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Pre operative anaemia

K Karkouti, P Yip, C Chan, L Chawla, V Rao
Acute kidney after cardiac surgery is more common in anaemic patients, whereas haemolysis during cardiopulmonary bypass may lead to iron-induced renal injury. Hepcidin promotes iron sequestration by macrophages: hepcidin concentration is reduced by anaemia and increased by inflammation. We analysed the associations in 525 patients between pre-operative anaemia (haemoglobin < 130 g.l-1 in men and < 120 g.l-1 in women), intra-operative hepcidin concentration and acute kidney injury (dialysis or > 26...
March 12, 2018: Anaesthesia
Natalie Woodhead, Rachel Pounds, Shirin Irani, Poonam Pradhan
Ulipristal acetate (UPA), is a selective progesterone-receptor modulator, it decreases fibroid size and reduces menstrual bleeding. We reviewed its use at the Heart of England Foundation Trust (HEFT), one of the largest prescribing trusts in the UK. The electronic records of patients treated with UPA from January 2013 to August 2015 were reviewed. One hundred and thirty four patients received UPA, 20 women (15%) received a second course. Eighty percent reported subjective global improvements in symptoms after the first course; 45...
March 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Oliver Collas, Francis P Robertson, Barry J Fuller, Brian R Davidson
Pre-operative anaemia and the need for intra-operative transfusion have been associated with increased morbidity and mortality following cardiac and major non-cardiac surgery. Anaemia is highly prevalent in patients with severe chronic liver disease. Whether this correlates with an altered morbidity and mortality following liver transplant has not been established. METHODS: Prospectively collected data was analysed for the period 1998-2012. Donor and recipient characteristics, blood profiles and complications were recorded...
February 27, 2018: International Journal of Surgery
Tadej Dovšak, Alojz Ihan, Vojko Didanovič, Andrej Kansky, Miha Verdenik, Nataša Ihan Hren
BACKGROUND: The immune system has a known role in the aetiology, progression and final treatment outcome of oral squamous cell cancers. The aim of this study was to evaluate the influence of radical surgery and radiotherapy on advanced oral squamous cell carcinoma blood counts, lymphocyte subsets and levels of acute inflammatory response markers. METHODS: Blood samples were obtained from 56 patients 5 days before and 10 days after surgery, 30 days and 1 year after radiotherapy...
March 1, 2018: BMC Cancer
G Blaudszun, K E Munting, A Butchart, C Gerrard, A A Klein
Anaemia is common before cardiac surgery and is associated with increased morbidity and mortality. The World Health Organization (WHO) definition of anaemia is lower for women than for men by 10 g.l-1 , potentially putting women at a disadvantage compared with men with regard to pre-operative optimisation. Our hypothesis was that women with borderline anaemia (defined by us as haemoglobin concentration 120-129 g.l-1 ) would have a higher rate of red cell transfusion, morbidity and mortality than non-anaemic women (haemoglobin ≥ 130 g...
January 19, 2018: Anaesthesia
Rocío Menéndez-Colino, Teresa Alarcon, Pilar Gotor, Rocío Queipo, Raquel Ramírez-Martín, Angel Otero, Juan I González-Montalvo
INTRODUCTION: The aim of this study was to determine the patient characteristics that predict 1-year mortality after a hip fracture (HF). METHODS: All patients admitted consecutively with fragility HF during 1 year in a co-managed orthogeriatric unit of a university hospital (FONDA cohort) were assesed. Baseline and admission demographic, clinical, functional, analytical and body-composition variables were collected in the first 72 h after admission. A protocol designed to minimize the consequences of the HF was applied...
January 6, 2018: Injury
Fatimat M Akinlusi, Kabiru A Rabiu, Idayat A Durojaiye, Adeniyi A Adewunmi, Tawaqualit A Ottun, Yusuf A Oshodi
BACKGROUND: Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. METHODS: A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011...
January 10, 2018: BMC Pregnancy and Childbirth
Martina Heschl, Hans Gombotz, Bettina Haslinger-Eisterer, Axel Hofmann, Nikolaus Böhler, Jens Meier
BACKGROUND: Pre-operative anaemia and transfusion are common among patients undergoing elective orthopaedic surgery. Application of 'patient blood management' might be the most effective way to reduce both anaemia and transfusion. Pre-operative administration of iron and/or erythropoietin (EPO) is one of the cornerstones of the first pillar of patient blood management, but in a daily clinical setting, efficacy and long-term safety of this measure have not been analysed thoroughly to date...
April 2018: European Journal of Anaesthesiology
M D Stoneham, S Von Kier, L Harvey, M Murphy
OBJECTIVES: To investigate the impact of a dedicated cell salvage practitioner team on blood loss and allogeneic transfusion in abdominal aortic aneurysm (AAA) surgery. BACKGROUND: Cell salvage reduces allogeneic transfusion in AAA surgery, but is commonly performed by the anaesthetic nurse. At our hospital, a dedicated patient blood management practitioner is present for all elective open AAA repairs. METHODS/MATERIALS: Data were collected on 171 AAA patients operated on at the John Radcliffe Hospital, Oxford over a 3-year period, looking at the Patient Blood Management processes, including: blood loss, cell salvage, near-patient testing (thrombelastography) and transfusion rates of allogeneic blood products...
