-
Europace : European Pacing,... Oct 2022
Topics: Atrial Fibrillation; Catheter Ablation; Hematoma; Humans; Laser Therapy; Lasers; Pulmonary Veins
PubMed: 35851915
DOI: 10.1093/europace/euac117 -
Transfusion Medicine Reviews Oct 2016Thrombocytopenia affects approximately one fourth of neonates admitted to neonatal intensive care units, and prophylactic platelet transfusions are commonly administered... (Review)
Review
Thrombocytopenia affects approximately one fourth of neonates admitted to neonatal intensive care units, and prophylactic platelet transfusions are commonly administered to reduce bleeding risk. However, there are few evidence-based guidelines to inform clinicians' decision-making process. Developmental differences in hemostasis and differences in underlying disease processes make it difficult to apply platelet transfusion practices from other patient populations to neonates. Thrombocytopenia is a risk factor for common preterm complications such as intraventricular hemorrhage; however, a causal link has not been established, and platelet transfusions have not been shown to reduce risk of developing intraventricular hemorrhage. Platelet count frequently drives the decision of whether to transfuse platelets, although there is little evidence to demonstrate what a safe platelet nadir is in preterm neonates. Current clinical assays of platelet function often require large sample volumes and are not valid in the setting of thrombocytopenia; however, evaluation of platelet function and/or global hemostasis may aid in the identification of neonates who are at the highest risk of bleeding. Although platelets' primary role is in establishing hemostasis, platelets also carry pro- and antiangiogenic factors in their granules. Aberrant angiogenesis underpins common complications of prematurity including intraventricular hemorrhage and retinopathy of prematurity. In addition, platelets play an important role in host immune defenses. Infectious and inflammatory conditions such as sepsis and necrotizing enterocolitis are commonly associated with late-onset thrombocytopenia in neonates. Severity of thrombocytopenia is correlated with mortality risk. The nature of this association is unclear, but preclinical data suggest that thrombocytopenia contributes to mortality rather than simply being a proxy for disease severity. Neonates are a distinct patient population in whom thrombocytopenia is common. Their unique physiology and associated complications make the risks and benefits of platelet transfusions difficult to understand. The goal of this review was to highlight research areas that need to be addressed to better understand the risks and benefits of platelet transfusions in neonates. Specifically, it will be important to identify neonates at risk of bleeding who would benefit from a platelet transfusion and to determine whether platelet transfusions either abrogate or exacerbate common neonatal complications such as sepsis, chronic lung disease, necrotizing enterocolitis, and retinopathy of prematurity.
Topics: Blood Platelets; Blood Transfusion; Hematology; Hemorrhage; Hemostasis; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Neovascularization, Pathologic; Platelet Count; Platelet Transfusion; Risk Factors; Thrombocytopenia
PubMed: 27282660
DOI: 10.1016/j.tmrv.2016.05.009 -
Japanese Journal of Radiology Feb 2009Traumatic pulmonary pneumatocele, occurring after blunt trauma, is a relatively rare event. Traumatic pneumatoceles are benign lesions resulting from blunt chest trauma...
Traumatic pulmonary pneumatocele, occurring after blunt trauma, is a relatively rare event. Traumatic pneumatoceles are benign lesions resulting from blunt chest trauma that need only conservative treatment unless complications arise. A 45-year old man was involved in a vehicle collision and was transferred to our institution. Chest imaging revealed multiple pneumatoceles in bilateral lung fields. The patient was treated conservatively without surgical intervention. The pneumatocele had completely disappeared after 4 months.
Topics: Accidents, Traffic; Hematoma; Humans; Lung Injury; Magnetic Resonance Imaging; Male; Middle Aged; Pneumothorax; Radiography, Thoracic; Thoracic Injuries; Tomography, X-Ray Computed
PubMed: 19373539
DOI: 10.1007/s11604-008-0296-x -
Seminars in Arthritis and Rheumatism Oct 1994Pulmonary hemorrhage is a rare and often fatal complication of systemic lupus erythematosus (SLE). Treatment with high-dose steroids and cyclophosphamide has been of... (Review)
Review
Pulmonary hemorrhage is a rare and often fatal complication of systemic lupus erythematosus (SLE). Treatment with high-dose steroids and cyclophosphamide has been of only modest value, with a reported mortality of up to 92%. We have recently seen three patients with active SLE who developed acute life-threatening pulmonary hemorrhage. Diagnostic evaluation of these patients showed negative sputum and blood cultures, negative glomerular basement membrane antibodies, and negative antineutrophilic cytoplasmic antibodies. In two patients, an open-lung biopsy was performed, and histological examination showed granular alveolar immunofluorescence staining for immunoglobulin and complement components. Treatment with plasmapheresis was initiated with prompt resolution of symptoms and clearing of chest radiograph. Two patients had recurrent bleeds despite treatment with cyclophosphamide and high-dose steroids and required repeated intubation. Plasmapheresis resulted in rapid radiographic and clinical improvement on each occasion. Two patients survived long-term and are presently without pulmonary problems; one patient died of sepsis after initial response to plasmapheresis. The dramatic improvement of the pulmonary disease in these patients leads us to conclude that rapid initiation of plasmapheresis should be strongly considered in SLE patients with severe, life-threatening pulmonary hemorrhage.
