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Transfusion independence

Katerina Pavenski, Simon Stanworth, Mark Fung, Erica M Wood, Joanne Pink, Michael F Murphy, Heather Hume, Susan Nahirniak, Kathryn E Webert, Susano Tanael, Denise Landry, Nadine Shehata
Many transfusion guidelines are available, but little appraisal of their quality has been undertaken. The quality of guidelines may potentially influence adoption. Our aim was to determine the quality of evidence-based transfusion guidelines (EBG) for red cells and plasma, using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and assess duplication and consistency of recommendations. MEDLINE and EMBASE were systematically searched for EBG from 2005 to June 3, 2016. Citations were reviewed for inclusion in duplicate...
June 1, 2018: Transfusion Medicine Reviews
Andrea Garatti, Alessandro Parolari, Alberto Canziani, Eugenio Mossuto, Andrea Daprati, Ali Abu Farah, Daniele Brugnetti, Marco Ranucci, Lorenzo Menicanti
AIMS: Despite several studies reporting a higher mortality rate for women undergoing isolated coronary artery bypass graft (CABG) surgery, this issue has not been completely clarified. The aim of the current study was to determine if sex differences in CABG surgery affect adjusted operative results and operative mortality. METHODS: Between January 2005 and December 2012, 3756 consecutive patients (3009 men and 747 women) underwent isolated CABG at our institution...
June 16, 2018: Journal of Cardiovascular Medicine
M Maruf, J Jayman, M Kasprenski, K Benz, Z Feng, D Friedlander, T Baumgartner, B J Trock, H Di Carlo, P D Sponseller, J P Gearhart
BACKGROUND: Primary bladder closure of classic bladder exstrophy (CBE) is a major operation that occasionally requires intraoperative or postoperative (within 72 h) blood transfusions. OBJECTIVE: This study reported perioperative transfusion rates, risk factors for transfusion, and outcomes from a high-volume exstrophy center in primary bladder closure of CBE patients. STUDY DESIGN: A prospectively maintained, institutional exstrophy-epispadias complex database of 1305 patients was reviewed for primary CBE closures performed at the authors' institution (Johns Hopkins Hospital) between 1993 and 2017...
June 7, 2018: Journal of Pediatric Urology
Moinay Kim, Jae Sung Ahn, Wonhyoung Park, Suk Kyung Hong, Sang Ryong Jeon, Sung Woo Roh, Seungjoo Lee
OBJECTIVE: Diffuse axonal injury (DAI) is known to be associated with poor outcome. DAI often associates with other intracranial injuries but their distinct features have not been established. In this retrospective cohort study, we compared clinical outcomes between pure and non-pure DAI patients. PATIENTS AND METHODS: Total of 1047 traumatic brain injury (TBI) patients visited our institute between 2011 and 2017. Age ranged between 15-85 years old and Glasgow coma scale (GCS) score less than 13 were included...
June 10, 2018: Clinical Neurology and Neurosurgery
Candice Ostrowka, Stéphanie Bonhomme, Pomme Jouffroy, Guillaume Riouallon
INTRODUCTION: Fractures of the pelvis (acetabulum and pelvic ring) are complex in both radiological diagnosis and therapeutic management. They show high risk of thrombosis, with variable rates of venous thromboembolic complications in the literature, ranging from 10% to 50%, with 0.5-10% risk of fatal pulmonary embolism. The objective of the present study was to determine the rate of venous thromboembolic events in a consecutive cohort of pelvic fracture and to attempt to identify thromboembolic risk factors in this population...
June 12, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ruchika Goel, Cassandra D Josephson
Transfusions of red blood cells (RBCs), platelets, and plasma are critical therapies for infants and neonates (particularly preterm neonates) in the neonatal intensive care unit, who are the most frequently transfused subpopulation across all ages. Although traditionally a significant gap has existed between the blood utilization and the evidence base essential to adequately guide transfusion practices in infants and neonates, pediatric transfusion medicine is evolving from infancy and gradually coming of age...
2018: F1000Research
Majid Eshghpour, Sahand Samieirad, Alireza Sharifian Attar, Hamed Kermani, Sadaf Seddigh
PURPOSE: Propofol and remifentanil are 2 useful drugs used in induced hypotensive anesthesia. The purpose of this study was to compare the effects of these drugs on intraoperative blood loss, transfusion requirements, and hemodynamic status during standardized orthognathic surgical procedures. MATERIALS AND METHODS: In this double-blind randomized clinical trial, 50 consecutive healthy patients with Class III skeletal deformity were candidates for bimaxillary orthognathic surgery at Qaem Hospital, Mashhad University of Medical Sciences (Mashhad, Iran), from November 2016 until December 2017...
