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https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#1
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28626370/donor-safety-in-haemapheresis-development-of-an-internet-based-registry-for-comprehensive-assessment-of-adverse-events-from-healthy-donors
#2
Hans-Gert Heuft, Eike Fischer, Tina Weingand, Thomas Burkhardt, Gerda Leitner, Hagen Baume, Jörg-Peter Schmidt, Andreas Buser, Gabriele Fauchald, Ute Reinicke Voigt, Behrouz Mansouri-Taleghani
BACKGROUND: Currently, there is an extensive but highly inconsistent body of literature regarding donor adverse events (AEs) in haemapheresis. As the reports diverge with respect to types and grading of AEs, apheresis procedures and machines, the range of haemapheresis-related AEs varies widely from about 0.03% to 6.6%. METHODS: The German Society for Transfusion Medicine and Immunohaematology (DGTI) formed a 'Haemapheresis Vigilance Working Party' (Arbeitsgemeinschaft Hämapheresevigilanz; AGHV) to create an on-line registry for comprehensive and comparable AE assessment with all available apheresis devices in all types of preparative haemapheresis: plasmapheresis (PLS), plateletpheresis (PLT), red blood cell apheresis, all kind of leukaphereses (autologous/allogeneic blood stem cell apheresis, granulocyte apheresis, lymphocyte/monocyte apheresis) and all possible types of multi-component apheresis...
June 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28624038/impact-of-blood-products-on-platelet-function-in-patients-with-traumatic-injuries-a-translational-study
#3
Hanne Hee Henriksen, Alexandra G Grand, Sandra Viggers, Lisa A Baer, Sacha Solbeck, Bryan A Cotton, Nena Matijevic, Sisse R Ostrowski, Jakob Stensballe, Erin E Fox, Tzu-An Chen, John B Holcomb, Pär I Johansson, Jessica C Cardenas, Charles E Wade
BACKGROUND: Reductions in platelet (PLT) count and function are associated with poor outcomes in trauma patients. We proposed to determine if patients expected to receive blood products have a decrease in PLT function higher than expected based on the reduction in PLT count, and if the reduction in function could be associated with the donor plasma/supernatant received. METHODS: PLT count and function were measured on admission to the emergency department and intensive care unit in severely injured patients expected to receive a transfusion...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622903/cell-saver-for-adult-spinal-deformity-surgery-reduces-cost
#4
Jeffrey L Gum, Leah Yacat Carreon, Michael P Kelly, Richard Hostin, Chessie Robinson, Douglas C Burton, David W Polly, Christopher I Shaffrey, Virginie LaFage, Frank J Schwab, Christopher P Ames, Han Jo Kim, Justin S Smith, R Shay Bess
STUDY DESIGN: Retrospective cohort. OBJECTIVES: To determine if the use of cell saver reduces overall blood costs in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: Recent studies have questioned the clinical value of cell saver during spine procedures. METHODS: ASD patients enrolled in a prospective, multicenter surgical database who had complete preoperative and surgical data were identified. Patients were stratified into (1) cell saver available during surgery, but no intraoperative autologous infusion (No Infusion group), or (2) cell saver available and received autologous infusion (Infusion group)...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28605004/preoperative-optimisation-of-anaemia-for-primary-total-hip-arthroplasty-a-systematic-review
#5
Dinesh P Alexander, Nicholas Frew
BACKGROUND: The 2009 NHS Blood and Transplant national comparative audit on blood use following primary total hip arthroplasty (THR) highlighted that preoperative anaemia was common and undertreated. They recommended that hospitals have a written policy for treating anaemia preoperatively. In our centre, we found that preoperative optimisation of anaemia, significantly reduced blood transfusion rate to <5%. The 2015 national audit showed that even though 48% of patients received tranexamic acid, 85% of patients required transfusion...
