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"Blood management"

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https://www.readbyqxmd.com/read/28921529/metastatic-spine-tumor-surgery-does-perioperative-blood-transfusion-influence-postoperative-complications
#1
Aye Sandar Zaw, Shashidhar B Kantharajanna, Karthikeyan Maharajan, Barry Tan, Amarasinghe A Saparamadu, Naresh Kumar
BACKGROUND: The question of independent association between allogeneic blood transfusion (ABT) and postoperative complications in cancer surgeries has been controversial and remains so. In metastatic spine tumor surgery (MSTS), previous studies investigated the influence of ABT on survival, but not on postoperative complications. We aimed to evaluate the influence of perioperative ABT on postoperative complications and infections in patients undergoing MSTS. STUDY DESIGN AND METHODS: This retrospective study included 247 patients who underwent MSTS at a single tertiary institution between 2005 and 2014...
September 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28921037/-the-patient-blood-management-concept-joint-recommendation-of-the-german-society-of-anaesthesiology-and-intensive-care-medicine-and-the-german-society-of-surgery
#2
REVIEW
P Meybohm, T Schmitz-Rixen, A Steinbicker, W Schwenk, K Zacharowski
Patient blood management is a multimodal concept that aims to detect, prevent and treat anemia, optimize hemostasis, minimize iatrogenic blood loss, and support a patient-centered decision to provide optimal use of allogeneic blood products. Although the World Health Organization (WHO) has already recommended patient blood management as a new standard in 2010, many hospitals have not implemented it at all or only in part in clinical practice. The German Society of Anaesthesiology and Intensive Care Medicine and the German Society of Surgery therefore demand that i) all professionals involved in the treatment should implement important aspects of patient blood management considering local conditions, and ii) the structural, administrative and budgetary conditions should be created in the health care system to implement more intensively many of the measures in Germany...
September 18, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28919087/outcomes-of-restrictive-versus-liberal-transfusion-strategies-in-older-adults-from-nine-randomised-controlled-trials-a-systematic-review-and-meta-analysis
#3
Geoff I Simon, Alison Craswell, Ogilvie Thom, Yoke Lin Fung
BACKGROUND: Guidelines for patient blood management recommend restrictive transfusion practice for most adult patients. These guidelines are supported by evidence from randomised controlled trials (RCTs); however, one of the patient groups not explicitly examined in these studies is the geriatric population. We examined RCTs relevant to transfusion outcomes in older patients. Our aim was to determine whether special guidelines are warranted for geriatric patients, recognising the different pathophysiological characteristics of this group...
September 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28889320/the-role-of-preoperative-iron-deficiency-in-colorectal-cancer-patients-prevalence-and-treatment
#4
M J Wilson, J W T Dekker, J J Harlaar, J Jeekel, M Schipperus, J J Zwaginga
BACKGROUND: In preoperative blood management of colorectal cancer patients, intravenous iron therapy is increasingly used to treat anaemia and prevent red blood cell transfusions. However, while iron deficiency is the most common cause of anaemia, little is known about the prevalence and namely type of iron deficiency in this population, whereas both types of iron deficiency (i.e. absolute and functional iron deficiency) are recommended to be treated differently by international cancer guidelines...
September 9, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28885447/promoting-safety-quality-and-value-through-patient-blood-management
#5
Jonathan H Waters
No abstract text is available yet for this article.
September 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28885446/implementing-a-health-system-wide-patient-blood-management-program-with-a-clinical-community-approach
#6
Steven M Frank, Rajiv N Thakkar, Stanley J Podlasek, K H Ken Lee, Tyler L Wintermeyer, Will W Yang, Jing Liu, Leo C Rotello, Thomas A Fleury, Pat A Wachter, Lisa E Ishii, Renee Demski, Peter J Pronovost, Paul M Ness
BACKGROUND: Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. METHODS: We formed the Johns Hopkins Health System blood management clinical community to reduce transfusion overuse across five hospitals...
