• Title/Summary/Keyword: Plasma fibrinogen

Search Result 64, Processing Time 0.017 seconds

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology

  • Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
    • Journal of Trauma and Injury
    • /
    • v.33 no.1
    • /
    • pp.1-12
    • /
    • 2020
  • Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

Dynamics of Rouleaux Patterns of Red Blood Cells under Pulse Magnetic Field (강한 펄스자기장 자극에 의한 적혈구 연전현상의 활동성 조사)

  • Hwang, Do Guwn
    • Journal of the Korean Magnetics Society
    • /
    • v.27 no.3
    • /
    • pp.92-97
    • /
    • 2017
  • It is widely known that pulsed magnetic field (PMF) is very useful tool to manipulate chemical and physiological processes in human body. The purpose of our study is to observe dynamics of rouleaux patterns of red blood cells (RBC) under PMF. The aggregation of RBCs or rouleaux formation is caused by fibrinogen in blood plasma. The maximum magnetic field intensity is 0.27 T and pulse time of 0.102 msec and pulse repetition rate was 1 Hz. PMF stimulus was applied to the palm of left hand for 5, 10, 15 and 20 min. Live blood analysis was used in vitro in order to quantitatively estimate the velocity of RBC exposed to PMF stimulus. The velocity of stacked-RBC of 10 minute PMF stimulus was increased up to $8{\times}10^{-4}m/sec$, but it decreased rapidly as the time passed. The results of present study have adduced that PMF stimulus on hand provide the improvement of RBC rouleaux formation, increase of RBC's moving velocity as well as low blood viscosity.

The Clinical Comparisons of 10% Pentastarch and 20% Albumin in Priming Solutions for Cardiopulmonary Bypass in Cardiac Operations (개심술중 심폐우회 충전용객속에서의 10% 펜타스타치와 20% 알부민의 임상 비교)

  • 백만종
    • Journal of Chest Surgery
    • /
    • v.27 no.2
    • /
    • pp.99-113
    • /
    • 1994
  • Pentastarch is a new synthetic hydroxyethyl starch similar to hetastarch. We report on the clinical comparisons the clinical efficacy and safety of 10% pentastarch in prime solutions for CPB in cardiac operations with that of 20% serum albumin. During CPB, group P [n = 20] received 500ml of 10% pentastarch and group A [n = 20] received 100ml of 20% albumin in prime solutions The postoperative time of ICU stay in group P and the day and amount of chest drain, hospital stay in group A were longer [p<0.05]. Fresh whole blood and PRBC were added only in group A and a higher amount of hartman solution was added in group A during CPB [p<0.05]. Prothrombin time was prolonged preoperatively and 2 days postoperatively in group A and 7 days postoperatively in group P [p<0.05] but there were no significant differences in bleeding time or fibrinogen level. Platelet count was higher immediately postoperatively in group A and preoperatively and 1, 2, and 7 days postoperatively in group P [p<0.05].Total protein and albumin level were higher 1 day postoperatively in group A and 2 and 7 days postoperatively in group P [p<0.05]. BUN was increased 2 days postoperatively in group A and Cr was increased 1 day postoperatively in group P [p<0.05]. CPK was higher preoperatively and 1, 2, and 7 days postoperatively in group A and plasma hemoglobin level was also higher 2 and 7 days postoperatively in group A [p<0.05]. There were no significant differences in arterial blood gas analysis but higher pO2 and lower pCO2 levels were maintained in group P and ejection fraction was higher 7 days postoperatively in group P [p<0.05]. Both groups were improved postoperatively in NYHA class and the hemodynamic parameters such as MAP, CO, CI, SV, LVSWI were well maintained in group P [p<0.05]. The amount of blood products used was higher in group A and urine output was higher immediately postoperatively in group A and 1, 2 days postoperatively in group P and the chest output was higher in group A. The complications were developed in 7 patients in group A and 5 patients in group P and mortality was not present in both groups.In conclusion, 10% pentastarch is as safe and effective as 20% albumin in prime solutions for cardiopulmonary bypass in cardiac operations.

  • PDF

Evaluation of Selective Media for Isolation of Staphylococcus aureus from Agricultural Products (농산물 중 Staphylococcus aureus의 분리를 위한 선택배지 평가)

  • Kim, Se-Ri;Lee, Seo-Hyun;Seo, Min-Kyoung;Kim, Won-Il;Park, Kyeong-Hun;Yun, Hye-Jeong;Yoon, Yo-Han;Yoo, Soon-Young;Ryu, Kyoung-Yul;Yun, Jong-Chul;Kim, Byung-Seok
    • Journal of Food Hygiene and Safety
    • /
    • v.27 no.2
    • /
    • pp.169-175
    • /
    • 2012
  • Five kinds of selective media, such as mannitol salt agar (MSA), Baird-Parker agar (BPA), Baird-Parker supplemented with rabbit plasma fibrinogen (BPA+RPF), CHROMagar Staphylococcus aureus (CSA), and Petrifilm Staph Express count system (Petrifilm), were compared to recommend the optimum selective media for isolation of Staphylococcus aureus from agricultural products. Seventy four target and non target bacteria were inoculated on five selective media to analyze sensitivity and specificity. In the recovery test of injured S. aureus cells, S. aureus was exposed to acid (1% lactic acid for 10 min), heat ($60^{\circ}C$ for 90s), and cold ($-20^{\circ}C$ for 1h) conditions. And artificially contaminated agricultural products (iceberg lettuce, green pepper, and cherry tomato) was enumerated on five selective media. The sensitivity of BPA+RPF, CSA, Petrifilm, MSA, and BPA were 100%, 100%, 100%, 90.5%, 90.5%, respectively. In addition, the specificity of BPA+RPF, CSA, MSA, BPA and Petrifilm were 100%, 100%, 84.6%, 75.0%, 67.3%, respectively. However, no difference among five selective media was observed in recovery on injured S. aureus cell and enumeration from agricultural products. This results suggest that BPA+RPF and CSA are the optimum media for detection of S. aureus from agricultural products.