June 7, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28596671/autologous-blood-transfusion-as-a-life-saving-measure-for-a-trauma-patient-with-fracture-femur-and-drug-induced-hemolytic-anemia-a-case-report
#6
Sumit Vishwakarma, Rahul Chaurasia, Arulselvi Subramanian, Vivek Trikha, Kabita Chatterjee
A positive direct antiglobulin test has been reported in 1:1000 to 1:14,000 blood donors and 1-15 % of hospital patients. Drugs may cause a positive direct antiglobulin test result and/or immune-mediated haemolysis with an incidence of approximately 1 in a 1 million population. Our aim is to highlight the importance of following strict transfusion protocols and management insight in a direct antiglobulin test positive patient showing incompatibility with multiple units possibly due to drug induced immune haemolytic anaemia (DIIHA)...
June 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28580663/autologous-blood-salvage-in-the-era-of-patient-blood-management
#7
REVIEW
R A Sikorski, N A Rizkalla, W W Yang, S M Frank
Almost 150 years after the first autologous blood transfusion was reported, intraoperative blood salvage has become an important method of blood conservation. The primary goal of autologous transfusion is to reduce or avoid allogeneic red blood cell transfusion and the associated risks and costs. Autologous salvaged blood does not result in immunological challenge and its consequences, provides a higher quality red blood cell that has not been subjected to the adverse effects of blood storage, and can be more cost-effective than allogeneic blood when used for carefully selected surgical patients...
June 5, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28579833/multiple-myeloma-in-niger-delta-nigeria-complications-and-the-outcome-of-palliative-interventions
#8
Ogbonna Collins Nwabuko, Elizabeth Eneikido Igbigbi, Innocent Ijezie Chukwuonye, Martin Anazodo Nnoli
BACKGROUND: Multiple myeloma (MM) is one of the hematological malignancies that require palliative care. This is because of the life-threatening nature and the suffering associated with the illness. The aim of this study is to bring to the fore the complications experienced by people living with MM in the Niger-Delta region of Nigeria and the outcome of various palliative interventions. METHODS: This was a 10-year multi-center retrospective study of 26 patients diagnosed and managed in three major centers in the Niger-Delta region of Nigeria from January 2003 to December 2012...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28577064/no-benefit-of-autologous-transfusion-drains-in-total-knee-arthroplasty
#9
Christoph Schnurr, Ioannis Giannakopoulos, Dariusch Arbab, Jens Dargel, Johannes Beckmann, Peer Eysel
PURPOSE AND HYPOTHESIS: Autologous blood transfusion drains are commonly used to reduce allogeneic blood transfusion rate after total knee arthroplasty. There is conflicting evidence as to whether autologous transfusion drains (ABT drains) were effective when restrictive transfusion triggers were used. The aim of our study was to ascertain where, as a part of a blood management protocol, autologous blood transfusion drains reduce the allogeneic blood transfusion rate after total knee arthroplasty...
June 2, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28567420/prognostic-significance-of-blood-transfusion-in-newly-diagnosed-multiple-myeloma-patients-without-autologous-hematopoietic-stem-cell-transplantation
#10
Liping Fan, Danhui Fu, Jinping Zhang, Haobo Huang, Qingqing Wang, Yamei Ye, Qianling Xie
The aim of this study was to evaluate whether blood transfusions affect overall survival (OS) and progression-free survival (PFS) in newly diagnosed multiple myeloma (MM) patients without hematopoietic stem cell transplantation. A total of 181 patients were enrolled and divided into two groups: 68 patients in the transfused group and 113 patients in the nontransfused group. Statistical analyses showed that there were significant differences in ECOG scoring, Ig isotype, platelet (Plt) counts, hemoglobin (Hb) level, serum creatinine (Scr) level, and β2-microglobulin (β2-MG) level between the two groups...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28558843/the-effectiveness-of-a-de-implementation-strategy-to-reduce-low-value-blood-management-techniques-in-primary-hip-and-knee-arthroplasty-a-pragmatic-cluster-randomized-controlled-trial
#11
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Stefanie N Hofstede, Cynthia So-Osman, M Elske van den Akker-van Marle, Ad A Kaptein, Theo Stijnen, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
BACKGROUND: Perioperative autologous blood salvage and preoperative erythropoietin are not (cost) effective to reduce allogeneic transfusion in primary hip and knee arthroplasty, but are still used. This study aimed to evaluate the effectiveness of a theoretically informed multifaceted strategy to de-implement these low-value blood management techniques. METHODS: Twenty-one Dutch hospitals participated in this pragmatic cluster-randomized trial. At baseline, data were gathered for 924 patients from 10 intervention and 1040 patients from 11 control hospitals undergoing hip or knee arthroplasty...
