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Medical knowledge about blood, its use in transfusions, and blood products has grown exponentially, as well as awareness about its safety, risks and costs. In a discipline where risks are proportional to benefits, medical specialists involved in open heart surgery need to have the latest information to make informed decisions. Dr. Attar's work reflects the contributors' direct interest and experience in blood and cardiac surgery introducing the latest information on blood and its use, hemostasis, blood conservation techniques and safety, the risks involved, alternatives to blood transfusions, the diagnosis and therapy of coagulopathy associated with cardiac surgery, and medicolegal aspects. Medical advances include the latest intraoperative diagnostic measures for platelet functions and therapy strategies for hemostasis abnormalities with cardiac surgery. This work is unique for its extensive and critical description of instruments and tests used intraoperatively, especially for the evaluation of the coagulation factors and platelets, the algorithms for transfusion guidelines and the detailed application of APROTININ and other antifibrinolytic agents in minimizing bleeding in cardiac surgery. Written for cardiac and transplant specialists -- from surgeons, anesthesiologists, surgical nurses to perfusionists -- this valuable and timely reference thoroughly explores the subject of blood transfusions in open heart surgery, its clinical applications, the current status of blood substitutes and important legal aspects.
All anesthesiologists are confronted with patients who show bleeding disorders, whether congenital, acquired, or pharmacologically induced. Although many studies, meta-analyses, guidelines, and textbooks have been published on the subject, they mostly cover specific aspects or require a thorough knowledge of hemostasis. The goal of this book is to provide the anesthesiologist with an overview of hemostasis and the mechanisms underlying bleeding and coagulation in general and to assist in the understanding of specific coagulation disorders as they may occur in the various anesthesia subspecialties. It is hoped that, through the provision of practical information and tools, the book will help residents and trained anesthesiologists to manage one of the most frustrating challenges that they face: the bleeding patient. A full understanding of coagulation requires a lifelong career, and this book is not intended to replace the consulting hematologist, whose expert opinion should always be sought. The available procoagulant blood products and drugs all have potentially dangerous side-effects; furthermore, in bleeding disorders pitfalls are frequent and a misdiagnosis can have potentially catastrophic consequences. The aim of the editors is thus instead to enhance the collaboration between the disciplines of Anesthesiology and Hematology.
The second edition of this handbook is an up-to-date guide to the application of catheter-based interventions across the entire age range of congenital heart disease patients, from fetal life through to adulthood. It considers the changes and improvements that have occurred during the last few years in terms of new procedures, new tools and devices (in particular in the field of valves), new imaging and pre-procedural strategies, such as 3D-printing, 3D- rotational angiography and fusion imaging. It provides readers with clear instructions on techniques for vascular access, valve dilatation, angioplasty, stent implantation, defect closure, defect creation, pulmonary valve implantation and on the hybrid approach, as well as on various other procedures. As in the first edition, topics are approached using a step-by-step format, ensuring that readers can immediately access the information relevant to their daily practice. Numerous explanatory figures and drawings are included in each chapter in order to further clarify how to plan, perform and evaluate diagnostic and interventional procedures in the field of congenital heart disease. It also highlights important tips and tricks that will assist health operators in achieving optimal outcomes, and includes an appendix with additional general equations and BSA, and oxygen consumption charts. This practical guide will be a valuable resource for surgeons and cardiologists in their daily clinical practice.
"Practicing critical care entails understanding human physiology, pharmacokinetics and molecular pathways in concert with adherence to evidence based literature. Some may say combining all of these entities into practice creates the "art" of critical care medicine. One strategy to gain proficiency in the practice of critical care medicine is to simulate what you would do in specific problem-based scenarios. That is the aim of this textbook aptly titled" "What Do I Do Now?" This text focuses on Cardiothoracic Critical Care and will cover guidelines for evidence-based practice, respiratory and metabolic physiology, common hemodynamic perturbations, ventricular failure and mechanical circulatory support devices. All clinicians who care for cardiothoracic patients who are critically ill can find pearls of practice wisdom complemented by literature citations within this text. So go ahead, place yourself at the foot of the bed and try to think through, "What Would I Do Now" when presented with each patient within these pages of your handheld cardiothoracic intensive care unit"--
Here, two of the foremost cardiothoracic surgeons have brought together many of the top cardiologists and haematologists to produce the most current reference source on all aspects of blood conservation, from an overall clinical approach to the use of erythropoietin and the benefits of post-operative blood salvage. The subject matter covers numerous areas involved in the preoperative considerations in cardiac surgery, the intraoperative decision-making in cardiac surgery, postoperative bleeding and management and a section on the algorithm for bloodless surgery used at the New York Hospital-Cornell Medical Center.
