Massive bleeding during spine surgery in a patient with ankylosing spondylitis
Ankylosing spondylitis is associated with pathophysiology that has important anaesthetic implications. We report a case where the sequelae of ankylosing spondylitis may have been responsible for massive bleeding during emergency spine surgery. A 69 yr old man with long standing ankylosing spondyliti...
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| Veröffentlicht in: | Canadian journal of anesthesia 1998-09, Vol.45 (9), p.903-906 |
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| container_title | Canadian journal of anesthesia |
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| creator | TETZLAFF, J. E YOON, H. J BELL, G |
| description | Ankylosing spondylitis is associated with pathophysiology that has important anaesthetic implications. We report a case where the sequelae of ankylosing spondylitis may have been responsible for massive bleeding during emergency spine surgery.
A 69 yr old man with long standing ankylosing spondylitis sustained a complex fracture of the lumbar spine in a fall, and was scheduled for stabilization of the spine. Under general anaesthesia, prone positioning was difficult because of the extreme spinal deformity. During exploration, dilatation of epidural veins was encountered and sustained haemorrhage was encountered throughout the surgical procedure. Estimated blood loss was 17,000 ml which was replaced with 31 units of packed red blood cells, 3200 ml of salvaged blood, 18 units of fresh frozen plasma, 26 units of platelets, 1,000 ml of albumin and 9,000 ml of crystalloid.
Extreme deformity of the spine led to positioning difficulties that may have contributed to massive blood loss during complex spine surgery. Difficulties with placement in the prone position in-patients with advanced ankylosing spondylitis should be anticipated. |
| doi_str_mv | 10.1007/BF03012228 |
| format | Article |
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A 69 yr old man with long standing ankylosing spondylitis sustained a complex fracture of the lumbar spine in a fall, and was scheduled for stabilization of the spine. Under general anaesthesia, prone positioning was difficult because of the extreme spinal deformity. During exploration, dilatation of epidural veins was encountered and sustained haemorrhage was encountered throughout the surgical procedure. Estimated blood loss was 17,000 ml which was replaced with 31 units of packed red blood cells, 3200 ml of salvaged blood, 18 units of fresh frozen plasma, 26 units of platelets, 1,000 ml of albumin and 9,000 ml of crystalloid.
Extreme deformity of the spine led to positioning difficulties that may have contributed to massive blood loss during complex spine surgery. Difficulties with placement in the prone position in-patients with advanced ankylosing spondylitis should be anticipated.</description><identifier>ISSN: 0832-610X</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/BF03012228</identifier><identifier>PMID: 9818117</identifier><identifier>CODEN: CJOAEP</identifier><language>eng</language><publisher>Toronto, ON: Canadian Anesthesiologists' Society</publisher><subject>Aged ; Albumins - therapeutic use ; Biological and medical sciences ; Blood Loss, Surgical ; Blood Transfusion, Autologous ; Blood Volume ; Diseases of the osteoarticular system ; Dura Mater - blood supply ; Erythrocyte Transfusion ; Humans ; Inflammatory joint diseases ; Isotonic Solutions ; Lumbar Vertebrae - surgery ; Male ; Medical sciences ; Orthopedic surgery ; Plasma ; Plasma Substitutes - therapeutic use ; Platelet Transfusion ; Prone Position ; Spinal Fractures - surgery ; Spinal Fusion ; Spondylitis, Ankylosing - complications ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Thoracic Vertebrae - injuries ; Thoracic Vertebrae - surgery ; Vasodilation ; Veins - pathology</subject><ispartof>Canadian journal of anesthesia, 1998-09, Vol.45 (9), p.903-906</ispartof><rights>1999 INIST-CNRS</rights><rights>Canadian Anesthesiologists 1998</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-b59f33324e6fac8bbd86511e047db93f1f00bde1abf278dfa3cb82f46b3509f93</citedby><cites>FETCH-LOGICAL-c374t-b59f33324e6fac8bbd86511e047db93f1f00bde1abf278dfa3cb82f46b3509f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1600607$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9818117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>TETZLAFF, J. E</creatorcontrib><creatorcontrib>YOON, H. J</creatorcontrib><creatorcontrib>BELL, G</creatorcontrib><title>Massive bleeding during spine surgery in a patient with ankylosing spondylitis</title><title>Canadian journal of anesthesia</title><addtitle>Can J Anaesth</addtitle><description>Ankylosing spondylitis is associated with pathophysiology that has important anaesthetic implications. We report a case where the sequelae of ankylosing spondylitis may have been responsible for massive bleeding during emergency spine surgery.
A 69 yr old man with long standing ankylosing spondylitis sustained a complex fracture of the lumbar spine in a fall, and was scheduled for stabilization of the spine. Under general anaesthesia, prone positioning was difficult because of the extreme spinal deformity. During exploration, dilatation of epidural veins was encountered and sustained haemorrhage was encountered throughout the surgical procedure. Estimated blood loss was 17,000 ml which was replaced with 31 units of packed red blood cells, 3200 ml of salvaged blood, 18 units of fresh frozen plasma, 26 units of platelets, 1,000 ml of albumin and 9,000 ml of crystalloid.
