injury or tumor in the nasal or paranasal cavity may cause intractable oronasal bleeding. These intractable cases are subsequently treated with surgical ligation or endovascular embolization of the bleeding arteries. While endovascular embolization has several merits compared to surgical ligation, the procedure needs attention because severe complications such as visual disturbance or cerebral infarction can occur. Therefore, comprehensive understanding of the head and neck vascular anatomy is essential for a more effective and safer endovascular treatment of intractable oronasal bleeding.

7 Cases of Nose Bleeding Child Treated by Hwanggigunjung-tang (황기건중탕(黃芪建中湯)으로 치료한 소아 비출혈 환자 7례)

  • Kim, Yeon-Soo;Kim, Nan-Ee;Jee, Seon-Young;Hwangbo, Min
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.2
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    • pp.131-138
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    • 2019
  • Objectives : This study was carried out to investigate the effect of Hwanggigunjung-tang on child with nose bleeding. Methods : We treated 7 nose bleeding patients with allergic rhinitis. We evaluated frequency, duration, amount of nose bleeding. Results : After the treatments objective score of nose bleeding was remarkably decreased. Conclusions : This study suggests that Hwanggigunjung-tang is effective with nose bleeding with allergic rhinitis.

Emergency bleeding control in a mentally retarded patient with active oral and maxillofacial bleeding injuries: report of a case (구강악안면 손상 후 과도한 출혈을 보인 정신지체 응급환자에서 신속지혈 예: 증례보고)

  • Mo, Dong-Yup;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Kim, Ha-Rang;Lee, Chun-Ui
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.303-308
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    • 2010
  • Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.

Emergency Reexploration for Bleeding after Open Heart Surgery wth Cardiopulmonary Bypass -A Report of 16 Cases- (개심술후 출혈로 인한 응급개흉술의 임상적 고찰)

  • 유재현
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1068-1073
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    • 1991
  • Bleeding after open heart surgery with cardiopulmonary bypass was a cause of concern. requiring reexploration of the chest in approximately 8 percent of patients who have had operations on the heart. From April., 1983 to October, 1991, 16 patients[2%] out of 777 patients who underwent open cardiac surgery had emergency reexploration with bleeding at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. In 12 cases[75%], reexploration was performed for continuous bleeding and the reminder[4 cases] were performed for suspected tamponade & hypotension. There were 9 cases[56%] of congenital heart disease and 7 cases of acquired heart disease. The mean blood loss were 997$\pm$472ml /sq. M in total cases and 1442$\pm$ 647ml /sq. M in cases repair of cyanotic heart disease. The mean interval till reoperation was 16.6hr [1hr~72hr] and 41 hr[12~72hr] in tamponade cases and 8.4hr[1hr~24hr] in continuous bleeding cases. The bleeding sites were identified in 7 cases: aortotomy site in 2 cases, ventriculotomy site, SVC, thymus, pleura and sternum wiring site in each other case. But no specific sites was found in the remaining 9 cases. The 8 cases had complications but all except 1 cases with hypoxic brain damage were recovered without sequale. We conclude that emergency thoractomy after open heart surgery may be lifesaving and-/or diminishing complications with bleeding if performed promptly with excessive bleeding, tamponade and unexpected hypotension.

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The Effects of Nafamostat Mesilate on a Bleeding Risk as an Anticoagulant During Use as a Continuous Renal Replacement Therapy: Systematic Review

  • Kang, YoungJu;Moon, Su Jee;Kang, Hye-Young
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.133-141
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    • 2018
  • Objectives: In the past, the pharmaceutical drug heparin was mostly used as the anticoagulant for continuous renal replacement therapy (CRRT), but the duration time is long to have the risk of a bleeding adverse effect, and in that case the drug therapy Nafamostat mesilate was utilized instead, as it is more safe in this case, with a short half-life and is increasing in use to permit lower concerns for bleeding incidents. However, there are insufficient number of large-scale studies on the comparison of Nafamostat mesilate and heparin. Methods: In this study, a systematic review are used to compare the bleeding risk of Nafamostat mesilate and Heparin, as subjected to patients and procedures for measuring risks performed with a CRRT, and the filter life span is to be evaluated as well in this patients. Results: As a result of literature review search, a total of 6 studies were included in systematic review. The reducing risk of bleeding and filter life span was analyzed. The retrospective cohort studies confirm that Nafamostat mesilate is less at risk of bleeding than heparin. And a cohort study confirms that Nafamostat mesilate is longer filter lifespan than heparin and randomized controlled trial studies show that Nafamostat mesilate is longer filter lifespan than not using the anticoagulants. Conclusion: Nafamostat mesilate is considered to be a good therapeutic option because it has a longer filter life span as well as the advantage of reducing bleeding.

