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Postoperative Low-Dose Tranexamic Acid After Major Spine Surgery: A Matched Cohort Analysis
Lauren K. Dunn,Ching-Jen Chen,Davis G. Taylor,Kamilla Esfahani,Brian Brenner,Charles Luo,Thomas J. Buell,Sarah N. Spangler,Avery L. Buchholz,Justin S. Smith,Christopher I. Shaffrey,Edward C. Nemergut 대한척추신경외과학회 2020 Neurospine Vol.17 No.4
Objective: This was a retrospective, cohort study investigating the efficacy and safety of continuous low-dose postoperative tranexamic acid (PTXA) on drain output and transfusion requirements following adult spinal deformity surgery. Methods: One hundred forty-seven patients undergoing posterior instrumented thoracolumbar fusion of ≥3 vertebral levels at a single institution who received low-dose PTXA infusion (0.5–1 mg/kg/hr) for 24 hours were compared to 292 control patients who did not receive PTXA. The cohorts were propensity matched based on age, sex, American Society of Anesthesiologist physical status classification, body mass index, number of surgical levels, revision surgery, operative duration, and total intraoperative TXA dose (n=106 in each group). Primary outcome was 72-hour postoperative drain output. Secondary outcomes were number of allogeneic blood transfusions. Results: There was no significant difference in postoperative drain output in the PTXA group compared to control (660±420 mL vs. 710±490 mL, p=0.46). The PTXA group received significantly more crystalloid (6,100±3,100 mL vs. 4,600±2,400 mL, p<0.001) and red blood cell transfusions postoperatively (median [interquartile range]: 1 [0–2] units vs. 0 [0–1] units; incidence rate ratio [95% confidence interval], 1.6 [1.2–2.2]; p=0.001). Rates of adverse events were comparable between groups. Conclusion: Continuous low-dose PTXA infusion was not associated with reduced drain output after spinal deformity surgery. No difference in thromboembolic incidence was observed. A prospective dose escalation study is warranted to investigate the efficacy of higher dose PTXA.
김병재(Byoung Jae Kim),윤상열(Sang Youl Yoon),성형진(Hyung Jin Sung),Charles G. Smith 대한기계학회 2007 대한기계학회 춘추학술대회 Vol.2007 No.10
This study proposes ideas for simultaneous mixing and pumping using asymmetric microelectrode arrays. The driving force of the mixing and pumping was based on electroosmotic flows induced by AC (alternating current) electric fields on asymmetric microelectrodes. The key idea was to bend/incline the microelectrodes like diagonal/ herringbone shapes. These microelectrode patterns forced fluid flows in the lateral direction leading to mixing and in the channel direction leading to pumping. The performances of the mixing and pumping were assessed in terms of the mixing efficiency and the pumping flow rate. The results indicated that the helical flow motions induced by the electrode arrays play a significant role in the mixing enhancement. The pumping performance was influenced by the slip velocity at the center region of the channel compared to that near the side walls.