May 21, 2018: Journal of Oral and Maxillofacial Surgery
Aminu K Bello, Christine M Ribic, Serge H Cournoyer, Mercedeh Kiaii, Martine LeBlanc, Melanie Poulin-Costello, David N Churchill, Norman Muirhead
Background: Several studies have demonstrated harm associated with using erythropoiesis-stimulating agents (ESA) to achieve higher hemoglobin (Hb) levels. Subsequently, more conservative use of ESAs has changed anemia therapy in patients with chronic renal failure. Objective: The objectives were to identify transfusion rates in hemodialysis (HD) patients during the first year of therapy, to identify factors associated with the probability of transfusion, describe reasons for the transfusions, and identify the Hb values associated with each transfusion...
2018: Canadian Journal of Kidney Health and Disease
Ruchika Goel, Eshan U Patel, Melissa M Cushing, Steven M Frank, Paul M Ness, Clifford M Takemoto, Ljiljana V Vasovic, Sujit Sheth, Marianne E Nellis, Beth Shaz, Aaron A R Tobian
Importance: Increasing evidence supports the role of red blood cells (RBCs) in physiological hemostasis and pathologic thrombosis. Red blood cells are commonly transfused in the perioperative period; however, their association with postoperative thrombotic events remains unclear. Objective: To examine the association between perioperative RBC transfusions and postoperative venous thromboembolism (VTE) within 30 days of surgery. Design, Setting, and Participants: This analysis used prospectively collected registry data from the American College of Surgery National Surgical Quality Improvement Program (ACS-NSQIP) database, a validated registry of 525 teaching and nonteaching hospitals in North America...
June 13, 2018: JAMA Surgery
Pierre Fenaux, Valeria Santini, Maria Antonietta Aloe Spiriti, Aristoteles Giagounidis, Rudolf Schlag, Atanas Radinoff, Liana Gercheva-Kyuchukova, Achilles Anagnostopoulos, Esther Natalie Oliva, Argiris Symeonidis, Mathilde Hunault Berger, Katharina S Götze, Anna Potamianou, Hari Haralampiev, Robert Wapenaar, Iordanis Milionis, Uwe Platzbecker
Erythropoiesis-stimulating agents are first choice for treating anemia in low-risk MDS. This double-blind, placebo-controlled study assessed the efficacy and safety of epoetin-α in IPSS low- or intermediate-1 risk (i.e., low-risk) MDS patients with Hb ≤ 10.0 g/dL, with no or moderate RBC transfusion dependence (≤4 RBC units/8 weeks). Patients were randomized, 2:1, to receive epoetin-α 450 IU/kg/week or placebo for 24 weeks, followed by treatment extension in responders. The primary endpoint was erythroid response (ER) through Week 24...
March 30, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Xiaowen Liu, Mingze Ma, Hua Huang, Yanong Wang
BACKGROUND: The association between perioperative blood transfusion and the prognosis of patients with gastric cancer is still unclear. METHODS: A total of 1581 patients with gastric cancer who underwent curative gastrectomy from 2000 to 2008 were evaluated. Perioperative blood transfusion was defined as the transfusion of packed red blood cells within seven days before surgery, during surgery, or within the postoperative hospitalization period. The association between perioperative blood transfusion and prognosis was evaluated using univariate and multivariate Cox regression analyses...
June 11, 2018: BMC Cancer
Xi-Nuo Zhang, Xiang-Yao Sun, Yong Hai, Xiang-Long Meng, Yun-Sheng Wang
Adult degenerative scoliosis (ADS) surgery is known for its high incidence of complications. The propose of this study was to determine current complication rates and the predictors of medical complications in surgical ASD patients. A retrospective study of 153 ADS patients who underwent long level spinal fusion with 2-year follow-up between 2012 and 2017. The patient- and surgical-related risk factors for each individual medical complication were identified by using univariate testing. All patients were divided into groups with and without medical complication, infection, neurological complications, and cardiopulmonary complications, respectively...
June 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Amr Badawy, Toshimi Kaido, Ahmed Hammad, Shintaro Yagi, Naoko Kamo, Atsushi Yoshizawa, Hideaki Okajima, Shinji Uemoto
BACKGROUND: Preoperative anemia was reportedly associated with increased morbidity and mortality after various types of surgeries. However, its impact on the outcomes after liver transplantation has not been thoroughly investigated. METHODS: We retrospectively investigated the clinical outcome of 216 consecutive adult patients who underwent living donor liver transplantation at our institute between January 2010 and June 2017 and stratified them according to the hemoglobin level before transplant...
