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preoperative hemodilution

Audrius Andrijauskas, Christer H Svensen, Narūnas Porvaneckas, Jūratė Šipylaitė, Edgaras Stankevičius, Darius Činčikas, Valentinas Uvarovas, Saulė Švedienė, Igoris Šatkauskas, Saulius Vosylius, Giedrius Kvederas
BACKGROUND AND OBJECTIVE: A mini volume loading test (mVLT) evaluating hemodilution during step-wise crystalloid infusion has established that the arterio-capillary plasma dilution difference is inversely correlated to the body hydration level of subjects. This observational study aimed to test whether this can be replicated in a perioperative setting using a 2.5-mLkg(-1) boluses. MATERIALS AND METHODS: The mVLT was performed before induction of regional anesthesia and 24h later...
2016: Medicina
Lukas Lannemyr, Gudrun Bragadottir, Vitus Krumbholz, Bengt Redfors, Johan Sellgren, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass. The authors evaluated the effects of normothermic cardiopulmonary bypass on renal blood flow, glomerular filtration rate, renal oxygen consumption, and renal oxygen supply/demand relationship, i.e., renal oxygenation (primary outcome) in patients undergoing cardiac surgery. METHODS: Eighteen patients with a normal preoperative serum creatinine undergoing cardiac surgery procedures with normothermic cardiopulmonary bypass (2...
February 2017: Anesthesiology
Serhat Huseyin, Volkan Yuksel, Orkut Guclu, Fatma Nesrin Turan, Suat Canbaz, Turan Ege, Hasan Sunar
BACKGROUND: Various adverse effects of homologous blood transfusion detected particularly in open heart surgery, in which it is frequently used, lead researchers to study on autologous blood use and to evaluate the patient's blood better. Due to the complications of homologous blood transfusion, development of techniques that utilize less transfusion has become inevitable. We aimed to evaluate the effects of acute normovolemic hemodilution (ANH) in patients undergoing open heart surgery...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Alexandra E Kisilevsky, Liam Stobart, Kristine Roland, Alana M Flexman
STUDY OBJECTIVE: To describe the perioperative blood conservation strategies and postoperative outcomes in patients who undergo complex spinal surgery for tumor resection and who also refuse blood product transfusion. DESIGN: A retrospective case series. SETTING: A single-center, tertiary care and academic teaching hospital in Canada. PATIENTS: All adult patients undergoing elective major spine tumor resection and refusing blood product transfusion who were referred to our institutional Blood Utilization Program between June 1, 2004, and May 9, 2014...
December 2016: Journal of Clinical Anesthesia
Sathappan Karuppiah, Christopher Mckee, Ashley Hodge, Mark Galantowicz, Joseph Tobias, Aymen Naguib
Over the years, there has been a growing recognition of the potential negative sequelae of allogeneic blood products on postoperative outcomes following cardiac surgery. In addition, followers of the Jehovah's Witness (JW) faith have a religious restriction against receiving blood or blood components. Advances in perioperative care, cardiopulmonary bypass (CPB), and surgical technique have minimized the need for allogeneic blood products. Specific blood conservation strategies include maximizing the preoperative hematocrit and coagulation function as well as intraoperative strategies, such as acute normovolemic hemodilution and adjustments of the technique of CPB...
September 2016: Journal of Extra-corporeal Technology
J Zhou
Autologous blood transfusion (ABT) has been gradually attracting more attention due to the increasingly prominent problem of blood transfusion safety and blood shortage in recent years. With the rapid development of blood conservation techniques, blood component separation technology, blood transfusion medicine and a constant increase in clinical needs, ABT technology has been expanded and innovated to a large degree. In this study, the development of preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH), intraoperative and postoperative autotransfusion, and other new technologies and theories are reviewed and existing questions are analyzed...
August 1, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
A V Solenkova, A Yu Lubnin, A A Imaev, N A Konovalov, T P Tissen, D S Asyutin, N A Dzyubanova, V A Korolishin, M A Martynova
The paper discusses the problem ofpredicting, prevention and therapy of massive intraoperative blood loss in patients with metastasis in spine and spinal cord. We analyze 60 surgical cases in last 14 years in our clinic. Amount of blood loss was more that 80% of total blood volume in each case (from 2.5 to 17 liters). Preoperative selective angiography data on intensity of tumor blood supply were essential for blood loss prediction. Simultaneous embolization oftumor during angiography dramatically reduced intraoperative blood loss...
