Anaesthesia
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Review Case Reports
Severe hypotension related to cell salvaged blood transfusion in obstetrics.
Intra-operative blood cell salvage has recently been adopted for use in women at risk of significant haemorrhage during caesarean section. It has also been advocated for use in those patients who refuse allogenic blood transfusion. ⋯ On starting the cell-salvaged blood transfusion, the blood pressure was noted to fall and this was temporally related to the transfusion of the cell-salvaged blood. We review the recent literature and case reports on hypotension related to cell-salvaged blood transfusion.
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It is generally believed that plaque rupture and myocardial oxygen supply-demand imbalance contribute approximately equally to the burden of peri-operative myocardial infarction. This review critically analyses data of post-mortem, pre-operative coronary angiography, troponin surveillance, other pre-operative non-invasive investigations, and peri-operative haemodynamic predictors of myocardial ischaemia and/or myocardial infarction. ⋯ Research and therapeutic interventions should be focused on the prediction and therapy of flow stagnation and thrombus formation. Plaque rupture appears to be a more random event, distributed over the entire peri-operative admission.