37 results match your criteria arterial-central venous


Acute hyperventilation increases oxygen consumption and decreases peripheral tissue perfusion in critically ill patients.

J Crit Care 2021 May 21. Epub 2021 May 21.

Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. Electronic address:

Purpose: This study aimed to evaluate the effects of acute hyperventilation on central venous-to-arterial carbon dioxide tension difference (Pv-aCO), central venous oxygen saturation (ScvO), central venous-to-arterial CO difference/arterial-central venous O difference ratio (COGAP-Ratio), and peripheral perfusion index (PI) in hemodynamically stable critically ill patients.

Methods: Fifty-four mechanically ventilated patients were evaluated. The cardiac index, Pv-aCO, ScvO, COGAP-Ratio, PI, and arterial and venous blood gas parameters were measured in the first set of measurements. Read More

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Elevated Arterial-Central Venous Carbon Dioxide Partial Pressure Difference Indicates Poor Prognosis in the Early Postoperative Period of Open Heart Surgery in Infants with Congenital Heart Disease.

Pediatr Cardiol 2021 Jun 9. Epub 2021 Jun 9.

Cardiac Intensive Care Unit, Department of Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.

Background: Elevated arterial-central venous carbon dioxide partial pressure difference (AVCO) may be an important marker to predict tissue and organ hypoperfusion in adults. We analyzed the hemodynamic data of infants with congenital heart disease who underwent corrective repair with cardiopulmonary bypass (CPB) to identify whether AVCO has clinical significance in early postoperative tissue hypoperfusion, occurrence of complications, and clinical outcomes.

Methods: Infants with clinical conditions of hypoperfusion, without volume responsiveness and with ineffective initial treatment, within 3 h of cardiac surgery were enrolled in this study. Read More

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[The predictive value of central venous-arterial CO difference/arterial-central venous O difference ratio for progressive organ dysfunction in patients with septic shock after resuscitation].

Authors:
C Yu W J Fan M Shao

Zhonghua Nei Ke Za Zhi 2021 Jun;60(6):533-538

Department of Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.

To study the predictive value of central venous-arterial CO difference (Pv-aCO)/arterial-central venous O difference (Ca-vO) ratio for progressive organ dysfunction in patients with septic shock after resuscitation. Septic shock patients receiving resuscitation in ICU were retrospectively enrolled from July 2018 to June 2019 at the First Affiliated Hospital Anhui Medical University. Hemodynamic and laboratory data were collected. Read More

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Subclavian Artery Injury Following Central Venous Catheter Placement.

Cureus 2021 Apr 4;13(4):e14287. Epub 2021 Apr 4.

Vascular Surgery, Cleveland Clinic Florida, Weston, USA.

Mechanical complications following central venous catheterization are not uncommon. We discuss a case of iatrogenic intra-arterial central venous catheter placement requiring neck exploration in a 93-year-old woman. The catheter was inadvertently passed through the jugular vein and into the right subclavian artery by a junior surgical resident. Read More

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Agreement of blood glucose measured with glucose meter in arterial, central venous, and capillary samples in adult critically ill patients.

Nurs Crit Care 2021 Apr 13. Epub 2021 Apr 13.

Intensive Care Unit, Hospital Universitario San Cecilio, Granada, Spain.

Background: The measurement of blood glucose in critically ill patients is still performed in many ICUs with glucose meters and capillary samples. Several prevalent factors in these patients affect the accuracy of the results and should be interpreted with caution. A weak recommendation from the Surviving Sepsis Campaign (SSC) suggests the use of arterial blood rather than capillary blood for point of care testing using glucose meters. Read More

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A Pharmacokinetic-Pharmacodynamic Study of Intravenous Midazolam and Flumazenil in Adult New Zealand White-Californian Rabbits ().

J Am Assoc Lab Anim Sci 2021 May 5;60(3):319-328. Epub 2021 Mar 5.

Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada; Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, Québec, Canada; Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine (UCVM), University of Calgary, Calgary, Alberta, Canada;, Email:

Flumazenil, a competitive GABA receptor antagonist, is commonly used in rabbits to shorten sedation or postanesthetic recovery after benzodiazepine administration. However, no combined pharmacokinetic (PK) and pharmacodynamic (PD) data are available to guide its administration in this species. In a prospective, randomized, blinded, crossover study design, the efficacy of IV flumazenil (FLU; 0. Read More

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Lactate Arterial-Central Venous Gradient among COVID-19 Patients in ICU: A Potential Tool in the Clinical Practice.

Crit Care Res Pract 2020 25;2020:4743904. Epub 2020 Sep 25.

Emergency Dept San Paolo Hospital, Via Terracina, 80125 Naples, Italy.

Objective: In physiological conditions, arterial blood lactate concentration is equal to or lower than central venous blood lactate concentration. A reversal in this rate (i.e. Read More

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September 2020

Peri-operative oxygen consumption revisited: An observational study in elderly patients undergoing major abdominal surgery.

Eur J Anaesthesiol 2021 01;38(1):4-12

From the Division of Anaesthesia and Intensive Care, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet (JJ, CN, SK, EB), Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital Huddinge, Stockholm (JJ, SK, EB), Department of Anaesthesia and Intensive Care, Nyköping County Hospital, Nyköping (CN) and Medical Statistics Unit, Department of Learning, Information, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden (EH).

Background: Monitoring oxygen consumption (VO2) is neither recommended nor included in peri-operative haemodynamic algorithms aiming at optimising oxygen delivery (DO2) in major abdominal surgery. Estimates of peri-operative VO2 changes are uncertain in earlier publications and have limited generalisability in the current high-risk surgical population. In a prospective non-interventional observational study in elderly patients undergoing major abdominal procedures, we investigated the change of VO2 after induction of anaesthesia and secondarily, the further changes during and after surgery in relation to DO2 and estimated oxygen extraction ratio (O2ER) by routine monitoring. Read More

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January 2021

Pseudo-arterial Temporary Hemodialysis Catheter Placement in the Left Internal Jugular Vein Ipsilateral to a Preexisting Brachio-axillary Arteriovenous Graft.

Indian J Nephrol 2020 Jan-Feb;30(1):29-31. Epub 2019 Dec 27.

The Robert Larner, M.D. College of Medicine, Department of Medicine, University of Vermont, Burlington, VT, UK.

Internal jugular vein (IJV) cannulation was originally described by English . in 1969 as the safest approach. Carotid artery puncture had an incidence rate of 4-6% before ultrasound guidance. Read More

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December 2019

Hemodynamic Monitoring in Patients With Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.

J Neurosurg Anesthesiol 2021 Oct;33(4):285-292

Departments of Anaesthesia and Intensive Care.

Aneurysmal subarachnoid hemorrhage (aSAH) often causes cardiopulmonary dysfunction. Therapeutic strategies can be guided by standard (invasive arterial/central venous pressure measurements, fluid balance assessment), and/or advanced (pulse index continuous cardiac output, pulse dye densitometry, pulmonary artery catheterization) hemodynamic monitoring. We conducted a systematic review and meta-analysis of the literature to determine whether standard compared with advanced hemodynamic monitoring can improve patient management and clinical outcomes after aSAH. Read More

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October 2021

Value of Central Venous to Arterial CO Difference after Early Goal-directed Therapy in Septic Shock Patients.

Indian J Crit Care Med 2019 Oct;23(10):449-453

Central ICU, Santa Casa Hospital, Porto Alegre, Rio Grande do Su, Brazil; Programa de Pós-graduação em Ciências Pneumológicas, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Su, Brazil.

Background And Aims: Venous to arterial difference of carbon dioxide (Pv-aCO) tracks tissue blood flow. We aimed to evaluate if Pv-aCO measured from a superior central vein sample is a prognostic index (ICU length of stay, SOFA score, 28th mortality rate) just after early goal-directed therapy (EGDT)comparing its ICU admission values between patients with normal and abnormal (>6 mm Hg) Pv-aCO. As secondary objectives, we evaluated the relationship of Pv-aCO with other variables of perfusion during the 24 hours that followed EGDT. Read More

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October 2019

Sampling Site Has a Critical Impact on Physiologically Based Pharmacokinetic Modeling.