March 2016: Anesteziologiia i Reanimatologiia
Marek A Mak, Adam Smołka, Jan Kowalski, Alicja Kuc, Filip Klausa, Karol Kremens, Dariusz Jarek, Ryszard Bachowski, Jacek Skiba
BACKGROUND: Commonly used cardiopulmonary bypass systems with cardiotomy reservoir, oxygenator and roller pump require preoperative crystalloid filling. Radical reduction of the filling fluid volume and replacing it with patient's own blood has fundamental impact on the outcome. AIM: Comparison between the cardiopulmonary bypass filled with patient's blood, applied in Poland for the first time, and the classical system filled with crystalloids. METHODS: Non-Randomized trial in which patients undergoing coronary artery bypass grafting were divided into two groups: first operated on with a use of cardiopulmonary bypass system with patient's own blood priming and a control group operated on with standard technique...
February 22, 2016: Kardiologia Polska
Yuhong Li, Yue Shan, Xuezheng Lin
Preoperative acute hypervolemic hemodilution (AHHD) is a technique used in anesthesia to reduce the number of blood cells lost during intraoperative bleeding. The aim of the present study was to evaluate the effect of the hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints. A total of 20 patients undergoing AHHD following epidural anesthesia were studied, and 20 patients who did not receive hemodilution were used as a control group. All patients were American Society of Anesthesiologists grade I, aged 20-40 years and undergoing hip arthroplasty surgery...
January 2016: Experimental and Therapeutic Medicine
Young Bae Jeon, Sangchul Yun, Si Young Ok, Han Joon Kim, Dongho Choi
Patients undergoing pancreaticoduodenectomy (PD) often require transfusion. However, transfusion-related complications and decreased blood donation in Korea encourage the development of new treatment strategies for PD patients. Although transfusion-free (TF) operation is thought to be beneficial, results supporting its beneficial effects are lacking. The aim of our study was to demonstrate the impact on PD patients of a TF program. From December 2003 to April 2013, 80 consecutive patients with periampullary lesions underwent PD performed...
February 2016: American Surgeon
Chantal L I Gielen, Anneke Brand, Waander L van Heerde, Theo Stijnen, Robert J M Klautz, Jeroen Eikenboom
INTRODUCTION: The origination of blood loss after cardiac surgery is not fully explained, but is related to operation trauma and use of cardiopulmonary bypass (CPB). However, the extent of their contribution is incompletely known and might differ between distinct operation procedures. MATERIALS AND METHODS: Three groups of CABG procedures were studied: 1) off-pump coronary artery bypass surgery (OPCAB, n=11) without CPB, 2) CABG with use of CPB (CABG, n=11) and 3) CABG with use of CPB combined with aortic valve replacement (AVR, n=11)...
April 2016: Thrombosis Research
Michael C Grant, Linda M S Resar, Steven M Frank
No abstract text is available yet for this article.
December 2015: Anesthesia and Analgesia
David A Scott, Hon-Ming Andrew Tung, Reuben Slater
Preoperative anemia and nadir hemoglobin (Hb) during cardiopulmonary bypass (CPB) have been identified as significant risk factors for blood transfusion during cardiac surgery. The aim of this study was to confirm the association between preoperative anemia, perioperative fluid management, and blood transfusion. In addition, the proportion of elective cardiac surgery patients presenting for surgery with anemia was identified to examine whether the opportunity exists for timely diagnosis and intervention. Data from referral until hospital discharge were comprehensively reviewed over a 12-month period for all nonemergency cardiac surgical patients operated on in our institution...
September 2015: Journal of Extra-corporeal Technology
J Skytte Larsson, G Bragadottir, V Krumbholz, B Redfors, J Sellgren, S E Ricksten
BACKGROUND: In the present randomized study, we evaluated the differential effects of a colloid and a crystalloid fluid on renal oxygen delivery (RD(O2)), glomerular filtration (GFR), renal oxygen consumption ((RV(O2))), and the renal oxygen supply-demand relationship (i.e., renal oxygenation) after cardiac surgery with cardiopulmonary bypass. METHODS: Thirty patients with normal preoperative renal function, undergoing uncomplicated cardiac surgery, were studied in the intensive care unit in the early postoperative period...
