1.
The Effect of Fibrinogen/Thrombin-Coated Collagen Patch (TachoSil((R))) Application in Pancreaticojejunostomy for Prevention of Pancreatic Fistula After Pancreaticoduodenectomy: A Randomized Clinical Trial
Kwon J, Shin SH, Lee S, Park G, Park Y, Lee SJ, Lee W, Song KB, Hwang DW, Kim SC, et al
World journal of surgery. 2019
Abstract
BACKGROUND Fibrin sealants and topical glue have been studied to reduce the incidence of postoperative pancreatic fistulas (POPF) after pancreatico-enteric anastomosis, but a definitive innovation is still needed. We aim to evaluate the effectiveness of fibrin sealant patch applied to pancreatico-enteric anastomosis to reduce postoperative complications, including POPF. METHODS This study was a single-center, prospective, randomized, phase IV trial involving three pancreaticobiliary surgeons. The primary outcome was POPF; secondary outcomes included complications, drain removal days, hospital stay, readmission rate, and cost. Risk factors for POPF were identified by logistic regression analysis. RESULTS A total of 124 patients were enrolled. Biochemical leakage (BL) or POPF occurred in 16 patients (25.8%) in the intervention group and 23 patients (37.1%) in the control group (no statistical significance). Clinically relevant POPF occurred in 4 patients (6.5%) in both the intervention and control groups (p = 1.000). Hospital stay (11.6 days vs. 12.1 days, p = 0.585) and drain removal days (5.7 days vs. 5.3 days, p = 0.281) were not statistically different between two groups. Complication rates were not different between the two groups (p = 0.506); nor were readmission rates (12.9% vs. 11.3%, p = 1.000) or cost ($13,549 vs. $15,038, p = 0.103). In multivariable analysis, age and soft pancreas texture were independent risk factors for BL or POPF in this study. Applying fibrin sealant patch is not a negative risk factor, but the p value may indicate a likelihood of reducing the incidence of BL (p = 0.084). CONCLUSIONS Fibrin sealant patches after pancreaticojejunostomy did not reduce the incidence of POPF or other postoperative complications. This study was registered at clinicaltrials.gov (NCT03269955).
2.
Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea
Han JJ, Yim HE, Lee JH, Kim YK, Jang GY, Choi BM, Yoo KH, Hong YS
Journal of Perinatology. 2009;29((6):):444-7.
Abstract
UNLABELLED To compare the efficacy of albumin to normal saline (NS) for initial hydration therapy for dehydrated term infants with severe metabolic acidosis due to acute diarrhea. STUDY DESIGN We randomized 33 infants presenting with moderate-to-severe dehydration and metabolic acidosis (pH <7. 25 or base excess (BE) <-15) into two groups, an albumin group (n=15) and a NS group (n=18). For initial hydration treatment, the albumin group received 5% albumin (10 ml kg(-1)), whereas the NS group received NS (10 ml kg(-1)). RESULT After 3 h of treatment, both groups improved. However, the magnitude of improvement in the pH, BE and HCO(3)(-) levels were not different in comparisons between these two groups. In addition, there were no differences either in the body weight and weight gain 4 days after treatment or in the length of hospital stay. CONCLUSION Albumin was not more effective than NS for initial hydration treatment of dehydrated term infants with metabolic acidosis due to acute diarrhea.
3.
Comparison of the efficacy in prevention of hepatitis B virus recurrence after liver transplantation between HBIG and lamivudine
Lee KW, Lee SK, Joh JW, Kim SJ, Park JH, Chon SE, Choi SH, Heo JS, Paik SW, Koh KW, et al
Transplantation Proceedings. 2001;33((7-8):):3643-4.
4.
Evaluation of STAT-CRIT hematocrit determination in comparison to Coulter and centrifuge: the effects of isotonic hemodilution and albumin administration
McNulty SE, Sharkey SJ, Asam B, Lee JH
Anesthesia & Analgesia. 1993;76((4):):830-4.
Abstract
The accuracy of the STAT-CRIT hematocrit (hct) was compared to Coulter and centrifuge methods in this study of the interrelationship between non-red cell blood constituents and accuracy of conductivity-based hct measurements. In the first part of the study, blood samples from 31 patients undergoing elective cardiac procedures were analyzed at three times: before induction of anesthesia (Time 1), during the rewarming period of cardiopulmonary bypass (CPB) (Time 2), and after transfusion of all cell-saver blood available after termination of CPB (Time 3). Laboratory evaluation included hct using the Stat-Crit, Coulter, and centrifuge methods, and sodium (Na), potassium (K), chloride (Cl), white blood cell count, total protein (TP), and albumin. In the second part of the study, patients were randomized to receive either 5% albumin (n = 14) or isotonic crystalloid (n = 14) after termination of CPB to determine the effect of protein colloid replacement on conductivity-based hct measurements. Blood samples were obtained before and after fluid volume replacement for multivariate analysis. Correlation of Coulter hct (absolute) with microhematocrit by centrifuge at all times (n = 93) was 0.95 (R2) with a bias and precision of -0.26 +/- 1.7%. Blood variables having the most significant effect on the Coulter-Stat-Crit difference (bias) were protein, Cl, and Na. Single regression analysis indicated that a 1-g/dL decrease in TP resulted in an absolute decrease in the hct reading by 1 hct% units. A 10-mmol/L change in either Cl or Na concentration resulted in a change in Stat-Crit accuracy of 3.5% and 2.5%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)