Risk of Hemorrhage Attributed to Underlying Chronic Diseases and Uninterrupted Aspirin Therapy of Patients Undergoing Minor Oral Surgical Procedures: A Retrospective Cohort Study

  • Rojanaworarit, Chanapong;Limsawan, Soontaree
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.3
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    • pp.165-176
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    • 2017
  • Objectives: This study aimed to estimate the risk of bleeding following minor oral surgical procedures and uninterrupted aspirin therapy in high-risk patients or patients with existing chronic diseases compared to patients who did not use aspirin during minor oral surgery at a public hospital. Methods: This retrospective cohort study analyzed the data of 2912 patients, aged 20 years or older, who underwent 5251 minor oral surgical procedures at a district hospital in Thailand. The aspirin group was comprised of patients continuing aspirin therapy during oral surgery. The non-aspirin group (reference) included all those who did not use aspirin during surgery. Immediate and late-onset bleeding was evaluated in each procedure. The risk ratio of bleeding was estimated using a multilevel Poisson regression. Results: The overall cumulative incidence of immediate bleeding was 1.3% of total procedures. No late-onset bleeding was found. A significantly greater incidence of bleeding was found in the aspirin group (5.8% of procedures, p<0.001). After adjusting for covariates, a multilevel Poisson regression model estimated that the bleeding risk in the aspirin group was 4.5 times higher than that of the non-aspirin group (95% confidence interval, 2.0 to 10.0; p<0.001). However, all bleeding events were controlled by simple hemostatic measures. Conclusions: High-risk patients or patients with existing chronic diseases who continued aspirin therapy following minor oral surgery were at a higher risk of hemorrhage than general patients who had not used aspirin. Nonetheless, bleeding complications were not life-threatening and could be promptly managed by simple hemostatic measures. The procedures could therefore be provided with an awareness of increased bleeding risk, prepared hemostatic measures, and postoperative monitoring, without the need for discontinuing aspirin, which could lead to more serious complications.

Endoscopic Hemostasis for Bleeding Gastric Ulcer Caused by Ibuprofen in a 16-month-old Infant

  • Na, So Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.105-110
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    • 2012
  • Gastric ulcers are rare in children and are typically seen in cases of Helicobacter pylori (H. pylori) infection, non-steroidal anti-inflammatory drugs (NSAIDs) use, and critical illnesses such as sepsis. The risk of a bleeding ulcer due to use of NSAIDs is dependent on the dose, duration, and the individual NSAIDs, but the bleeding may occur soon after the initiation of NSAID therapy. An experience is described of a 16-month-old infant with a bleeding gastric ulcer after taking the usual dosage of ibuprofen for 3 days. The infant was also successfully treated with endoscopic hemostasis. Even a small amount of ibuprofen may be associated with bleeding gastric ulcers in infant.

A Clincal Case of Abnormal Uterine Bleeding (붕루(崩漏) 환자(患者)의 임상보고 1례)

  • Im, Kyu-Jung;Yoo, Dong-Youl
    • Journal of Haehwa Medicine
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    • v.23 no.1
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    • pp.167-172
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    • 2014
  • Purpose : The purpose of this report is to record the effects of oriental treatments for the abnormal uterine bleeding Methods : This is a case report of a 16 year old female patient suffering from abnormal uterine bleeding for eight months. She was treated by Herb therapy for 3 months. During the treatments, we checked changes of symptoms. Results : After Herb therapy, abnormal uterine bleeding was disappeared and recovered the normal menstrual cycle. Conclusion : This clinical case shows that Herb therapy has potentially effective for abnormal uterine bleeding. More clinical data and studies are required for the treatment of abnormal uterine bleeding.