(OT)Re: [HSF] Reclacitrant sternal bleeding
prasannasimha
prasannasimha at gmail.com
Sun Dec 10 09:01:12 EST 2006
Ani his native language is "American English". (I could not help
laughing when I read your statement especially with the Mmmmm).
Ani I have a job for you - you need to put your VAD problems and
expeiences and solutions in the Wiki. There is a link to it.
http://ctsurgcomplications.wikia.com/index.php?title=VENTRICULAR_ASSIST_DEVICES&action=edit
http://ctsurgcomplications.wikia.com/index.php?title=HEART_TRANSPLANTATION&action=edit
Please try to do some editing in your spare time. There is a place to
log in / create account to enable your contributions to be acknowledged.
(top right corner)
If you have problems editing , please go ahead and still edit and type
matter in , I can do the spring cleaning afterwards.
Prasanna
Ani Anyanwu wrote:
> Native language???? Mmmm
>
> I thought recalcitrant was an English word Michael.....
> ----- Original Message -----
> From: Michael Firstenberg<mailto:msfirst at gmail.com>
> To: OpenHeart-L at lists.hsforum.com<mailto:OpenHeart-L at lists.hsforum.com>
> Sent: Saturday, December 09, 2006 6:06 PM
> Subject: Re: [HSF] Reclacitrant sternal bleeding
>
>
> Prasanna,
> For those of us who use American English vs the much more prim,
> proper, and sophisticated dialect, I must ask is "recalcitrant" the
> most appropriate word. Although it probably described your
> experience (and clearly reflects you are more in command than I of my
> native language), I am wondering that it would not be the first word
> to pop into my mind if I wanted to search the topic?
>
> -michael
>
>
> Merriam-Webser online:
> Main Entry: re·cal·ci·trant 
> Pronunciation: -tr&nt
> Function: adjective
> Etymology: Late Latin recalcitrant-, recalcitrans, present participle
> of recalcitrare to be stubbornly disobedient, from Latin, to kick
> back, from re- + calcitrare to kick, from calc-, calx heel
> 1 : obstinately defiant of authority or restraint
> 2 a : difficult to manage or operate b : not responsive to treatment
> c : RESISTANT <this subject is recalcitrant both to observation and
> to experiment -- G. G. Simpson>
>
>
>
>
>
> On Dec 9, 2006, at 8:39 AM, prasannasimha wrote:
>
> >
> > I have done a write up of management of recalcitrant sternal
> > bleeding on the Wiki (sarcastically I would wonder about my
> > credentials to write it after losing the patient !!)
> > This is hardly discussed in any text book and is a rarely occurring
> > event which we probably see (hopefully) once or twice in our careers.
> > I request all of you to visit the Wiki and give it a read and
> > either edit it directly or add any other relevant points that I
> > have missed. I lost most of my emails recently and so I am doing
> > most of this based on memory of the discussion we had on our list
> > and from personal experience (for whatever it is worth)
> >
> > It is at
> > http://ctsurgcomplications.wikia.com/wiki/<http://ctsurgcomplications.wikia.com/wiki/>
> > Recalcitrant_Sternal_Bleeding
> > Prasanna
> >
> >
> >
> > prasannasimha wrote:
> >> Jacob serendipity - I was trying to dig out the article for giving
> >> a reply to Hal's boiling blood !!
> >> Prasanna
> >> Jacob Lavee, MD wrote:
> >>> Bob and Nasser,
> >>> Old tricks never die, they unfortunately just fade away. Please
> >>> read my abstract from 1989 regarding the clear clinical and
> >>> electron-microscopy prooved benefit in using one unit of fresh
> >>> whole blood after cardiac surgery:
> >>>
> >>> J Thorac Cardiovasc Surg. 1989 Feb;97(2):204-12.
> >>> The effect of transfusion of fresh whole blood versus platelet
> >>> concentrates after cardiac operations. A scanning electron
> >>> microscope study of platelet aggregation on extracellular matrix.
> >>> Lavee J, Martinowitz U, Mohr R, Goor DA, Golan M, Langsam J,
> >>> Malik Z, Savion N. Department of Cardiac Surgery, Maurice and
> >>> Gabriela Goldschleger Eye Research Institute, Sheba Medical
> >>> Center, Tel Hashomer, Israel.