J Pharmacol Exp Ther 2020 01 11;372(1):30-45. Epub 2019 Oct 11.

Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington

It has been shown that arterial (central) and venous (peripheral) plasma drug concentrations can be very different. While pharmacokinetic studies typically measure drug concentrations from the peripheral vein such as the arm vein, physiologically based pharmacokinetic (PBPK) models generally output simulated concentrations from the central venous compartment that physiologically represents the right atrium, a merge of the superior and inferior vena cava. In this study, a physiologically based peripheral forearm sampling site model was developed and verified using nicotine, ketamine, lidocaine, and fentanyl as model drugs. Read More

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January 2020

Pcv-aCO/Ca-cvO Combined With Arterial Lactate Clearance Rate as Early Resuscitation Goals in Septic Shock.

Am J Med Sci 2019 09 6;358(3):182-190. Epub 2019 May 6.

Department of Critical Care Medicine, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China. Electronic address:

Background: We aimed to investigate the prognostic significance of central venous-arterial carbon dioxide tension to arterial-central venous oxygen content ratio (Pcv-aCO/Ca-cvO) combined with arterial lactate clearance rate (LCR) as early resuscitation goals in septic shock.

Materials And Methods: We enrolled 145 septic shock patients admitted to our department from March 2013 to May 2017 in this study. They all received an initial resuscitation therapy according to the Surviving Sepsis Campaign guideline, and were classified into 4 groups according to Pcv-aCO/Ca-cvO and LCR at 6 hours after resuscitation (T6): Group A: Pcv-aCO/Ca-cvO > 1. Read More

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September 2019

[Using peripheral perfusion index and venous-to-arterial CO(2) difference/arterial-central venous O(2) difference ratio to assess lactate clearance in septic patients after resuscitation].

Zhonghua Nei Ke Za Zhi 2018 Dec;57(12):917-921

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

The relationship of venous-to-arterial CO(2) difference(Pv-aCO(2))/arterial-central venous O(2) difference (Ca-vO(2)) ratio, peripheral perfusion index(PI) and lactate clearance(LC) were investigated during resuscitation in septic patients. And, the meaning of the combination PI and Pv-aCO(2)/Ca-vO(2) ratio to interpret incoherence of lactate clear was explored. The patients with sepsis were prospectively observed, who admitted to critically care medicine department of Peking Union Medical College Hospital. Read More

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December 2018

Variation in Frequency of Intraoperative Arterial, Central Venous and Pulmonary Artery Catheter Placement During Kidney Transplantation: An Analysis of Invasive Monitoring Trends.

J Med Syst 2018 Mar 2;42(4):66. Epub 2018 Mar 2.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.

The rapidly increasing number of kidney transplantations warrants assessment of anesthesia care in this patient population. We explored the frequency of arterial catheter (AC), central venous catheter (CVC) and pulmonary artery catheter (PAC) placement during kidney transplantation in the USA using data from the National Anesthesia Clinical Outcomes Registry (NACOR) and assessed the between-facility variation in the frequency of catheter placement. We defined cases of kidney transplantation using Agency for Healthcare Research and Quality Clinical Classification Software. Read More

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[Central venous-arterial carbon dioxide tension to arterial-central venous oxygen content ratio combined with lactate clearance rate as early resuscitation goals of septic shock].

Authors:
X H Gao P J Li W Cao

Zhonghua Yi Xue Za Zhi 2018 Feb;98(7):508-513

Second Department of Critical Care Medicine of Lanzhou University Second Hospital, Lanzhou 730030, China.

To investigate the prognostic significance of central venous-arterial carbon dioxide tension to arterial-venous oxygen content ratio (Pcv-aCO(2)/Ca-cvO(2)) combined with lactate clearance rate (LCR) as early resuscitation goals of septic shock. One hundred and forty-five septic shock patients admitted to Second Department of Critical Care Medicine of Lanzhou University Second Hospital from March 2013 to May 2017 were enrolled in this study.All septic shock patients received an initial resuscitation therapy according to early goal-directed therapy. Read More

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February 2018

Clarification on the Method of Calculating Central Venous-to-Arterial CO2 Difference/Arterial-Central Venous O2 Difference Ratio.

