Medizinische Klinik (Munich, Germany : 1983)
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Med. Klin. (Munich) · May 2009
Multicenter Study Clinical TrialLow levels of prothrombin time (INR) and platelets do not increase the risk of significant bleeding when placing central venous catheters.
Central venous catheters are frequently placed in intensive care medicine for multiple indications. The risk of severe bleeding after cannulation is considered to be increased in patients with abnormal coagulation, common in critically ill patients. ⋯ These findings demonstrate that coagulation disorders with altered prothrombin time (INR) or platelets do not increase the risk of significant bleeding when inserting a central venous catheter. Therefore, the prophylactic correction of coagulation by transfusion of blood products or coagulation factors is not necessary before central venous catheter insertion.
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Med. Klin. (Munich) · May 2009
Controlled Clinical Trial[Long-term therapy with propofol has no impact on microcirculation in medical intensive care patients].
Microcirculation has become a major focus of research in critical care medicine due to its growing clinical relevance detecting changes in organ perfusion at an early stage. A negative impact of propofol infusion on microcirculation during short-term anesthesia was described recently. The influence of long-term sedation with propofol on microflow of critical care patients is still unclear. ⋯ In hemodynamically stable intensive care patients, long-term therapy with propofol did not affect sublingual microflow in this small cohort. However, intensive care physicians should keep such possible interactions in mind avoiding administration of these substances in patients with manifested shock. The effects of propofol in hemodynamically impaired patients should be evaluated in further studies.