Perioperative Haemostatic Management in a Patient Undergoing Craniotomy for Excision of Meningioma: Role of Thromboelastography
Journal Title: Journal of Advanced Research in Medicine - Year 2018, Vol 5, Issue 3
Abstract
Although there is a general predisposition towards hyper-coagulability during brain tumour surgery, hypocoagulability may exist in certain cases even before surgery, detectable only when the physical characteristics of clot formation are studied by viscoelastic point-of-care tests like thromboelastography (TEG). Herein we present a case of a 66-year old male patient with left frontal convexity meningioma, scheduled for craniotomy and excision of tumor. Patient’s preoperative coagulation profile (as assessed by conventional tests) was within normal limits but he was bleeding profusely from the beginning of the surgery and there was massive bleeding during tumour resection. Based on findings of TEG which revealed a severe hypocoagulable picture (low α angle, MA value and CI value with high K value), 10 units of cryoprecipitate and 4 units of random donor platelets were transfused intra-operatively in addition to 2 units of PRBCs. Haemodynamic stability was achieved and subsequent intra-operative course was better. One more unit of PRBC was transfused in the immediate post-operative period and a repeat TEG after 4 hours showed a trend towards normalization of TEG parameters suggesting a restoration of coagulation competency which also correlated with improved clinical condition of the patient.
Authors and Affiliations
Dr. Hemlata
Keywords
Related Articles
- EP ID EP362532
- DOI 10.24321/2349.7181.201815
- Views 124
- Downloads 0
An Interesting Case of Sebaceous Gland Carcinoma of Upper Eyelid with Tubercular Lymphadenitis
Sebaceous gland carcinoma (SGC) is a rare, potentially aggressive tumor and the third most common malignancy of the eyelid. We present a case of SGC (confirmed by histopathology) of right upper eyelid in a 48-year-old f...
Clinical Correlates of Hepatitis B or Hepatitis C Coinfections in People Living with HIV/AIDS (PLHIV)
Introduction: Hepatitis B virus (HBV) coinfected HIV patients are likely to have chronic hepatitis B infection and associated severe liver disease, however effect of hepatitis B on HIV has not been proven to be off any e...
The Prevalence of Transfusion-Transmitted Infections (TTIs) and Distribution Pattern of ABO Rh Blood Group in Blood Donors and Possible Correlation of TTIs with ABO and Rh Blood Groups – A Study at RBTC (North-West) Delhi
Hepatitis B, Hepatitis C and HIV infections represent global health problems of significant magnitude. There are studies and hypothesis which suggest that genetic predispositions like ABO and Rh blood group may affect oc...
New Oral Anticoagulants: An Overview
Oral anticoagulant therapy is used in the prevention and treatment of venous thromboembolism (VTE), prevention of stroke and other systemic emboli in patients with atrial fibrillation (AF) and artificial heart valves. V...
Evaluation of Pro-Inflammatory Markers IL-6 and TNF-a and their Correlation with Non-Alcoholic Fatty Liver Disease
Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is a condition in which excess fat accumulates in the liver of a patient with no history of alcohol abuse or other causes for secondary hepatic steatosis. The pathoge...