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"Blood management"

Eeva-Maija Kinnunen, Marisa De Feo, Daniel Reichart, Tuomas Tauriainen, Giuseppe Gatti, Francesco Onorati, Luca Maschietto, Ciro Bancone, Francesca Fiorentino, Sidney Chocron, Karl Bounader, Magnus Dalén, Peter Svenarud, Giuseppe Faggian, Ilaria Franzese, Giuseppe Santarpino, Theodor Fischlein, Daniele Maselli, Carmelo Dominici, Saverio Nardella, Riccardo Gherli, Francesco Musumeci, Antonino S Rubino, Carmelo Mignosa, Giovanni Mariscalco, Filiberto G Serraino, Francesco Santini, Antonio Salsano, Francesco Nicolini, Tiziano Gherli, Marco Zanobini, Matteo Saccocci, Vito G Ruggieri, Jean Philippe Verhoye, Andrea Perrotti, Fausto Biancari
BACKGROUND: Excessive bleeding and blood transfusion are associated with adverse outcome after cardiac surgery, but their mechanistic effects are difficult to disentangle in patients with increased operative risk. This study aimed to evaluate the incidence and prognostic impact of bleeding and transfusion of blood products in low-risk patients undergoing coronary artery bypass grafting (CABG). STUDY DESIGN AND METHODS: Sixteen tertiary European centers of cardiac surgery contributed to the prospective European registry of CABG (E-CABG)...
October 23, 2016: Transfusion
Stephen T McSorley, David Mansouri, Paul G Horgan, Donald C McMillan
No abstract text is available yet for this article.
October 17, 2016: Annals of Surgery
Emanuele Maiorano, Bruno Dino Bodini, Francesca Cavaiani, Catia Pelosi, Valerio Sansone
BACKGROUND: To identify variables influencing length of stay (LOS) and short-term functional outcome in patients undergoing total knee arthroplasty (TKA). A secondary aim was to verify the effect of the same variables on blood management and the rate of postoperative infection. METHOD: We retrospectively reviewed 353 patients, 258 females and 85 males, who underwent primary TKA in a single specialist orthopaedic centre. Anamnestic and anthropometric data and the Modified Barthel Index Score (MBI) at admission were recorded, and entered as covariates in four longitudinal regression models, separately carried out for female and male groups...
October 11, 2016: Knee
(no author information available yet)
No abstract text is available yet for this article.
September 2016: Anesthesia and Analgesia
Donald S Likosky, Timothy A Dickinson, Theron A Paugh
Cardiac surgery accounts for between 15% and 20% of all blood product utilization in the United States. A body of literature suggests that patients who are exposed to even small quantities of blood have an increased risk of morbidity and mortality, even after adjusting for pre-operative risk. Despite this body of literature supporting a restrictive blood management strategy, wide variability in transfusion rates exist across institutions. Recent blood management guidelines have shed light on a number of potentially promising blood management strategies, including acute normovolemic hemodilution (ANH) and retrograde autologous priming (RAP)...
September 2016: Journal of Extra-corporeal Technology
Donald S Likosky, Theron A Paugh, Steven D Harrington, Xiaoting Wu, Mary A M Rogers, Timothy A Dickinson, Alphonse DeLucia, Barbara R Benedetti, Richard L Prager, Min Zhang, Gaetano Paone
BACKGROUND: Although blood transfusions are common and have been associated with adverse sequelae after cardiac surgical procedures, few contemporaneous models exist to support clinical decision making. This study developed a preoperative clinical decision support tool to predict perioperative red blood cell transfusions in the setting of isolated coronary artery bypass grafting. METHODS: We performed a multicenter, observational study of 20,377 patients undergoing isolated coronary artery bypass grafting among patients at 39 hospitals participating in the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative's PERFusion measures and outcomes (PERForm) registry between 2011 and 2015...
October 7, 2016: Annals of Thoracic Surgery
J C Oldroyd, K M Venardos, N J Aoki, A J Zatta, Z K McQuilten, L E Phillips, N Andrianopoulos, D J Cooper, P A Cameron, J P Isbister, E M Wood
BACKGROUND: The Australian and New Zealand (ANZ) Massive Transfusion (MT) Registry (MTR) has been established to improve the quality of care of patients with critical bleeding (CB) requiring MT (≥ 5 units red blood cells (RBC) over 4 h). The MTR is providing data to: (1) improve the evidence base for transfusion practice by systematically collecting data on transfusion practice and clinical outcomes; (2) monitor variations in practice and provide an opportunity for benchmarking, and feedback on practice/blood product use; (3) inform blood supply planning, inventory management and development of future clinical trials; and (4) measure and enhance translation of evidence into policy and patient blood management guidelines...
October 6, 2016: BMC Research Notes
Andra H James, Chad Grotegut, Homa Ahmadzia, Cathleen Peterson-Layne, Evelyn Lockhart
The purpose of this article is to review the use of blood products and hemostatic agents in the management of coagulopathy at the time of postpartum hemorrhage. Blood product administration strategies are broadly reviewed, including the role of the blood bank, the role of massive transfusion protocols, the role of laboratory monitoring, and the role of anesthesia management. Aspects of patient blood management are discussed. The concept refers to an evidence-based, comprehensive, multidisciplinary approach to optimizing the care of patients who might need transfusion and includes measures to avoid or minimize transfusion such as preoperative anemia management, cell salvage, and the use of hemostatic medication to reduce bleeding...
October 3, 2016: Seminars in Thrombosis and Hemostasis
Manita Rajkarnikar
No abstract text is available yet for this article.
October 2016: Transfusion and Apheresis Science
Kevin M Trentino, Stuart G Swain, Gary C Geelhoed, Frank F S Daly, Michael F Leahy
No abstract text is available yet for this article.