June 7, 2018: World Journal of Surgery
Miriam Stucchi, Silvia Cantoni, Enrico Piccinelli, Stefano Savonitto, Nuccia Morici
Reference hemoglobin (Hb) values for the definition of anemia are still largely based on the 1968 WHO Scientific Group report, which established a cutoff value of <13 g/dL for adult men and <12 g/dL for adult nonpregnant women. Subsequent studies identified different normal values according to race and age. Estimated prevalence of anemia on admission in the setting of an acute coronary syndrome (ACS) is between 10% and 43% of the patients depending upon the specific population under investigation. Furthermore, up to 57% of ACS patients may develop hospital-acquired anemia (HAA)...
2018: Vascular Health and Risk Management
M A Wahab, A Shehta, M Elshoubary, A M Yassen, M Elmorshedi, T Salah, A M Sultan, O Fathy, W R Elsarraf, U Shiha, K Zalata, A N Elghawalby, M Eldesoky, A Monier, R Said, A M Elsabagh, M Ali, A Kandeel, U Abdalla, M Aboelella, M Elsadany, E E Abdel-Khalek, A Marwan, F M ElMorsi, R Adly
BACKGROUND: Living donor liver transplantation (LDLT) is considered a safe alternative to deceased donor liver transplantation (DDLT). In Egypt, DDLT program is still awaited, making LDLT the only hope for patients with end-stage liver disease, mainly due to chronic hepatitis C virus (HCV) infection. The current study is conducted to evaluate our experience of LDLT and discuss the lessons learned from 500 consecutive cases in HCV area. METHODS: We reviewed the data of patients who underwent LDLT at Gastrointestinal Surgery Center, Mansoura University during the period between May 2004 and March 2017...
June 2018: Transplantation Proceedings
Fei Liu, Qin Li, Yonggang Wei, Bo Li
BACKGROUND: The value of laparoscopic liver resection (LLR) for difficult lesions (located in segments I, IVa, VII, and VIII) is still controversial nowadays. The aim of this study was to summarize quantitatively the evidence related to this issue. MATERIALS AND METHODS: Two investigators independently searched the Medline, Embase, Science Citation Index Expanded, and Cochrane Library databases for eligible studies published before December 2017. The RevMan 5.3 software was utilized for statistical meta-analysis...
June 7, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Alfred H Stammers, Eric A Tesdahl, Linda B Mongero, Andrew Stasko
INTRODUCTION: Myocardial protection is performed using diverse cardioplegic (CP) solutions with various combinations of chemical and blood constituents. Newer CP formulations that extend ischemic intervals may require greater asanguineous volume, contributing to hemodilution. METHODS: We evaluated intraoperative hemodilution and red blood cell (RBC) transfusion rates among three common CP solutions during cardiac valve surgery. Data from 5,830 adult cardiac primary valve procedures where either four-to-one blood CP (4:1), del Nido solution (DN) or microplegia (MP) was used at 173 United States surgical centers...
June 1, 2018: Perfusion
Jena L Miller, Dana M Block-Abraham, Karin J Blakemore, Ahmet A Baschat
INTRODUCTION: The insertion site of the fetoscope for laser occlusion (FLOC) treatment of twin-twin transfusion syndrome (TTTS) determines the likelihood of treatment success. We assessed a standardized preoperative ultrasound approach for its ability to identify critical landmarks for successful FLOC. METHODS: Three surgeons independently performed preoperative ultrasound and deduced the likely orientation of the intertwin membrane (ITM) and vascular equator (VE) based on the sites of the cord insertion, the lie of the donor, and the size discordance between twins...
June 6, 2018: Fetal Diagnosis and Therapy
Kui Li, Yu Zou, Jin Sun, Hong Wen
OBJECTIVES: To evaluate the efficacy of prophylactic balloon occlusion (PBO), and to compare haemostatic effects and perioperative outcomes of PBO of the internal iliac arteries (IIA), common iliac arteries (CIA) and infrarenal abdominal aorta (IAA) in patients with placenta accreta. METHODS: One hundred and ninety-nine patients with placenta accreta were retrospectively reviewed. One hundred and twelve cases who underwent PBO were allocated into PBO group, and 87 cases without endovascular intervention were classified as the control group...
June 5, 2018: European Radiology
Carolina Olano, Ximena Pazos, Karla Avendaño, Alfonso Calleri, Carlos Ketzoian
Introduction:  Despite the widespread use of small-bowel capsule endoscopy (CE), there is still limited data on its utility and effectiveness for the diagnosis and management of patients with iron-deficiency anemia (IDA). Aim:  To assess the diagnostic yield of CE and the factors predicting positive findings in patients with IDA. Methods:  Patients with unexplained IDA and negative upper and lower endoscopy were included. A positive diagnostic yield was considered when CE diagnosed one or more lesions that could explain the IDA...
June 2018: Endoscopy International Open
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