S K Samra — Page 3 | PubMed Health

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A study of blood utilization in association with hysterectomy.

We performed a retrospective study of 167 women undergoing hysterectomy in a large tertiary-care teaching hospital in order to assess intraoperative blood requirements and to study the decision-making process that occurs when blood is transfused intraoperatively. Recommended preoperative blood orders for hysterectomy patients based on data from the study are provided. Although "type and screen" is commonly considered to be an adequate preoperative order for patients undergoing vaginal hysterectomy, our data indicate that 2 units may be a more appropriate order when the procedure is combined with pelvic floor repair. The preoperative hematocrit, the estimated intraoperative blood loss, and the duration of the hysterectomy were integral to the decision-making process. If women undergoing hysterectomy were transfused intraoperatively only when their hematocrit actually fell to 30 percent, and not in anticipation of such an event, unnecessary transfusions would be reduced.

Adult↗

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A study of aspirin induced changes in bleeding time, platelet aggregation, and Sonoclot coagulation analysis in humans.

The purpose of this study was to determine whether or not a newer test of platelet function, Sonoclot coagulation analysis, can identify the patients who develop significant prolongation of bleeding time after aspirin ingestion. Template bleeding time, platelet aggregation in response to arachidonic acid, collagen, epinephrine, adenosine diphosphate, and ristocetin, and Sonoclot coagulation analysis were performed before and after ingestion of aspirin in 22 adult volunteers. Mean bleeding time increased from 5.32 +/- 2.16 min to 7.34 +/- 2.1 min, but remained within normal range (2.5 to 9 min). There was marked intersubject variability in the effect of aspirin on bleeding time, and difference between men and women was not significant. There was significant decrease in platelet aggregation in response to arachidonic acid, collagen and epinephrine. Sonoclot coagulation analysis did not show significant effect of aspirin administration. There was no correlation among changes in bleeding time, platelet aggregation, and Sonoclot coagulation analysis. Five patients with known platelet function disorders and prolonged bleeding times (mean = 18.5 min, range 14 to 22) without any other coagulation abnormalities were also studied. In four of these patients who had normal platelet count, Sonoclot graphs were morphologically similar to those in the volunteers with normal bleeding times, but in one patient with thrombocytopenia, morphology was altered. It is our conclusion that Sonoclot coagulation analysis is unlikely to identify patients with prolonged bleeding time in whom platelet count and other coagulation factors are normal.

Adult↗