Extreme deformity of the spine led to positioning difficulties that may have contributed to massive blood loss during complex spine surgery. Difficulties with placement in the prone position in-patients with advanced ankylosing spondylitis should be anticipated.</description><subject>Aged</subject><subject>Albumins - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood Loss, Surgical</subject><subject>Blood Transfusion, Autologous</subject><subject>Blood Volume</subject><subject>Diseases of the osteoarticular system</subject><subject>Dura Mater - blood supply</subject><subject>Erythrocyte Transfusion</subject><subject>Humans</subject><subject>Inflammatory joint diseases</subject><subject>Isotonic Solutions</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Orthopedic surgery</subject><subject>Plasma</subject><subject>Plasma Substitutes - therapeutic use</subject><subject>Platelet Transfusion</subject><subject>Prone Position</subject><subject>Spinal Fractures - surgery</subject><subject>Spinal Fusion</subject><subject>Spondylitis, Ankylosing - complications</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Thoracic Vertebrae - injuries</subject><subject>Thoracic Vertebrae - surgery</subject><subject>Vasodilation</subject><subject>Veins - pathology</subject><issn>0832-610X</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkMFLwzAYxYMoc04v3oUg4kGofknaJj3qcCpMvSh4K0mbzGiXzqRV-t_bseLAw-Md3o_H4yF0TOCSAPCrmxkwIJRSsYPGJM7SSGQ82UVjEIxGKYG3fXQQwgcAiDQRIzTKBBGE8DF6epQh2G-NVaV1ad0Cl61fW1hZp3Fo_UL7DluHJV7JxmrX4B_bvGPpPruqDhu0dmVX2caGQ7RnZBX00eAT9Dq7fZneR_Pnu4fp9TwqGI-bSCWZYYzRWKdGFkKpst9FiIaYlypjhhgAVWoilaFclEayQglq4lSxBDKTsQk63_SufP3V6tDkSxsKXVXS6boNOQdIEhKTHjz9B37UrXf9tjyjNAbo1UMXG6jwdQhem3zl7VL6LieQrx_Otw_38MnQ2KqlLv_Q4dI-PxtyGQpZGS9dYcO2MQVIgbNfP4OClg</recordid><startdate>19980901</startdate><enddate>19980901</enddate><creator>TETZLAFF, J. 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E</au><au>YOON, H. J</au><au>BELL, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Massive bleeding during spine surgery in a patient with ankylosing spondylitis</atitle><jtitle>Canadian journal of anesthesia</jtitle><addtitle>Can J Anaesth</addtitle><date>1998-09-01</date><risdate>1998</risdate><volume>45</volume><issue>9</issue><spage>903</spage><epage>906</epage><pages>903-906</pages><issn>0832-610X</issn><eissn>1496-8975</eissn><coden>CJOAEP</coden><abstract>Ankylosing spondylitis is associated with pathophysiology that has important anaesthetic implications. We report a case where the sequelae of ankylosing spondylitis may have been responsible for massive bleeding during emergency spine surgery.
A 69 yr old man with long standing ankylosing spondylitis sustained a complex fracture of the lumbar spine in a fall, and was scheduled for stabilization of the spine. Under general anaesthesia, prone positioning was difficult because of the extreme spinal deformity. During exploration, dilatation of epidural veins was encountered and sustained haemorrhage was encountered throughout the surgical procedure. Estimated blood loss was 17,000 ml which was replaced with 31 units of packed red blood cells, 3200 ml of salvaged blood, 18 units of fresh frozen plasma, 26 units of platelets, 1,000 ml of albumin and 9,000 ml of crystalloid.
Extreme deformity of the spine led to positioning difficulties that may have contributed to massive blood loss during complex spine surgery. Difficulties with placement in the prone position in-patients with advanced ankylosing spondylitis should be anticipated.</abstract><cop>Toronto, ON</cop><pub>Canadian Anesthesiologists' Society</pub><pmid>9818117</pmid><doi>10.1007/BF03012228</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Albumins - therapeutic use Biological and medical sciences Blood Loss, Surgical Blood Transfusion, Autologous Blood Volume Diseases of the osteoarticular system Dura Mater - blood supply Erythrocyte Transfusion Humans Inflammatory joint diseases Isotonic Solutions Lumbar Vertebrae - surgery Male Medical sciences Orthopedic surgery Plasma Plasma Substitutes - therapeutic use Platelet Transfusion Prone Position Spinal Fractures - surgery Spinal Fusion Spondylitis, Ankylosing - complications Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Thoracic Vertebrae - injuries Thoracic Vertebrae - surgery Vasodilation Veins - pathology |
| title | Massive bleeding during spine surgery in a patient with ankylosing spondylitis |
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