December 15, 2017: Transfusion Medicine
I Stoica, F O'Kelly, M B McDermott, F M J Quinn
BACKGROUND: Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic destructive granulomatous inflammation of the kidney. It was first described in 1916, and is thought to affect 6/1000 cases of pyelonephritis. Its manifestations are varied, and with a limited number of cases in the literature, the optimal diagnosis and management of XGP in the paediatric cohort is still unknown. MATERIAL AND METHODS: The medical records of children who were diagnosed and treated for XGP at the current unit during the period 1963-2016, inclusive, were retrospectively reviewed...
November 24, 2017: Journal of Pediatric Urology
L F Miles, S A Kunz, L H Na, S Braat, K Burbury, D A Story
Iron deficiency anaemia is strongly associated with poor outcomes after cardiac surgery. However, pre-operative non-anaemic iron deficiency (a probable anaemia precursor) has not been comprehensively examined in patients undergoing cardiac surgery, despite biological plausibility and evidence from other patient populations of negative effect on outcome. This exploratory retrospective cohort study aimed to compare an iron-deficient group of patients undergoing cardiac surgery with an iron-replete group. Consecutive non-anaemic patients undergoing elective coronary artery bypass grafting or single valve replacement in our institution between January 2013 and December 2015 were considered for inclusion...
December 2, 2017: Anaesthesia
Saverio Paltrinieri, Marco Fossati, Valentina Menaballi
Objectives The objective of this study was to evaluate the diagnostic performances of manual and instrumental measurement of reticulocyte percentage (Ret%), reticulocyte number (Ret#) and reticulocyte production index (RPI) to differentiate regenerative anaemia (RA) from non-regenerative anaemia (NRA) in cats. Methods Data from 106 blood samples from anaemic cats with manual counts (n = 74; 68 NRA, six RA) or instrumental counts of reticulocytes (n = 32; 25 NRA, seven RA) collected between 1995 and 2013 were retrospectively analysed...
February 2018: Journal of Feline Medicine and Surgery
Mario Ronga, Daniele Bonzini, Marco Valoroso, Giuseppe La Barbera, Jacopo Tamini, Mario Cherubino, Paolo Cherubino
INTRODUCTION: Anaemia in patients with trochanteric fracture is associated with increased morbidity and mortality and it is an independent risk factor for functional mobility of patients. Several authors have reported the blood loss following operative treatment comparing different fixation systems but few authors have evaluated many associated variables that could influence the perioperative blood loss. PURPOSE: To evaluate the blood loss in patients that had their trochanteric fracture stabilized with dynamic hip screw (DHS) or Gamma nail...
October 2017: Injury
G Blaudszun, A Butchart, A A Klein
This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia...
September 21, 2017: Transfusion Medicine
A Butcher, T Richards
Pre-operative anaemia and perioperative red blood cell transfusion carry significant consequence when it comes to surgical outcomes. The establishment of patient-centred clinical pathways has been designed to harness and endorse good transfusion practice, termed the three pillars of patient blood management (PBM). These focus on the timely and appropriate management of anaemia, prevention of blood loss and restrictive transfusion where appropriate. This article reviews the current evidence and ongoing research in the field of PBM in surgery...
September 22, 2017: Transfusion Medicine
Holger Haas, Christian D Weber
Background A thorough pre-operative evaluation is required prior to total joint arthroplasty (TJA). The objective of screening is to identify patient- and procedure-related risk constellations. Pre-operative diagnostic measures are vital in order to anticipate, reduce or even eliminate threats to patient safety. Furthermore, the clinical and radiographical workup may confirm the indication and type of surgical procedure, but this is not the subject of this article. Objective An overview of the current literature on pre-operative diagnostic principles is presented...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
Olivier Borens, Éric Thein, Christophe Tissot, Anne-Sophie Brunel
Total joint replacement comes with a high success rate and has been shown to have a very positive impact on our patients suffering from arthritis. Against all efforts about 2 % of our patients will suffer an implant related infection. As the treatment of infected arthroplasties is difficult and expensive the knowledge of risk factors is becoming more and more important for the treatment team in order to improve our preventive measures. Prevention must be performed pre-, intra- and postoperatively. Preoperative optimization of blood sugar levels, nutritional status and correction of general anaemia for example are paramount and the general practitioner as well as the surgeon should be aware of these and other modifiable risk factors in order to operate on the patient in the best possible conditions...
December 14, 2016: Revue Médicale Suisse
Alex Eeles, Ravishankar Rao Baikady
Anaemia and allogeneic blood transfusions in surgical patients are associated with poor outcomes. Patient blood management (PBM) has been developed as an evidence-based clinical tool, by which clinicians can optimise anaemia, manage peri-operative bleeding, avoid unnecessary blood transfusion and improve patient outcome. This article aims to highlight the recent updates regarding evidence-based PBM in the perioperative period, following a thorough literature review involving original research articles, published guidelines and consensus documents discovered through an extensive PubMed and Medline search...
June 2017: Indian Journal of Anaesthesia
A-M Bougeard, A Brent, M Swart, C Snowden
The majority of UK hospitals now have a Local Lead for Peri-operative Medicine (n = 115). They were asked to take part in an online survey to identify provision and practice of pre-operative assessment and optimisation in the UK. We received 86 completed questionnaires (response rate 75%). Our results demonstrate strengths in provision of shared decision-making clinics. Fifty-seven (65%, 95%CI 55.8-75.4%) had clinics for high-risk surgical patients. However, 80 (93%, 70.2-87.2%) expressed a desire for support and training in shared decision-making...
August 2017: Anaesthesia
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
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