November 2015: British Journal of Anaesthesia
Lintao Li, Haishan Wu, Yuli Wu, Peiliang Fu, Zheru Ding
OBJECTIVE: To summarize the perioperative blood management strategies for joint arthroplasty. METHODS: The literature concerning preoperative, intraoperative, and postoperative blood management was reviewed and summarized. RESULTS: At present, a variety of blood management and conservation strategies are available. Preoperative strategies include iron supplementation, erythropoietin (EPO), and preoperative autologous donation (PAD). Intraoperative options include acute normovolemic hemodilution (ANH), antifibrinolytics, and the use of a tourniquet...
June 2015: Chinese Journal of Reparative and Reconstructive Surgery
Xuelong Zhou, Chenjing Zhang, Yin Wang, Lina Yu, Min Yan
BACKGROUND: Previous studies have evaluated the efficacy of preoperative acute normovolemic hemodilution (PANH) in reducing the need for allogeneic blood transfusion. However, the results to date have been controversial. In this study, we sought to reassess the efficacy and safety of PANH based on newly emerging evidence. METHODS: Medline, EMBASE, ISI Web of Knowledge, and Cochrane Central Register of Controlled Trials databases were searched using the key words "hemodilution," "autotransfusion," or "hemorrhage" to retrieve all randomized controlled trials examining the benefits of PANH compared with control patients not undergoing PANH in any type of surgery...
December 2015: Anesthesia and Analgesia
Adil Harroud, Alexander G Weil, Jean Turgeon, Claude Mercier, Louis Crevier
OBJECT A major challenge in sagittal craniosynostosis surgery is the high transfusion rate (50%-100%) related to blood loss in small pediatric patients. Several approaches have been proposed to prevent packed red blood cell (PRBC) transfusion, including endoscopic surgery, erythropoietin ortranexamic acid administration, and preoperative hemodilution. The authors hypothesized that a significant proportion of postoperative anemia observed in pediatric patients is actually dilutional. Consequently, since 2005, at CHU Sainte-Justine, furosemide has been administered to correct the volemic status and prevent PRBC transfusion...
January 2016: Journal of Neurosurgery. Pediatrics
Robert S Kramer, Crystal R Herron, Robert C Groom, Jeremiah R Brown
Acute kidney injury (AKI) after cardiac surgery is a common and underappreciated syndrome that is associated with poor shortand long-term outcomes. AKI after cardiac surgery may be epiphenomenon, a signal for adverse outcomes by virtue of other affected organ systems, and a consequence of multiple factors. Subtle increases in serum creatinine (SCr) postoperatively, once considered inconsequential, have been shown to reflect a kidney injury that likely occurred in the operating room during cardiopulmonary bypass (CPB) and more often in susceptible individuals...
March 2015: Journal of Extra-corporeal Technology
Cem Arıtürk, Zehra Serpil Ozgen, Meltem Kilercik, Halim Ulugöl, Eyup Murat Ökten, Uğur Aksu, Hasan Karabulut, Fevzi Toraman
AIM: Acute kidney injury after cardiopulmonary bypass has been associated with dilutional anemia during surgery. We aimed both to explore if this relation is modulated by blood transfusion and to understand the postoperative contribution of protein oxidation. METHODS: In this randomized prospective study, after ethics committee approval and informed consent, 30 patients undergoing first-time elective coronary artery bypass grafting (CABG) with hematocrit between 21% and 25% at any time during extracorporeal circulation (ECC) were randomly and equally allocated into two groups...
August 30, 2015: Heart Surgery Forum
Donald S Likosky, Gaetano Paone, Min Zhang, Mary A M Rogers, Steven D Harrington, Patricia F Theurer, Alphonse DeLucia, Astrid Fishstrom, Anton Camaj, Richard L Prager
BACKGROUND: Pneumonia, a known complication of coronary artery bypass grafting (CABG), significantly increases a patient's risk of morbidity and mortality. Although not well characterized, red blood cell (RBC) transfusions may increase a patient's risk of pneumonia. We describe the relationship between RBC transfusion and postoperative pneumonia after CABG. METHODS: A total of 16,182 consecutive patients underwent isolated CABG between 2011 and 2013 at 1 of 33 hospitals in the state of Michigan...
September 2015: Annals of Thoracic Surgery
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