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Endovascular approach to acute aortic trauma
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作者 Riyad Karmy-Jones Desarom Teso +2 位作者 Nicole Jackson Lisa Ferigno Robert Bloch 《World Journal of Radiology》 CAS 2009年第1期50-62,共13页
Traumatic thoracic aortic injury remains a major cause of death following motor vehicle accidents.Endovascular approaches have begun to supersede open repair,offering the hope of reduced morbidity and mortality.The av... Traumatic thoracic aortic injury remains a major cause of death following motor vehicle accidents.Endovascular approaches have begun to supersede open repair,offering the hope of reduced morbidity and mortality.The available endovascular technology is associated with specific anatomic considerations and complications.This paper will review the current status of endovascular management of traumatic thoracic aortic injuries. 展开更多
关键词 AORTA COMPLICATIONS Outcomes TRAUMATIC ENDOVASCULAR
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Donor preoperative oxygen delivery and post-extubation hypoxia impact donation after circulatory death hypoxic cholangiopathy
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作者 Thomas J Chirichella C Michael Dunham +8 位作者 Michael A Zimmerman Elise M Phelan M Susan Mandell Kendra D Conzen Stephen E Kelley Trevor L Nydam Thomas E Bak Igal Kam Michael E Wachs 《World Journal of Gastroenterology》 SCIE CAS 2016年第12期3392-3403,共12页
AIM: To evaluate donation after circulatory death (DCD) orthotopic liver transplant outcomes [hypoxic cholangiopathy (HC) and patient/graft survival] and donor risk-conditions.METHODS: From 2003-2013, 45 DCD donor tra... AIM: To evaluate donation after circulatory death (DCD) orthotopic liver transplant outcomes [hypoxic cholangiopathy (HC) and patient/graft survival] and donor risk-conditions.METHODS: From 2003-2013, 45 DCD donor transplants were performed. Predonation physiologic data from UNOS DonorNet included preoperative systolic and diastolic blood pressure, heart rate, pH, SpO<sub>2</sub>, PaO<sub>2</sub>, FiO<sub>2</sub>, and hemoglobin. Mean arterial blood pressure was computed from the systolic and diastolic blood pressures. Donor preoperative arterial O<sub>2</sub> content was computed as [hemoglobin (gm/dL) &#x000d7; 1.37 (mL O<sub>2</sub>/gm) &#x000d7; SpO<sub>2</sub>%) + (0.003 &#x000d7; PaO<sub>2</sub>)]. The amount of preoperative donor red blood cell transfusions given and vasopressor use during the intensive care unit stay were documented. Donors who were transfused &#x02265; 1 unit of red-cells or received &#x02265; 2 vasopressors in the preoperative period were categorized as the red-cell/multi-pressor group. Following withdrawal of life support, donor ischemia time was computed as the number-of-minutes from onset of diastolic blood pressure &#x0003c; 60 mmHg until aortic cross clamping. Donor hypoxemia time was the number-of-minutes from onset of pulse oximetry &#x0003c; 80% until clamping. Donor hypoxia score was (ischemia time + hypoxemia time) &#x000f7; donor preoperative hemoglobin.RESULTS: The 1, 3, and 5 year graft and patient survival rates were 83%, 77%, 60%; and 92%, 84%, and 72%, respectively. HC occurred in 49% with 16% requiring retransplant. HC occurred in donors with increased age (33.0 &#x000b1; 10.6 years vs 25.6 &#x000b1; 8.4 years, P = 0.014), less preoperative multiple vasopressors or red-cell transfusion (9.5% vs 54.6%, P = 0.002), lower preoperative hemoglobin (10.7 &#x000b1; 2.2 gm/dL vs 12.3 &#x000b1; 2.1 gm/dL, P = 0.017), lower preoperative arterial oxygen content (14.8 &#x000b1; 2.8 mL O<sub>2</sub>/100 mL blood vs 16.8 &#x000b1; 3.3 mL O<sub>2</sub>/100 mL blood, P = 0.049), greate 展开更多
关键词 Orthotopic liver transplantation Ischemic cholangiopathy Hypoxic cholangiopathy Donation after circulatory death Biliary complications Reperfusion injury
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