Shock 2017 12;48(6):690-691

Department of Adult Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.

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December 2017

Understanding the Calculation of Central Venous-to-Arterial CO2 Difference/Arterial-Central Venous O2 Difference Ratio.

Authors:
Huaiwu He Dawei Liu

Shock 2017 12;48(6):690

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.

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December 2017

The pseudo-normalization of the ratio index of the venous-to-arterial CO tension difference to the arterial-central venous O difference in hypoxemia combined with a high oxygen consumption condition.

Authors:
Huaiwu He Dawei Liu

J Crit Care 2017 08 29;40:305-306. Epub 2017 May 29.

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. Electronic address:

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The Prognostic Value of Central Venous-to-Arterial CO2 Difference/Arterial-Central Venous O2 Difference Ratio in Septic Shock Patients with Central Venous O2 Saturation ≥80.

Shock 2017 11;48(5):551-557

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.

Background: It is a great challenge for physician to assess the relationship between O2 delivery and O2 consumption in septic shock patients with high ScvO2. Recently, the venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio (P(v-a)CO2/C(a-v)O2) has shown potential for reflecting anaerobic metabolism. Therefore, we evaluated the value of using the P(v-a)CO2/C(a-v)O2 ratio to predict mortality and assess anaerobic metabolism in septic shock patients with high ScvO2 (≥ 80%). Read More

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November 2017

Central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio: An experimental model or a bedside clinical tool?

J Crit Care 2016 10 24;35:219-20. Epub 2016 May 24.

Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China. Electronic address:

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October 2016

High central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio is associated with poor lactate clearance in septic patients after resuscitation.

J Crit Care 2016 Feb 31;31(1):76-81. Epub 2015 Oct 31.

Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.

Objective: Recently, the central venoarterial carbon dioxide difference/arterial-central venous oxygen difference (P(v-a)CO2/C(a-v)O2) ratio has been suggested as an additional indicator of anaerobic metabolism. We investigated the relationship between the P(v-a)CO2/C(a-v)O2 ratio and 8-hour lactate clearance (LC) in septic patients after resuscitation.

Methods And Results: We prospectively obtained 168 sets of measurements from 84 septic patients. Read More

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February 2016

Inaccuracy of Venous Point-of-Care Glucose Measurements in Critically Ill Patients: A Cross-Sectional Study.

PLoS One 2015 12;10(6):e0129568. Epub 2015 Jun 12.

Research Institute HCor, Hospital do Coração, São Paulo, SP, Brazil.

Introduction: Current guidelines and consensus recommend arterial and venous samples as equally acceptable for blood glucose assessment in point-of-care devices, but there is limited evidence to support this recommendation. We evaluated the accuracy of two devices for bedside point-of-care blood glucose measurements using arterial, fingerstick and catheter venous blood samples in ICU patients, and assessed which factors could impair their accuracy.

Methods: 145 patients from a 41-bed adult mixed-ICU, in a tertiary care hospital were prospectively enrolled. Read More

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The effect of high-frequency oscillatory ventilation combined with tracheal gas insufflation on extravascular lung water in patients with acute respiratory distress syndrome: a randomized, crossover, physiologic study.

J Crit Care 2014 Aug 2;29(4):568-73. Epub 2014 Apr 2.

First Department of Critical Care Medicine and Pulmonary Services, National and Kapodistrian University of Athens Medical School, Evaggelismos General Hospital, Athens, Greece.

Purpose: High-frequency oscillation combined with tracheal gas insufflation (HFO-TGI) improves oxygenation in patients with acute respiratory distress syndrome (ARDS). There are limited physiologic data regarding the effects of HFO-TGI on hemodynamics and pulmonary edema during ARDS. The aim of this study was to investigate the effect of HFO-TGI on extravascular lung water (EVLW). Read More

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High-frequency oscillation and tracheal gas insufflation in patients with severe acute respiratory distress syndrome and traumatic brain injury: an interventional physiological study.

