Heparinase-guided thrombelastography in an anticoagulated parturient

The anticoagulated parturient.

Neuraxial analgesia and anesthesia are routinely administered to the parturient. A devastating, albeit rare, complication of neuraxial anesthesia is spinal or epidural hematoma, and primarily occurs in patients with disorders of hemostasis. A parturient with a clinically active coagulation disorder, or someone with a history of easy bruising and/or bleeding, is considered to have an absolute co...

Use of heparinase modified thrombelastography in liver transplantation.

Severe coagulopathies can occur during liver transplantation, particularly after reperfusion of the grafted liver. Heparin release has been proposed as one of the factors contributing to this coagulopathy. We have analysed the thrombelastograph (TEG) traces of 55 patients after reperfusion using native and heparinase-treated samples. In almost all cases an abnormal native TEG was improved in vi...

Reduced haemostatic factor transfusion using heparinase-modified thrombelastography during cardiopulmonary bypass.

We set out to determine if the heparinase-modified thrombelastogram using anticoagulated blood from patients during cardiac surgery could guide treatment with haemostatic components. In 60 patients a simple algorithm predicted a possible 60-80% decrease in the use of haemostatic components. In a second series, 30 patients were allocated to receive components using this intra-operative algorithm...

Ultrasound-guided femoral and sciatic nerve blocks in an anticoagulated patient. Case reports.

BACKGROUND AND OBJECTIVES The use of the ultrasound to guide the puncture in peripheral nerve blocks has become increasingly more frequent. With the lower probability of promoting vascular damage the ultrasound has become an interesting tool in peripheral nerve blocks especially in patients in use of anticoagulants or with coagulopathies. The objective of this article was to report two cases in...

Recommendations for anticoagulated patients undergoing image-guided spinal procedures.