May 30, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28514773/a-feasibility-study-of-the-full-outpatient-conduction-of-hematopoietic-transplants-in-persons-with-multiple-sclerosis-employing-autologous-non-cryopreserved-peripheral-blood-stem-cells
#12
Guillermo J Ruiz-Argüelles, Andrés A León-Peña, Mónica León-González, Ana Karen Nuñez-Cortes, Juan Carlos Olivares-Gazca, Iván Murrieta-Alvarez, Jocelyn Vargas-Espinosa, Emilio Medina-Ceballos, Yahveth Cantero-Fortiz, Alejandro Ruiz-Argüelles, Manuel A Ruiz-Delgado, Rodrigo J Ruiz-Delgado, Guillermo Ruiz-Reyes, Manuel Priesca-Marín, Merari Starlight Torres-Priego, David Blumenkron-Marroquin, Guillermo J Ruiz-Delgado
BACKGROUND: With the goal of achieving immune system reset, autologous hematopoietic stem cell transplantations have been performed in patients with multiple sclerosis (MS). MATERIAL AND METHODS: Two hundred and eighty-six consecutive patients with MS were autografted in a single center using non-frozen peripheral blood stem cells (PBSCs), on an outpatient basis and conditioning with cyclophosphamide and rituximab. The protocol was registered in ClinicalTrials.gov identifier NCT02674217...
2017: Acta Haematologica
https://www.readbyqxmd.com/read/28447921/the-effectiveness-of-acute-normolvolemic-hemodilution-and-autologous-prime-on-intraoperative-blood-management-during-cardiac-surgery
#13
Alfred H Stammers, Linda B Mongero, Eric Tesdahl, Andrew Stasko, Samuel Weinstein
OBJECTIVE: Intraoperative blood management during cardiac surgery is a multifaceted process incorporating various interventions directed at optimizing oxygen delivery and enhancing hemostasis. The purpose of this study was to evaluate the effects of acute normovolemic hemodilution (ANH) and autologous priming (AP) on preserving the hematocrit during cardiopulmonary bypass (CPB). METHOD: Case records from a national registry of adult patients who underwent cardiac surgery between January and October 2016 were reviewed...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28443261/diabetes-mellitus-caused-by-secondary-hemochromatosis-after-multiple-blood-transfusions-in-2-patients-with-severe-aplastic-anemia
#14
Hyun Jin Kim, Yoon-Myung Kim, Eungu Kang, Beom Hee Lee, Jin-Ho Choi, Han-Wook Yoo
Hemochromatosis is an inherited or secondary disorder caused by excessive iron storage leading to multiple organ damage. We describe 2 patients with diabetes mellitus caused by hemochromatosis secondary to multiple blood transfusions due to severe aplastic anemia. Subject 1, who was diagnosed with severe aplastic anemia at 15 years of age, received multiple red blood cell transfusions before he underwent autologous peripheral blood stem cell transplantation (PBSCT) at 22 years of age. At 21 years of age, hyperglycemia was detected with increased hemoglobin A1c and serum ferritin levels, 9...
March 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28437543/association-of-donor-age-and-sex-with-survival-of-patients-receiving-transfusions
#15
Gustaf Edgren, Henrik Ullum, Klaus Rostgaard, Christian Erikstrup, Ulrik Sartipy, Martin J Holzmann, Olof Nyrén, Henrik Hjalgrim
Importance: Following animal model data indicating the possible rejuvenating effects of blood from young donors, there have been at least 2 observational studies conducted with humans that have investigated whether donor age affects patient outcomes. Results, however, have been conflicting. Objective: To study the association of donor age and sex with survival of patients receiving transfusions. Design, Setting, and Participants: A retrospective cohort study based on the Scandinavian Donations and Transfusions database, with nationwide data, was conducted for all patients from Sweden and Denmark who received at least 1 red blood cell transfusion of autologous blood or blood from unknown donors between January 1, 2003, and December 31, 2012...
