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Titolo:
Changes of haemostasis. in patients undergoing major abdominal surgery - is there a difference between elderly and younger patients?
Autore:
Boldt, J; Huttner, I; Suttner, S; Kumle, B; Piper, SN; Berchthold, G;
Indirizzi:
Klinikum Stadt Ludwigshafen, Dept Anaesthesiol & Intens Care Med, D-67063 Ludwigshafen, Germany Klinikum Stadt Ludwigshafen Ludwigshafen Germany D-67063 shafen, Germany Klinikum Stadt Ludwigshafen, Surg Clin, D-67063 Ludwigshafen, Germany Klinikum Stadt Ludwigshafen Ludwigshafen Germany D-67063 shafen, Germany
Titolo Testata:
BRITISH JOURNAL OF ANAESTHESIA
fascicolo: 3, volume: 87, anno: 2001,
pagine: 435 - 440
SICI:
0007-0912(200109)87:3<435:COHIPU>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC-SURGERY; COAGULATION; MARKERS; PFA-100(TM); HEMOSTASIS;
Keywords:
surgery, abdominal; age factors; blood, haemostasis; blood, platelet function;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Boldt, J Klinikum Stadt Ludwigshafen, Dept Anaesthesiol & Intens Care Med,Bremserstr 79, D-67063 Ludwigshafen, Germany Klinikum Stadt Ludwigshafen Bremserstr 79 Ludwigshafen Germany D-67063
Citazione:
J. Boldt et al., "Changes of haemostasis. in patients undergoing major abdominal surgery - is there a difference between elderly and younger patients?", BR J ANAEST, 87(3), 2001, pp. 435-440

Abstract

Many physiological functions are altered in the elderly. It is not clear whether this applies to haemostatic mechanisms in patients undergoing major surgery. Twenty-five consecutive patients <60 yr and 25 consecutive patients >70 yr scheduled for abdominal surgery for malignancies were included in our study. Various standard coagulation variables and specific markers of coagulation were serially measured before surgery (baseline), at arrival on the intensive care unit (ICU), 4 h after arrival on ICU, and on the morningof the first postoperative day. Platelet function was assessed using the Platelet Function Analyser PFA-100 \ with adenosine diphosphate (ADP) as an inductor. Anaesthesia and surgery were similar between the elderly (76(3) years) and younger (53(5) years) groups. Baseline plasma levels of prothrombin fragments F1+2, thrombin-antithrombin III (TAT) complex, and D-dimers. were significantly different between the two groups, indicating thrombin activation and fibrin formation in the elderly. Postoperatively, only F1+2 plasma levels were significantly higher in the elderly (4.0(0.8) nmol/l) than in the younger patients (2.2(0.9) nmol/l), whereas the course of D-dimer and TAT did not differ significantly between the two groups. Endothelial-derived markers of coagulation (Von Willebrand factor, collagen-binding activity of von Willebrand factor) were not different between the groups throughout the study period. Platelet function was impaired in the elderly compared with the younger patients. It is concluded that elderly patients showed more prothrombin activation/thrombin generation and increased fibrinolytic activity prior to surgery than younger patients. However, perioperative changes of coagulation in the elderly were similar to those seen in younger patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 01:02:26