RESUMO
A case is reported of management of massive intraoperative blood loss in a male patient with severe hemophilia. Extirpation of hip pseudotumor with one-stage osteosynthesis with an intramedullary joint-pin in a 43 year old male patient was accompanied with 7.5 l blood loss. The infusion-transfusion therapy (ITT) contained transfusion media about 1/3 of the total volume, fresh-frozen plasma and erythrocyte-containing media were used 1:1. Infusion solutions consisted of balanced polyelectrolytic solutions, hydroxyethylated starches 130/0.4, hyperchaes. Intraoperative normovolemic hemodilution and reinfusion of wound blood were made (CellSaver). ITT target markers were standard hemodynamics control tests. Hemostasis monitoring was conducted with thromboelastography. Complex ITT based on modern principles of clinical transfusiology provided a complete and safe compensation of massive intraoperative blood loss in a patient with severe hemophilia.
Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Transfusão de Sangue/métodos , Hemodiluição/métodos , Hemofilia A/sangue , Doença Aguda , Adulto , Volume Sanguíneo , Fixação Interna de Fraturas , Hematoma/sangue , Hematoma/complicações , Hematoma/diagnóstico por imagem , Hematoma/cirurgia , Hemofilia A/complicações , Hemofilia A/diagnóstico por imagem , Fraturas do Quadril/sangue , Fraturas do Quadril/complicações , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/cirurgia , Humanos , Derivados de Hidroxietil Amido/uso terapêutico , Masculino , Substitutos do Plasma/uso terapêutico , Radiografia , Resultado do TratamentoAssuntos
Músculos/fisiologia , Esportes , Biópsia por Agulha , Humanos , Masculino , Músculos/anatomia & histologiaRESUMO
Muscle fibers composition was investigated in vastus lateralis muscles of 103 skaters. In the total population of skaters muscle fibers composition was as follows: muscle fibers, type I--in 54 +/- 2%, muscle fibers, type II A--in 35 +/- 1% and muscle fibers, type II B--in 11 +/- 1%. 13 +/- 8% muscle fibers, type I; 1.56 +/- 6% muscle fibers, type II A and 31 +/- 7% muscle fibers, type II B were observed in the muscles of sprinters, while the muscles of long-distance skaters contained 60 +/- 4%, 33 +/- 4% and 7 +/- 2% muscle fibers, respectively.