September 27, 2016: Transfusion
Maryam Elmi, Alyson Mahar, Daniel Kagedan, Calvin H L Law, Paul J Karanicolas, Yulia Lin, Jeannie Callum, Natalie G Coburn, Julie Hallet
BACKGROUND: Red blood cell transfusions (RBCT) carry risk of transfusion-related immunodulation that may impact postoperative recovery. This study examined the association between perioperative RBCT and short-term postoperative outcomes following gastrectomy for gastric cancer. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database, we compared outcomes of patients (transfused v. nontransfused) undergoing elective gastrectomy for gastric cancer (2007-2012)...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Andreas Greinacher, Kerstin Weitmann, Anne Lebsa, Ulf Alpen, Doris Gloger, Wolfgang Stangenberg, Volker Kiefel, Wolfgang Hoffmann
BACKGROUND: Changes in demographics with increases in older age groups and decreases in younger age groups imply an increased demand for blood transfusions paralleled by a decrease in the population eligible for blood donation. However, more restrictive transfusion triggers and the patient blood management initiative also reduce the demand for red blood cells (RBCs). Eastern Germany is a model region for the impact of demographic changes, which manifest in this region approximately 10 years earlier than in other regions due to the 50% birth rate decline after 1989...
September 25, 2016: Transfusion
Guixiang Sun, Xiangfu Liu, Zhiguo Liu, Jianguo Tan, Yiwen Hao, Guiqiu Shan, Qun Luo, Deqing Wang, Yanchao Xing, Xianqing Zhang, Jiwu Gong, Lihua Kuang, Simon J Stanworth, Aiqing Wen
BACKGROUND: Cirrhosis is a complex acquired disorder of hemostasis and patients frequently receive blood transfusions. But there is very limited data on patterns of blood use at a patient level. AIMS: To characterize blood use in cirrhotic patients in China and compare with recommendations to help identify areas where quality improvement strategies can be targeted. We also compared findings to a similar study undertaken in UK. METHODS: A cross-sectional study was conducted in 11 hospitals over a 2-month period...
September 3, 2016: Digestive and Liver Disease
Michael J R Desborough, Peter A Smethurst, Lise J Estcourt, Simon J Stanworth
Allogeneic platelet transfusions are widely used for the prevention and treatment of bleeding in thrombocytopenia. Recent evidence suggests platelet transfusions have limited efficacy and are associated with uncertain immunomodulatory risks and concerns about viral or bacterial transmission. Alternatives to transfusion are a well-recognised tenet of Patient Blood Management, but there has been less focus on different strategies to reduce bleeding risk by comparison to platelet transfusion. Direct alternatives to platelet transfusion include agents to stimulate endogenous platelet production (thrombopoietin mimetics), optimising platelet adhesion to endothelium by treating anaemia or increasing von Willebrand factor levels (desmopressin), increasing formation of cross-linked fibrinogen (activated recombinant factor VII, fibrinogen concentrate or recombinant factor XIII), decreasing fibrinolysis (tranexamic acid or epsilon aminocaproic acid) or using artificial or modified platelets (cryopreserved platelets, lyophilised platelets, haemostatic particles, liposomes, engineered nanoparticles or infusible platelet membranes)...
September 21, 2016: British Journal of Haematology
Jens Meier
Despite impressive progress in surgical technique, aortic surgery is still associated with relatively high morbidity and mortality. One of the most important contributors to this phenomenon is the triad of bleeding, anemia, and transfusion. All three factors are known to influence the outcome of aortic surgery to a great extent. However, over the last few years a multidisciplinary, multimodal concept has been established, which enables the physician to avoid bleeding, anemia, and transfusion as much as possible...
September 2016: Best Practice & Research. Clinical Anaesthesiology
Aryeh Shander, Arthur W Bracey, Lawrence T Goodnough, Irwin Gross, Nabil E Hassan, Sherri Ozawa, Marisa B Marques
No abstract text is available yet for this article.
October 2016: Anesthesia and Analgesia
Douglas A Hardesty, Sean Doerfler, Sukhmeet Sandhu, Robert G Whitmore, Patricia Ford, Scott Rushton, Peter D LeRoux
BACKGROUND: Jehovah's Witnesses (JW) are a Christian faith with > 1 million members in the United States who do not accept autologous blood transfusions. The optimal management of these patients undergoing neurosurgical procedures is not well defined. Here, we examined the feasibility and safety of JW undergoing neurosurgery in a blood management program. STUDY DESIGN AND METHODS: Sixty-eight JW patients including 23 males and 45 females (mean age 53 +/- 12 years) who underwent a variety of cranial (n=19) and spinal (n=49) neurosurgical procedures over a 5-year period were identified retrospectively and their hospital charts, anesthetic records and operative reports reviewed...
September 15, 2016: World Neurosurgery
G Folléa
OBJECTIVES: In a context of regular review of transfusion practice, the aim of this review is to present an update of the scientific basis of the so-called "patient blood management" (PBM), the state of its development in Europe, and possible ways to progress its development further in France. METHODS: Analysis and synthesis of the data from scientific literature on the scientific basis of PBM (methods, indications, efficacy, risks, efficiency). RESULTS: PBM appears as an evidence-based, patient centred, multidisciplinary approach, aiming to optimise the care of patients who might need transfusion and, consequently, the use of blood products...
September 14, 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Nabil E Hassan, Pierre R Tibi, Marisa B Marques
No abstract text is available yet for this article.
October 2016: Anesthesia and Analgesia
David Liu, Michael Dan, Sara Martinez Martos, Elaine Beller
A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim...
September 2016: Knee Surgery & related Research
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