September 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28870300/enhancing-recovery-after-total-knee-arthroplasty
#7
REVIEW
Richard W Rutherford, Jason M Jennings, Douglas A Dennis
There have been multiple successful efforts to improve and shorten the recovery period after elective total joint arthroplasty. The development of rapid recovery protocols through a multidisciplinary approach has occurred in recent years to improve patient satisfaction as well as outcomes. Bundled care payment programs and the practice of outpatient total joint arthroplasty have provided additional pressure and incentives for surgeons to provide high-quality care with low cost and complications. In this review, the evidence for modern practices are reviewed regarding patient selection and education, anesthetic techniques, perioperative pain management, intraoperative factors, blood management, and postoperative rehabilitation...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28869718/prevalence-and-causes-of-preoperative-anaemia-in-elective-major-surgery-patients
#8
Frank S Hong, Nicole Sieradzki, Claire Pollock, Faye Nasra, Allison Mo, Abbey Willcox, Leonid Churilov, Wai Khoon Ho, Carole Smith
BACKGROUND: Preoperative anaemia is associated with increased morbidity and mortality in surgical patients. Recent national patient blood management guideline recommended screening surgical patients for anaemia and in particular iron deficiency anaemia, without reference to the prevalence of anaemia or iron deficiency anaemia in this patient population. AIMS: To establish the prevalence and cause of preoperative anaemia in elective major surgery patients. METHODS: Patients attending the anaesthetic pre-admission clinics from 1 July 2013 to 30 June 2014 prior to their major elective surgery in our institution were screened for anaemia and iron deficiency by measuring full blood count, iron studies and C-reactive protein...
September 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28830476/comparison-of-continuous-infusion-versus-bolus-injection-of-factor-concentrates-for-blood-management-after-total-knee-arthroplasty-in-patients-with-hemophilia
#9
Young Shil Park, Won-Ju Shin, Kang-Il Kim
BACKGROUND: Total knee arthroplasty (TKA) has become the treatment of choice for end-stage hemophilic arthropathy of the knee. Theoretically in hemophilia A, perioperative continuous infusion (CI) of factor VIII (FVIII) would provide a more consistent FVIII level than general bolus injections (BI) in TKA. Current study was designed to evaluate the effectiveness of CI of coagulation factor concentrates during the perioperative period compared to BI. METHODS: A total of 42 TKAs were performed in 31 patients with severe hemophilia A...
August 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28830388/total-knee-arthroplasty-risk-factors-for-allogeneic-blood-transfusions-in-the-south-asian-population
#10
Syed Hamza Mufarrih, Nada Qaisar Qureshi, Arif Ali, Azeem Tariq Malik, Huda Naim, Shahryar Noordin
BACKGROUND: Total knee arthroplasty (TKA) is the recommended treatment for end-stage knee osteoarthritis. Considering the various risks associated with intra and postoperative blood transfusions, better understanding is required with respect to the risk factors contributing to a greater possibility of blood transfusion during or after surgery. Although literature highlights several such factors, our study is among the first to identify these risk factors in the South Asian population which differs from other populations in several ways...
August 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28817529/do-institution-level-blood-utilization-and-blood-management-initiatives-meaningfully-impact-transfusion-practices-in-cardiac-surgery
#11
Matthew M Townsley, Joseph G Timpa, James E Davies, Marisa B Marques
No abstract text is available yet for this article.
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28811051/patient-blood-management-in-the-intensive-care-unit
#12
REVIEW
Aryeh Shander, Mazyar Javidroozi, Gregg Lobel
Patient Blood Management underscores a fundamental shift from a product-centered approach to a patient-centric approach through timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve patient outcome. In this concept, allogeneic blood transfusion is not viewed as the treatment of default for anemic patients, but one among many treatment modalities that should be weighed based on its merits-potentials risks and benefits-for the individual patient in the context of other alternatives...
July 31, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28776639/postpartum-obstetric-red-cell-transfusion-practice-a-retrospective-study-in-a-tertiary-obstetric-centre
#13
Benjamin Stephens, Farah Sethna, Philip Crispin
BACKGROUND: Traditional management of anaemia due to postpartum haemorrhage (PPH) has relied upon salvage therapy with red cell transfusion. Recently published guidance recommends a change in approach toward holistic patient blood management. AIMS: To determine whether postpartum red cell transfusion practices are consistent with best practice and to identify opportunities for improvement. MATERIALS AND METHODS: A retrospective audit of postpartum red cell transfusions was conducted at a tertiary level obstetrics unit...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28738983/power-knowledge-and-transfusions-the-need-to-refocus-on-patient-blood-management
#14
EDITORIAL
Aryeh Shander, Sherri Ozawa, Gregg Lobel
No abstract text is available yet for this article.