June 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28422403/blood-chimerism-in-dizygotic-monochorionic-twins-during-5-years-observation
#16
M H Dziegiel, M H Hansen, S Haedersdal, A N Barrett, K Rieneck, K M Main, A T Hansen, F B Clausen
Dizygotic monochorionic twin pregnancies can result in blood chimerism due to in utero twin-to-twin exchange of stem cells. In this case, we examined the proportion of allogeneic red blood cells by flow cytometry and the proportion of allogeneic nucleated cells by digital polymerase chain reaction at 7 months and again at 5 years. We found an increase in the proportion of allogeneic cells from 63% to 89% in one twin, and a similar increase in autologous cells in the other twin from 57% to 84%. A paradigm for stem cell therapy could be modeled on this case: induction of tolerance and chimerism by antenatal transfusion of donor stem cells...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28385576/blood-transfusions-may-impair-endothelium-dependent-vasodilatation-during-coronary-artery-bypass-surgery
#17
Alessio Rungatscher, Elisabetta Milani, Cecilia Covajes, Seth Hallström, Leonardo Gottin, Gian Cesare Guidi, Giovanni Battista Luciani, Giuseppe Faggian
OBJECTIVE: The hemolytic product free-hemoglobin (fHb) reduces nitric oxide (NO) bioavailability. The present study aims to establish whether administration of different blood transfusions result in increased circulating fHb levels and NO consumption with effects on arterial NO-dependent blood flow in patients undergoing CABG surgery. METHODS: Ninety-five consecutive patients undergoing elective CABG surgery were prospectively divided in four groups based on blood transfusion requirements during surgery: stored blood cells (SBC, n...
July 2017: Microvascular Research
https://www.readbyqxmd.com/read/28375559/transfusion-of-35-day-stored-red-blood-cells-does-not-alter-lipopolysaccharide-tolerance-during-human-endotoxemia
#18
Anna L Peters, Maike E van Hezel, Robert B Klanderman, Anita M Tuip-de Boer, W Joost Wiersinga, Anne H van der Spek, Robin van Bruggen, Dirk de Korte, Nicole P Juffermans, Alexander P J Vlaar
BACKGROUND: Transfusion-related immunomodulation (TRIM) encompasses immunosuppressive and proinflammatory effects induced by red blood cell (RBC) transfusion. Changes that occur during storage in the RBC product have been hypothesized to underlie TRIM, mediated by tolerance of toll-like receptors (TLR). We investigated whether transfusion of 35-day-stored autologous RBCs alters cytokine production in response to stimulation with lipopolysaccharide (LPS) or lipotheic acid (LTA), in a clinically relevant model of endotoxemia...
April 4, 2017: Transfusion
https://www.readbyqxmd.com/read/28338491/perioperative-management-of-blood-loss-in-spine-surgery
#19
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Hamid Hassanzadeh
Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent. Perioperative methods have been established to combat the excessive blood loss and decrease the need for blood products...
March 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28332214/serum-eye-drops-a-survey-of-international-production-methods
#20
D C Marks, P F van der Meer
BACKGROUND: Serum eye drops (SEDs) are used to treat dry eye syndrome and non-healing corneal lesions when other treatments fail. Despite many clinical studies demonstrating the efficacy of both autologous and allogeneic SEDs, there is no internationally harmonized method for producing SEDs. MATERIALS AND METHODS: A 40-question survey requesting information regarding donor selection, blood collection and processing, infectious disease screening, shelf life and regulatory requirements for the production of autologous and allogeneic SEDs was developed by the Biomedical Excellence for Safer Transfusion Collaborative...
March 23, 2017: Vox Sanguinis
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