This document discusses different methods for intraoperative blood conservation. It describes three main types of autologous blood transfusion: preoperative autologous donation, acute normovolumic hemodilution, and intraoperative cell salvage. Intraoperative cell salvage involves collecting blood lost during surgery, washing and separating red blood cells, and reinfusing them to the patient. The document outlines the detailed cell salvage process and different devices used, including cell processors that centrifuge and wash blood and ultrafiltration devices that filter whole blood. It notes advantages and considerations for each method of autologous blood transfusion.
EMBOLISM AND FILTERS USED IN CARDIOPULMONARY BYPASSGLORY MINI MOL. A
FILTERS USED IN CARDIOPULMONARY BYPASS
EMBOLISM
DEFINITION: obstruction of an artery, by a clot of blood or an air bubble.
This emboli is categorized to
Biological emboli
Foreign emboli
Gaseous emboli
There are current technologies to decrease this embolic event delivered to patient
Membrane oxygenators
FILTER
Blood surface coating
Bubble traps
Emboli detection system
Blood Filters
Depth filters
Consist of packed fibers of Dacron wool or
polyurethane foam .
No defined pore size
These filters have large wetted surface
areas to filter the blood by absorption , they are effective in
trapping gross bubbles.
Screen filters
composed of a woven
mesh of polyester fibers
defined pore sizes
From 20 -40 μm
(all of the arterial line filters used are the screen type)
Jehowah's witnesses and blood conservation strategies by Dr.Minnu M. PanditraoMinnu Panditrao
dr. Mrs. Minnu M. Panditrao explains the problems faced by anesthesiologists in anesthetising the Jehowah's Witness patients because of their beliefs. Ina ddition she also discribes various strategies of Blood conservation.
EMBOLISM AND FILTERS USED IN CARDIOPULMONARY BYPASSGLORY MINI MOL. A
FILTERS USED IN CARDIOPULMONARY BYPASS
EMBOLISM
DEFINITION: obstruction of an artery, by a clot of blood or an air bubble.
This emboli is categorized to
Biological emboli
Foreign emboli
Gaseous emboli
There are current technologies to decrease this embolic event delivered to patient
Membrane oxygenators
FILTER
Blood surface coating
Bubble traps
Emboli detection system
Blood Filters
Depth filters
Consist of packed fibers of Dacron wool or
polyurethane foam .
No defined pore size
These filters have large wetted surface
areas to filter the blood by absorption , they are effective in
trapping gross bubbles.
Screen filters
composed of a woven
mesh of polyester fibers
defined pore sizes
From 20 -40 μm
(all of the arterial line filters used are the screen type)
Jehowah's witnesses and blood conservation strategies by Dr.Minnu M. PanditraoMinnu Panditrao
dr. Mrs. Minnu M. Panditrao explains the problems faced by anesthesiologists in anesthetising the Jehowah's Witness patients because of their beliefs. Ina ddition she also discribes various strategies of Blood conservation.
Blood products:Collection, Processing and Storage of whole human blood, dried...Steffi Thomas
blood and its components, conditions for being a donor, anti-coagulants, whole human blood, changes in composition during storage, red blood cells, concentrated platelets, plasma, dried human plasma, fresh frozen plasma, dried human serum, plasma substitutes, ideal properties of plasma substitute, dextran, gum saline, polyvinylpyrrolidone
Surgery resident postgraduate presentation on the use of blood and products presented dept of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria
A brief presentation for second-year students in Iraqi Technical Institutes (studying Medical Laboratory Technology). This introduction covers the types of blood samples, how to collect these samples, common sites for collection, and anticoagulants in a test-tubes.
Specimen collection and Biological VariationsSamson Ojedokun
Specimen collection involves various procedures in obtaining patient samples directly or indirectly for analytical procedures.
It is important to take stringent precautions to control the analytical accuracy and precision of results which largely depends on the preanalytical factors or variables.
The Norwood procedure is the first of three surgeries required to treat single-ventricle conditions such as hypoplastic left heart syndrome (HLHS). Because the left side of the heart can’t be fixed, the series of surgeries rebuilds other parts of the heart.
The Norwood procedure is performed in the baby’s first or second week of life.to redirect the blood flow.
Three goals for the Norwood procedure:
1, Build a new aorta.
2, Direct blood from the right ventricle through the new aorta and on to the rest of the body.
3, Direct the right ventricle to pump blood to the lungs until the next surgery.
Anomalous left coronary artery from the pulmonary arteryManu Jacob
In a normal heart, both coronary arteries arise (branch) from the aorta.