> >>>
> >>> To evaluate the effect of fresh whole blood transfusion versus
> >>> platelet concentrates transfusion on platelet aggregation after
> >>> cardiac operations, 24 patients were randomized to receive either
> >>> one unit of fresh whole blood (12 patients) or 10 platelet units
> >>> (12 patients) after cardiopulmonary bypass. Platelet aggregation
> >>> on extracellular matrix, platelet count, and mean platelet volume
> >>> were studied preoperatively, at termination of cardiopulmonary
> >>> bypass, after protamine administration, and after the transfusion
> >>> of fresh whole blood or after transfusion of each two platelet
> >>> units. Extracellular matrix produced by cultured bovine corneal
> >>> cells closely resembles the vascular subendothelial basal lamina,
> >>> and is an ideal in vitro model in the study of platelet
> >>> interaction with the subendothelium. Platelet aggregation on
> >>> extracellular matrix, studied by a scanning electron microscope,
> >>> was graded from 1 to 4, wherein grade 1 represents nonactivated
> >>> platelets and grade 4 a mature platelet aggregate. With this
> >>> grading system, the two groups were similar in preoperative
> >>> values (3.3 +/- 0.9 versus 3.7 +/- 0.4) and values after
> >>> cardiopulmonary bypass (1.5 +/- 1.0 in both groups). One unit of
> >>> fresh whole blood restored platelet aggregation on extracellular
> >>> matrix to preoperative status (3.0 +/- 1.0), whereas eight
> >>> platelet units were needed for the same result (3.2 +/- 0.8). One
> >>> unit of fresh whole blood increased platelet count in a manner
> >>> similar to that achieved by six platelet units and increased mean
> >>> platelet volume to a level higher than that achieved by 10
> >>> platelet units. These results suggest that the effect of one unit
> >>> of fresh whole blood on platelet aggregation after
> >>> cardiopulmonary bypass is at least equal, if not superior, to the
> >>> effect of 8 to 10 platelet units.
> >>>
> >>>
> >>> Jay Lavee
> >>>
> >>> ----- Original Message ----- From: <Rwmfglycar at aol.com<mailto:Rwmfglycar at aol.com>>
> >>> To: <OpenHeart-L at lists.hsforum.com<mailto:OpenHeart-L at lists.hsforum.com>>
> >>> Sent: Friday, December 08, 2006 3:42 PM
> >>> Subject: Re: [HSF] Reclacitrant sternal bleeding
> >>>
> >>>
> >>>
> >>>> Dear Nasser, I saw the hot blood trick done by my father in
> >>>> 1944. I went with him to do a prostatectomy in a country town,
> >>>> He did a Freyer prostatectomy and the prostate bed bled.
> >>>> Multiple stitches, packs, local adrenaline did not stop the
> >>>> bleeding. His mask was not properly over his nose and sweat from
> >>>> his forehead trickled down his nose and dropped into the
> >>>> bladder. He called for a blood donor. Within half an hour a
> >>>> gentleman in his street clothes was wheeled into the operating
> >>>> theatre. A quick cross match was done on a glass slide. The
> >>>> donor was brought close to the operating table. There were steel
> >>>> needles in patient and donor arms, connected by tubing that
> >>>> met in a threeway stopcock. With a big glass syringe blood was
> >>>> pulled from the donor and then pushed into the patient. I can't
> >>>> remember how many syringe fulls were delivered but by the time
> >>>> the transfer was completed the bleeding had stopped and the
> >>>> operation could be completed. I was the fly on the wall watching
> >>>> this. Later we drove home in his Hudson car. He told me later
> >>>> that the patient had done well,
> >>>> Bob
> >>>> _______________________________________________
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> >>>>
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> >>>> http://www.eset.com<http://www.eset.com/>
> >>>>
> >>>>
> >>>>
> >>> Jacob Lavee, MD
> >>> Director, Heart Transplantation Unit
> >>> Deputy Director, Department of Cardiac Surgery
> >>> Sheba Medical Center
> >>> Tel Hashomer 52621
> >>> Israel
> >>>
> >>> Tel- 972-3-5302225
> >>> Fax 972-3-5302410
> >>> E mail jaylavee at netvision.net.il<mailto:jaylavee at netvision.net.il>
> >>> _______________________________________________
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> >>>
> >>
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