This unique volume presents the cutting edge of haemostasis in surgery and includes the advances in the science pertaining to related important medical and surgical problems. It is the only book that includes all the surgical subspecialties focusing specifically on the problems of haemostasis in each field. State-of-the-art laboratory and clinical reviews are included and modern devices used in the different specialties are also covered. The contributors are well-known authorities in their special fields and haematological area. Each is covered comprehensively with special emphasis on unanswered questions. The book is addressed to all surgeons and physicians with an interest in this exciting field.
Cardiopulmonary Bypass, 2nd edition, offers a complete introduction to this specialist technique for medical and technical personnel involved in extracorporeal cardiopulmonary support. A clinically based overview of the subject is provided and updated chapters incorporate the most current developments in the field. Introductory chapters cover equipment and preparation of the cardiopulmonary bypass machine, safety and monitoring, routine conduct of bypass, and the process of weaning from mechanical to physiological circulation. Specialist chapters on mechanical support, ECMO, special surgical procedures, blood conservation techniques, and particular medical conditions that affect the conduct of cardiopulmonary bypass are also included. This new edition includes self-assessment multiple choice questions at the end of each chapter, allowing readers to test their own understanding of the material. Written and edited by specialists from leading cardiac centres in the UK and USA, this is an invaluable resource for clinical perfusion scientists, cardiac surgeons and cardiothoracic anaesthetists in training.
Since publication of the First Edition in 1982, Hemostasis and Thrombosis has established itself as the pre-eminent book in the field of coagulation disorders. No other book is as inclusive in scope, with coverage of the field from the standpoint of both basic scientists and clinicians. This comprehensive resource details the essentials of bleeding and thrombotic disorders and the management of patients with these and related problems, and delivers the most up-to-date information on normal biochemistry and function of platelets or endothelial cells, as well as in-depth discussions of the pharmacology of anticoagulant, fibrinolytic, and hemostatic drugs. NEW to the Sixth Edition... • A new team of editors, each a leader in his field, assures you of fresh, authoritative perspectives. • Full color throughout • A companion website that offers full text online and an image bank. • A new introductory section of chapters on basic sciences as related to the field • Entirely new section on Hemostatic and Thrombotic Disorders Associated with Systemic Conditions includes material on pediatric patients, women's health issues, cancer, sickle cell disease, and other groups. • Overview chapters preceding each section address broad topics of general importance. This is the tablet version which does not include access to the supplemental content mentioned in the text.
This textbook provides a succinct overview of cardiac surgery, with key concepts being emphasized throughout. An abundance of illustrations, intra-operative photographs, tables as well as information boxes, aids the reader to visualise, grasp and retain difficult concepts. The inclusion of evidence-based approaches to the management of a range of cardiac surgical conditions equips the reader with an understanding of how to overcome a variety of potentially tough clinical challenges. Concise Cardiac Surgery: A Complete Guide comprehensively covers a range of techniques used in cardiac surgery. It is therefore, an ideal resource for the trainee and practising cardiac surgeon seeking a practically focused text detailing how to apply the latest techniques and evidence-based approaches in their day-to-day practice.
This latest edition provides a comprehensive, state-of-the-art overview of the major issues specific to managing bleeding patients. Like the previous edition, the sections of this new edition have been structured to review the overall scope of issues, among them bleeding associated with disease condition, bleeding from specific organs, bleeding associated with medication, and bleeding associated with procedures. In addition to thoroughly revised and updated chapters from the previous edition, the latest edition features new chapters on such topics as the basics of hemostasis, bleeding due to rare coagulation factor deficiencies, bleeding associated with connective tissue disorders, massive transfusion protocol, bleeding associated with ventricular assist device, and evaluation of bleeding risk prior to invasive procedures. The volume also includes brief etiology and a practical reference guide regarding type of blood components, medication, dose, and duration. Written by authors from a variety of integrated disciplines, Management of Bleeding Patients, Second Edition is a valuable resource for clinicians working in the area of bleeding management.