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28731875/management-of-complex-spine-surgery
#15
Massimo Lamperti, Boris Tufegdzic, Rafi Avitsian
PURPOSE OF REVIEW: The main objective of this article is to present the updated data regarding the perioperative management of patients undergoing major spine surgery in an era where the surgical techniques are changing and there is a high demand for these surgeries in older and high-risk patients. RECENT FINDINGS: Preoperative assessment and stabilization is now more structured protocol and it is based on a multidisciplinary approach to the patient. The Enhanced Recovery After Surgery (ERAS) programs and the Perioperative Surgical Home on major spine surgery are not yet fully evidence based but it seems that the use of a perioperative optimization of patients and use of a drugs' bundle is more effective than using single drugs or interventions on the postoperative pain reduction and faster recovery from surgery...
October 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28728892/-pediatric-preparations-of-blood-products
#16
C Boulat
The transfusion in pediatrics may require specific preparations to adapt to the various characteristics from preterm neonates to big child: weight, immaturity, immune system, blood volume, long and short-term prognosis, and to meet the needs of pathologies related to the perinatal period. The knowledge of the process for preparation, conservation and administration of these particular products shall permit a transfusion in safe conditions by supporting the prescribers in a personalized blood management.
July 17, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28722245/patient-blood-management-in-obstetrics-management-of-anaemia-and-haematinic-deficiencies-in-pregnancy-and-in-the-post-partum-period-nata-consensus-statement
#17
M Muñoz, J P Peña-Rosas, S Robinson, N Milman, W Holzgreve, C Breymann, F Goffinet, J Nizard, F Christory, C-M Samama, J-F Hardy
No abstract text is available yet for this article.
July 19, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28719425/organizational-contributors-to-the-variation-in-red-blood-cell-transfusion-practices-in-cardiac-surgery-survey-results-from-the-state-of-michigan
#18
Anton Camaj, Darin B Zahuranec, Gaetano Paone, Barbara R Benedetti, Warren D Behr, Marc A Zimmerman, Min Zhang, Robert S Kramer, Jason Penn, Patricia F Theurer, Theron A Paugh, Milo Engoren, Alphonse DeLucia, Richard L Prager, Donald S Likosky
BACKGROUND: While large volumes of red blood cell transfusions are given to preserve life for cardiac surgical patients, indications for lower volume transfusions (1-2 units) are less well understood. We evaluated the relationship between center-level organizational blood management practices and center-level variability in low volume transfusion rates. METHODS: All 33 nonfederal, Michigan cardiac surgical programs were surveyed about their blood management practices for isolated, nonemergent coronary bypass procedures, including: (1) presence and structure of a patient blood management program, (2) policies and procedures, and (3) audit and feedback practices...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28695971/transfusion-requirements-following-total-knee-arthroplasty-in-patients-with-preexisting-blood-dyscrasia
#19
Martin Roche, Tsun Yee Law, Samuel Rosas, Augustus J Rush, Anton Khlopas, Morad Chughtai, Michael A Mont
INTRODUCTION: There is a paucity of studies investigating the incidence of transfusions in various blood dyscrasias after total knee arthroplasty (TKA). The purpose of this study was: 1) to compare the incidence of transfusion post-TKA in patients with and without blood dyscrasia; 2) to compare the post-TKA transfusion incidence of patients with the various individual blood dyscrasias; and 3) to stratify the findings based on gender and age. MATERIALS AND METHODS: A retrospective review of a Medicare database for patients with preexisting blood dyscrasia was conducted...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28673310/the-evaluation-of-enhanced-feedback-interventions-to-reduce-unnecessary-blood-transfusions-affinitie-protocol-for-two-linked-cluster-randomised-factorial-controlled-trials
#20
Suzanne Hartley, Robbie Foy, Rebecca E A Walwyn, Robert Cicero, Amanda J Farrin, Jill J Francis, Fabiana Lorencatto, Natalie J Gould, John Grant-Casey, Jeremy M Grimshaw, Liz Glidewell, Susan Michie, Stephen Morris, Simon J Stanworth
BACKGROUND: Blood for transfusion is a frequently used clinical intervention, and is also a costly and limited resource with risks. Many transfusions are given to stable and non-bleeding patients despite no clear evidence of benefit from clinical studies. Audit and feedback (A&F) is widely used to improve the quality of healthcare, including appropriate use of blood. However, its effects are often inconsistent, indicating the need for coordinated research including more head-to-head trials comparing different ways of delivering feedback...
July 3, 2017: Implementation Science: IS
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