[HSF] aortic root replacement ,svere hyperbilirubinemia

[erdinç naseri]

Hal,
Thanks for the eresponse. Let me clarify 2 things:
1.We don't have any facility to prepare platelet concentrates.
2.After decanulation we used CATS while the sternum was still open and we had exactly 740 cc of bleeding which was aspirated to CATS and given back to the patient.No hypotension ,no decrease in urine output , no systemic metabolic acidosis.
3.Patient got 3 units of blood ( 1 autologous and 2 fresh blood).
Considering the above mentioned facts and that there is no increase in ALT,Alakline phosphatase and other hepatic enzymes I will ask your second opinion.
erdinc> From: Hgrmd at aol.com> Date: Sat, 4 Aug 2007 10:13:58 -0400> Subject: Re: [HSF] aortic root replacement ,svere hyperbilirubinemia> To: OpenHeart-L at lists.hsforum.com> CC: > > Erdinc,> I say this with the utmost respect, but I think it was ill advised to have > done this elective Bentall knowing that there were no platelets available. > I suspect the problems with bleeding wouldn't have been nearly as severe if > the platelet count had been appropriately treated. What you are seeing now is > most likely the effects of shock liver from excessive bleeding. The one > glimmer of hope is that the creatinine is falling. Perhaps the patient will > avoid hepatorenal syndrome. Still, I would have to predict the likelihood of > survival is cloudy at best. I hope I'm wrong.> > Hal> > > > ************************************** Get a sneak peek of the all-new AOL at > http://discover.aol.com/memed/aolcom30tour> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------