Topics: Adult; Female; Fluorescent Antibody Technique; Hemorrhage; Humans; Lung; Lung Diseases, Interstitial; Lupus Erythematosus, Systemic; Male; Plasmapheresis
PubMed: 7839153
DOI: 10.1016/s0049-0172(05)80005-8 -
Annales Francaises D'anesthesie Et de... Sep 2012The treatment of pulmonary embolism is mainly based on anticoagulants and intravenous thrombolysis in case of collapse. The cerebral hemorrhage is the main complication...
The treatment of pulmonary embolism is mainly based on anticoagulants and intravenous thrombolysis in case of collapse. The cerebral hemorrhage is the main complication of thrombolysis and contraindicates anticoagulation. We report the case of a patient with a subdural and intraparenchymal hematoma complicating intravenous thrombolysis. The patient had persistent respiratory and hemodynamic instability related to the pursuit of embolic phenomena. The implementation of a cava filter was performed and the patient had a favorable outcome.
Topics: Decompression, Surgical; Hematoma, Subdural, Acute; Hemodynamics; Humans; Intracranial Hemorrhages; Male; Middle Aged; Pulmonary Embolism; Thrombolytic Therapy; Tomography, X-Ray Computed; Vena Cava Filters
PubMed: 22841355
DOI: 10.1016/j.annfar.2012.06.026 -
European Heart Journal Mar 2019
Topics: Aged; Angiography; Angioplasty; Chronic Disease; Hematoma; Humans; Hypertension, Pulmonary; Iatrogenic Disease; Lung; Male; Pulmonary Embolism; Tomography, X-Ray Computed
PubMed: 30753407
DOI: 10.1093/eurheartj/ehz055 -
Journal of Cardiothoracic Surgery May 2024Spontaneous retroperitoneal hematoma (SRH) is a rare complication of anticoagulation therapy. Presentation may vary from limb paresis to hypovolemic shock due to blood...
Spontaneous retroperitoneal hematoma (SRH) is a rare complication of anticoagulation therapy. Presentation may vary from limb paresis to hypovolemic shock due to blood loss. The optimal treatment is controversial. It can be managed conservatively or surgically. We report a case of a 73-year-old man presenting with progressively worsening abdominal pain and severe pain radiating to his left lower limb twenty-five days after his pulmonary endarterectomy (PEA) surgery. He was on anticoagulation per our institutional protocol for PEA patients. Investigations revealed a large, spontaneously occurring iliopsoas hematoma. Our patient was treated conservatively, and the SRH stabilised.
Topics: Humans; Male; Aged; Endarterectomy; Retroperitoneal Space; Hematoma; Pulmonary Artery; Tomography, X-Ray Computed; Pulmonary Embolism; Anticoagulants; Postoperative Complications
PubMed: 38762548
DOI: 10.1186/s13019-024-02726-7 -
European Journal of Radiology Aug 1996Trauma is a major cause of morbidity and mortality worldwide. Despite the advent of specialised trauma centres the outcome of patients who sustain major trauma remains... (Review)
Review
Trauma is a major cause of morbidity and mortality worldwide. Despite the advent of specialised trauma centres the outcome of patients who sustain major trauma remains disappointing. Plain radiography and more advanced imaging techniques such as ultrasound, computerised tomography (CT) and angiography, have a major role to play in the early decision making and subsequent management of patients who sustain polytrauma. This article discusses the choice of emergency imaging techniques available in chest trauma for clinicians and radiologists; their evaluation and some of the common pitfalls that may lead to errors of interpretation.
Topics: Aorta; Aortography; Fractures, Bone; Hematoma; Hemothorax; Humans; Lung; Lung Injury; Mediastinal Emphysema; Pleura; Pneumonia, Aspiration; Pneumopericardium; Pneumothorax; Pulmonary Edema; Rib Fractures; Thoracic Injuries; Tomography, X-Ray Computed
PubMed: 8872071
DOI: 10.1016/0720-048x(96)01030-3 -
Clinical Obstetrics and Gynecology Mar 2017Subcapsular liver hematoma is a rare but potentially life-threatening complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. It... (Review)
Review
Subcapsular liver hematoma is a rare but potentially life-threatening complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. It may present with nonspecific signs and symptoms, none of which are diagnostic, and can mimic pulmonary embolism of cholecystitis. There is no consensus on the management of subcapsular liver hematoma. Unruptured liver hematoma can be conservatively managed. When rupture occurs, surgical, endovascular approaches and, rarely, liver transplantation, may be required. Actual literature is scant and retrospective in nature. Data on follow-up, time to resolution and outcome of subsequent pregnancies are very limited. We here review the diagnosis and management of liver hematoma.
Topics: Female; HELLP Syndrome; Hematoma; Humans; Liver Diseases; Pregnancy
PubMed: 28005587
DOI: 10.1097/GRF.0000000000000253 -
Chest May 2019
Review
Topics: Aged; Anticoagulants; Embolization, Therapeutic; Female; Follow-Up Studies; Hematoma; Humans; Lung Neoplasms; May-Thurner Syndrome; Retroperitoneal Space; Risk Assessment; Rivaroxaban; Shock, Hemorrhagic; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler
PubMed: 31060707
DOI: 10.1016/j.chest.2018.10.052