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The Coagulopathy of...
The Coagulopathy of Acute Type A Aortic Dissection : A Prospective, Observational Study
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- Zindovic, Igor (author)
- Lund University,Lunds universitet,Blödningsrubbningar och akut typ-A dissektion,Forskargrupper vid Lunds universitet,Bleeding disorders and acute typ-A dissection,Lund University Research Groups,Skåne University Hospital
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- Sjögren, Johan (author)
- Lund University,Lunds universitet,Blödningsrubbningar och akut typ-A dissektion,Forskargrupper vid Lunds universitet,Bleeding disorders and acute typ-A dissection,Lund University Research Groups,Skåne University Hospital
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- Bjursten, Henrik (author)
- Lund University,Lunds universitet,Skonsammare hjärtkirurgi,Forskargrupper vid Lunds universitet,Less invasive cardiac surgery,Lund University Research Groups,Skåne University Hospital
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- Ingemansson, Richard (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Ingimarsson, Jonas (author)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Skåne University Hospital
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- Larsson, Mårten (author)
- Lund University,Lunds universitet,Blödningsrubbningar och akut typ-A dissektion,Forskargrupper vid Lunds universitet,Bleeding disorders and acute typ-A dissection,Lund University Research Groups,Skåne University Hospital
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- Svensson, Peter J. (author)
- Lund University,Lunds universitet,Klinisk koagulationsmedicin, Malmö,Forskargrupper vid Lunds universitet,Clinical Coagulation, Malmö,Lund University Research Groups,Skåne University Hospital
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- Strandberg, Karin (author)
- Lund University,Lunds universitet,Klinisk kemi, Malmö,Forskargrupper vid Lunds universitet,Clinical Chemistry, Malmö,Lund University Research Groups
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- Wierup, Per (author)
- Cleveland Clinic Foundation
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- Nozohoor, Shahab (author)
- Lund University,Lunds universitet,Blödningsrubbningar och akut typ-A dissektion,Forskargrupper vid Lunds universitet,Bleeding disorders and acute typ-A dissection,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- Elsevier BV, 2019
- 2019
- English.
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In: Journal of Cardiothoracic and Vascular Anesthesia. - : Elsevier BV. - 1053-0770. ; 33:10, s. 2746-2754
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Abstract
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- Objective: To evaluate the hemostatic system in patients undergoing surgery for acute type A aortic dissection (ATAAD) compared with those undergoing elective aortic procedures. Design: This was a prospective, observational study. Setting: The study was performed at a single university hospital. Participants: Twenty-five patients with ATAAD were compared with 20 control patients undergoing elective surgery of the ascending aorta or the aortic root. Interventions: No interventions were performed. Measurements and Main Results: Platelet count and levels of fibrinogen, D-dimer, prothrombin time/international normalized ratio, activated partial thromboplastin time, and antithrombin were analyzed perioperatively and compared between the 2 groups. Patients with ATAAD had lower preoperative levels of platelets (188 [156-217] × 10 9 /L v 221 [196-240] × 10 9 /L; p = 0.018), fibrinogen (1.9 [1.6-2.4] g/L v 2.8 [2.2-3.0] g/L; p = 0.003), and antithrombin (0.81 [0.73-0.94] kIU/L v 0.96 [0.92-1.00] kIU/L; p = 0.003) and significantly higher levels of D-dimer (2.9 [1.7-9.7] mg/L v 0.1 [0.1-0.2] mg/L; p < 0.001) and prothrombin time/international normalized ratio (1.15 [1.1-1.2] v 1.0 [0.93-1.0]; p = 0.001). Surgery caused significant changes of the coagulation system in both groups. Intraoperative bleeding volumes were larger in the ATAAD group (2,407 [1,804-3,209] mL v 1,212 [917-1,920] mL; p < 0.001), and patients undergoing ATAAD surgery received significantly more transfusions of red blood cells (2.5 [0.25-4.75] U v 0 [0-2.75] U; p = 0.022), platelets (4 [3.25-6] U v 2 [2-4] U; p = 0.002), and plasma (2 [0-4] U v 0 [0-0] U; p = 0.004) compared with the elective group. Conclusions: This study demonstrates that ATAAD is associated with a coagulopathic state. Surgery causes additional damage to the hemostatic system in ATAAD patients, but also in patients undergoing elective surgery of the ascending aorta or the aortic root.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- aneurysm
- aorta
- bleeding
- dissection
Publication and Content Type
- art (subject category)
- ref (subject category)
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Zindovic, Igor
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Sjögren, Johan
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Bjursten, Henrik
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Ingemansson, Ric ...
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Ingimarsson, Jon ...
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Larsson, Mårten
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show more...
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Svensson, Peter ...
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Strandberg, Kari ...
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Wierup, Per
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Nozohoor, Shahab
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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Journal of Cardi ...
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Lund University