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Abnormal coagulation profile in brain tumor patients during surgery
T J Iberti1, M Miller, A Abalos
1Department of Surgery, Mount Sinai Medical Center, New York, New York.
Neurosurgery
|March 1, 1994
Summary
Neurosurgery patients show altered blood clotting and bleeding times compared to abdominal surgery patients. These hemostatic differences may stem from dehydration and hyperosmolality, not just hormone levels.
Area of Science:
- Neurosurgery
- Coagulation Science
- Endocrinology
Background:
- Neurosurgical patients face high risks of thrombosis and thromboembolism.
- Perioperative hemostasis in neurosurgery differs from general surgery.
Purpose of the Study:
- Compare perioperative clotting and coagulation in elective craniotomy vs. abdominal surgery patients.
- Investigate the role of plasma arginine vasopressin in neurosurgical hemostasis.
Main Methods:
- Compared 20 craniotomy patients with 20 abdominal surgery patients.
- Measured clotting factors, activated partial thromboplastin times, bleeding times, plasma arginine vasopressin, serum osmolality, and hemoglobin.
- Monitored parameters perioperatively up to 12 hours post-surgery.
Main Results:
- Neurosurgery patients exhibited significantly reduced partial thromboplastin times and bleeding times.
- Both groups showed elevated factor assays and plasma arginine vasopressin during surgery.
- Neurosurgical patients uniquely showed elevated Factor IX levels, higher serum osmolality, and hemoglobin.
Conclusions:
- Hemostatic differences exist between neurosurgical and abdominal surgery patients.
- These differences are not fully explained by arginine vasopressin or measured clotting factors.
- Perioperative dehydration and hyperosmolality may contribute to observed hemostatic changes in neurosurgery.