In anomalous left coronary artery from the pulmonary artery (ALCAPA), something goes wrong while the heart is forming in the womb
The left coronary artery arises from the pulmonary artery instead of the aorta
n a Ross procedure, a surgeon removes the abnormal aortic valve. The surgeon then replaces it with the child's own pulmonary valve. The surgeon uses a valve from a cadaver donor (conduit) to replace the pulmonary valve.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
3. Intra operative
blood
conservation
Advantages of autologous
blood
Prevents transfusion-transmitted
disease
Prevents red cell alloimmunization
Supplements the blood supply
Provides compatible blood for patients
with alloantibodies
Prevents some adverse transfusion
reactions
Provides reassurance to patients
concerned about blood risks
AUTOLOGUS
BLOOD
TRANFUSIO
N
7. Intra operative
blood
conservation
Three general types of
salvage procedures:
1.Cell processors and salvage
devices that wash and save
red blood cells, i.e., "cell
washers" or RBC-savers
2.Direct transfusion
3.Ultrafiltration of whole
blood
Blood salvage proceduresTYPES
10. Intra operative
blood
conservation
1.COLLECTION
•Using a dual lumen tube,
anticoagulant is fed to the
operation site to be mixed
immediately with shed blood
and sucked away.
•The choice of
anticoagulant either
Heparin or Citrate.
Method
11. Intra operative
blood
conservation
•Blood and anticoagulant are
carried into a sterile reservoir by
vacumm.
•It is filtered to remove large
clots and debris.
•Most collection reservoirs have a
filter in the 40-150 micron
range.
•Between 1:5 and 1:10 ratio of
anticoagulant to collected blood.
2.STORAGEMethod
12. Intra operative
blood
conservation
Blood and anticoagulant are drawn
from the collection pot into a
centrifuge to be processed.
The force supplied by the centrifuge
holds the more dense red blood cells
against the outer wall of the bowl.
The less dense white blood cells,
platelets, plasma and anticoagulant
move towards the centre of the bowl
where they spill over into a waste
bag
3.CENTRIFUGE
Method
13. Intra operative
blood
conservation
Blood is washed with a
saline solution and red
blood cells are separated
from waste products.
A sterile isotonic saline
solution is pumped into the
centrifuge bowl. Only a
0.9% sterile normal saline
is recommended.
4.washing
Method
14. Intra operative
blood
conservation
Waste products include
white blood cells,
platelets, plasma,
anticoagulant, fat and free
plasma haemoglobin.
These are collected in a
bag.
5.Waste separation
Method
16. Intra operative
blood
conservation
Red blood cells can then
be reinfused immediately
or taken to recovery or the
Ward to be reinfused later.
There is, however, a limit
of 6 hours during which
reinfusion can take place.
7.Reinfusion
Method
18. Intra operative
blood
conservation
Practical
consideratios
1. If not transfused immediately, units collected from a
sterile operating field and processed with a device for
intraoperative blood collection that washes with 0.9% saline,
USP, shall be stored under one of the following conditions
prior to initiation of transfusion:
At room temperature for up to 4 hours after terminating
collection;
At 1–6° C for up to 24 hours, provided that storage at 1–
6° C is begun within 4 hours of ending the collection.
2. Transfusion of blood collected intraoperatively by other
means shall begin within 6 hours of initiating the collection
3. Each unit collected intraoperatively shall be labeled with
the patient's first name, last name, and hospital identification
number; the date and time of initiation of collection and of
expiration; and the statement "For Autologous Use Only."
4. If stored in the blood bank, the unit shall be handled like
any other autologous unit.
19. Intra operative
blood
conservation
•Hemofiltration or ultrafiltration devices
filter the patient's anticoagulated whole
blood.
•The filter process removes unwanted excess
non-cellular plasma water, low molecular
weight solutes, platelet inhibitors, and some
particulate matter including activated
cytokines, anaphylatoxins, and other waste
substances through hemoconcentration; thus
making concentrated whole blood available
for reinfusion.
• Hemofilter devices return the patient's
whole blood with all the blood elements and
fractions including platelets, clotting
factors, and plasma proteins with a
substantial Hb level.
Ultrafiltration
of Whole
Blood
Ultrafiltration
21. Intra operative
blood
conservation
Direct transfusion is a blood salvaging
method associated with cardiopulmonary
bypass (CPB) circuits or other
extracorporeal circuits (ECC).
Following bypass surgery the ECC circuit
contains a significant volume of diluted
whole blood that can be harvested in
transfer bags and re-infused into
patients. Residual CPB blood is fairly
dilute ([Hb] = 6–9 g/dL) and can also
contain potentially harmful
contaminants such as activated
cytokines, anaphylatoxins, and other
waste substances
Direct transfusion
DIRECT
TRANFUSION