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Preoperative Treatment With Corticosteroids

George R. Holswade, MD; Ralph L. Nachman, MD; Thomas Killip, MD

AMA Arch Surg. 1967;94(3):365-369.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

THE DEVELOPMENT of a hemorrhagic diathesis following an open-heart operation is a serious complication.¹ Hemorrhagic disease may develop as a function of: (1) abnormalities directly related to extracorporeal circulation such as thrombocytopenia, defibrination, or fibrinolysis,² (2) depressed coagulation factors associated with hepatic decompensation, (3) occult thrombocytopenia occurring in the setting of congestive splenomegaly or drug purpura,³ and (4) subclinical qualitative defects of platelet function. Combinations of these abnormalities may also occur.

In order to decrease the possibility of hemorrhagic complications following openheart procedures, a comprehensive coagulation study has been performed upon all adult patients at The New York Hospital-Cornell Medical Center who were candidates for open-heart surgery over the past 3 years. Included in the comprehensive coagulation study have been the following determinations: clotting time (Lee-White), bleeding time (Duke), tourniquet test (Rumpel-Leede), clot retraction (Qualitative), platelet estimate (blood smear), platelet count (Phase), fibrinogen (Fowell), fibrinolysis (Euglobin), prothrombin . . . [Full Text PDF of this Article]

Author Affiliations
New York

From the departments of surgery and medicine, Cornell University Medical College, New York.

Footnotes
Submitted for publication Nov 30, 1966.

Read in part before the 39th Scientific Sessions of the American Heart Association, New York, Oct 23, 1966.

Reprint requests to 525 E 68th St, New York 10021 (Dr. Holswade).

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