Crit Care 2013 Jul 11;17(4):R136. Epub 2013 Jul 11.

Introduction: In acute respiratory distress syndrome (ARDS), combined high-frequency oscillation (HFO) and tracheal gas insufflation (TGI) improves gas exchange compared with conventional mechanical ventilation (CMV). We evaluated the effect of HFO-TGI on PaO2/fractional inspired O2 (FiO2) and PaCO2, systemic hemodynamics, intracranial pressure (ICP), and cerebral perfusion pressure (CPP) in patients with traumatic brain injury (TBI) and concurrent severe ARDS.

Methods: We studied 13 TBI/ARDS patients requiring anesthesia, hyperosmolar therapy, and ventilation with moderate-to-high CMV-tidal volumes for ICP control. Read More

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Incidence of milrinone blood levels outside the therapeutic range and their relevance in children after cardiac surgery for congenital heart disease.

Intensive Care Med 2013 May 22;39(5):951-7. Epub 2013 Feb 22.

Department of Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, AB, Canada.

Purpose: To evaluate whether variability in milrinone blood levels (MBL) occurs during administration to critically ill children after surgical repair of congenital heart disease, and the clinical relevance of this variability.

Methods: Prospective cohort study conducted in the pediatric intensive care unit of a tertiary care teaching and referral hospital. MBL were measured at three time periods after starting milrinone infusion (9-12, 18-24, 40-48 h) and at the end of the infusion. Read More

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Correlation of arterial, central venous and capillary lactate levels in septic shock patients.

J Med Assoc Thai 2011 Feb;94 Suppl 1:S175-80

Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Bangkok, Thailand.

Background: Blood lactate level increases in response to tissue hypoxia and this level is currently used to monitor shock management. To obtain the arterial lactate value in clinical practice is a time consuming process. Our previous study demonstrated good correlation between the capillary lactate determined by a portable lactate analyzer and the standard arterial lactate in critically ill patients. Read More

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February 2011

Transpulmonary plasma catecholamines in acute high-altitude pulmonary hypertension.

Wilderness Environ Med 2011 Mar 25;22(1):37-45. Epub 2010 Nov 25.

Department of Anesthesiology, University of Heidelberg, Germany.

Objective: High altitude leads to an increase in sympathetic nervous system (SNS) activity and pulmonary arterial pressure (PAP). We assessed whether the SNS contributes to this increase in PAP.

Methods: Sympathetic discharge to the pulmonary vasculature was assessed by measuring plasma norepinephrine concentrations in central venous blood entering the lung and systemic arterial blood leaving the lung (arterial-central venous difference; a - cv(diff)). Read More

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Reduced inotropic support after aprotinin therapy during pediatric cardiac operations.

Ann Thorac Surg 1999 Jan;67(1):173-6

Department of Pediatric Cardiology, University of Mainz, Germany.

Background: Several reports indicate that aprotinin treatment before and during cardiopulmonary bypass (CPB) might have a protective effect on the myocardium. We evaluated the hemodynamic effects of perioperative aprotinin treatment.

Methods: We conducted a randomized, double-blind, placebo-controlled trial in 34 infants (mean age, 2. Read More

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January 1999

Prevalence of the factor V leiden mutation in children and neonates with thromboembolic disease.

J Pediatr 1998 Dec;133(6):777-81

Division of Hematology, Department of Pediatrics, and Division of Neurology, Department of Medicine, University of Pennsylvania, Philadelphia, USA.

Objective: Resistance to activated protein C (APC) has been identified as a risk factor for thrombotic disease in adults. In over 90% of cases, the basis for the APC resistance is a mutation in the coagulation factor V gene (factor V Leiden) that renders the protein more resistant to inactivation by APC. We sought to determine the prevalence of the factor V Leiden (FVL) mutation in neonates and children who had experienced an arterial or venous thromboembolic event. Read More

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December 1998