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Intraoperative Cell Salvage

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https://www.readbyqxmd.com/read/27871571/spine-tumor-resection-among-patients-who-refuse-blood-product-transfusion-a-retrospective-case-series
#1
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
https://www.readbyqxmd.com/read/27787286/haemorrhage-at-caesarean-section-a-framework-for-prevention-and-research
#2
Jennifer E Jardine, Penny Law, Matthew Hogg, Deirdre Murphy, Khalid S Khan
PURPOSE OF REVIEW: Caesarean section rates are increasing across the world. Postpartum haemorrhage is a major cause of morbidity and mortality; major haemorrhage is more common after caesarean delivery. There is a wide range of practice in the prevention and treatment of postpartum haemorrhage at caesarean section. The aim of this review is to summarize current opinion in the management of postpartum haemorrhage at caesarean section. RECENT FINDINGS: Recent large randomized controlled trials have shown a possible effect from the routine use of tranexamic acid and ergometrine...
December 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27730349/unexpected-microscopically-positive-proximal-resection-margins-in-esophageal-squamous-cell-carcinoma-after-chemoradiotherapy-predictors-and-prognostic-significance
#3
Chien-Hung Chiu, Yin-Kai Chao, Yu-Wen Wen, Hsien-Kun Chang, Chen-Kan Tseng, Yun-Hen Liu
BACKGROUND: Esophageal cancer has the propensity to spread in a longitudinal manner (either proximally or distally), potentially resulting in the unexpected presence of microscopic disease at grossly tumor-free margins. The clinical significance of this phenomenon in patients treated with chemoradiotherapy (CRT) remains unclear. The purpose of this study was to investigate the prevalence, predictors, and prognostic impact of microscopically positive proximal resection margins (PPRMs) in patients with esophageal squamous cell carcinoma (ESCC) who received CRT...
October 11, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27715476/individualized-laparoscopic-therapy-for-portal-hypertension-a-preliminary-single-center-experience
#4
Dou-Sheng Bai, Kui-Sheng Yang, Guo-Qing Jiang, Jian-Jun Qian, Ping Chen, Sheng-Jie Jin
BACKGROUND: To investigate the effects and technical points of several individualized laparoscopic therapies for patients suffering from cirrhotic portal hypertension. METHODS: In total, 385 cirrhotic patients who underwent the treatment of individualized laparoscopic therapy from February 2012 to December 2015 at the Clinical Medical College of Yangzhou University were enrolled in this study. We retrospectively analyzed the clinical data and the key technical points...
October 7, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27671218/anesthetic-management-of-transapical-off-pump-mitral-valve-repair-with-neochord-implantation
#5
Ali Sait Kavakli, Nilgun Kavrut Ozturk, Raif Umut Ayoglu, Mustafa Emmiler, Lutfi Ozyurek, Kerem Inanoglu, Sadik Ozmen
OBJECTIVES: Various minimally invasive surgical approaches have been used in mitral valve (MV) surgery. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive, alternative procedure for the treatment of degenerative mitral regurgitation. There are several special considerations for the anesthesiologist during the TOP-MINI procedure. The main purpose of this study was to present the anesthetic management of the TOP-MINI procedure...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27668331/efficacy-of-intraoperative-cell-salvage-in-decreasing-perioperative-blood-transfusion-rates-in-first-time-cardiac-surgery-patients-a-retrospective-study
#6
Claudia L Côté, Alexandra M Yip, Jeffrey B MacLeod, Bill O'Reilly, Joshua Murray, Maral Ouzounian, Craig D Brown, Rand Forgie, Marc P Pelletier, Ansar Hassan
BACKGROUND: Evidence regarding the safety and efficacy of intraoperative cell salvage (ICS) in transfusion reduction during cardiac surgery remains conflicting. We sought to evaluate the impact of routine ICS on outcomes following cardiac surgery. METHODS: We conducted a retrospective analysis of patients who underwent nonemergent, first-time cardiac surgery 18 months before and 18 months after the implementation of routine ICS. Perioperative transfusion rates, postoperative bleeding, clinical and hematological outcomes, and overall cost were examined...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27614051/very-low-rate-of-patient-related-adverse-events-associated-with-the-use-of-intraoperative-cell-salvage
#7
Diana DeAndrade, Jonathan H Waters, Darrell J Triulzi, Louis Alarcon, Mary Kay Wisniewski, Robert Dyga, Mark H Yazer
BACKGROUND: The rate of patient-related clinical adverse events (AEs) associated with the use of intraoperative cell salvage (ICS) was analyzed. STUDY DESIGN AND METHODS: The perfusion service and electronic risk management databases in a nine-hospital regional health care system were reviewed over an approximately 11-year period. The number of ICS cases performed during this period and basic patient demographics were also extracted. RESULTS: There were 43,198 patients for whom ICS was utilized during the study period...
September 9, 2016: Transfusion
https://www.readbyqxmd.com/read/27559005/pediatric-patient-blood-management-programs-not-just-transfusing-little-adults
#8
REVIEW
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27536627/patient-blood-management-in-hip-replacement-arthroplasty
#9
REVIEW
Jong Hee Lee, Seung Beom Han
Perioperative blood transfusions are common in total hip arthroplasty because of preoperative anemia and perioperative blood loss. Perioperative anemia and the need for allogeneic blood transfusion are related with increased morbidity. To reduce perioperative allogeneic blood transfusion, keeping the preoperative hemoglobin level above 12.0 g/dL is important in orthopedic patients. By using the anti-fibrinolytic agent or perioperative cell salvage, reduce intraoperative blood loss is very important for the reduction of perioperative blood loss...
December 2015: Hip & Pelvis
https://www.readbyqxmd.com/read/27499818/allogeneic-blood-product-usage-in-coronary-artery-bypass-grafting-cabg-with-minimalized-extracorporeal-circulation-system-mecc-versus-standard-on-pump-coronary-artery-bypass-grafting
#10
M Lisy, E Schmid, J Kozok, P Rosenberger, U A Stock, G Kalender
AIM: Intraoperative allogeneic blood product transfusion (ABPT) in cardiac surgery is associated with worse overall outcome, including mortality. The objective of this study was to evaluate the ABPTs in minimalized extracorporeal cardiopulmonary (MECC(TM)) compared with standard open system on-pump coronary revascularization. METHODS: Data of 156 patients undergoing myocardial revascularization between September 2008 and September 2010 were reviewed. 83 patients were operated by the MECC technique and 73 were treated by standard extracorporeal circulation (sECC)...
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27468494/-predicting-possible-ways-to-reduce-and-correction-of-massive-intraoperative-blood-loss-in-spinal-tumor-surgery
#11
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
https://www.readbyqxmd.com/read/27421661/is-autologous-salvaged-blood-a-viable-option-for-patient-blood-management-in-oncologic-surgery
#12
Aye Sandar Zaw, Shashidhar Bangalore Kantharajanna, Naresh Kumar
Oncologic surgery is sometimes associated with substantial blood loss, and principles of patient blood management can be applied in the perioperative care of these patients. Although autologous salvaged blood is an option for perioperative blood conservation, it is often not used in oncologic surgery over concern of reinfusing tumor cells and thereby causing tumor dissemination. We reviewed the literature regarding safety and effectiveness of salvaged blood in oncologic surgery. Salvaged blood seems to be comparable to allogeneic blood in terms of safety...
June 21, 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27418211/argatroban-for-anticoagulation-of-a-blood-salvage-system-an-ex-vivo-study
#13
Martin Beiderlinden, Carsten Brau, Santo di Grazia, Michael Wehmeier, Tanja A Treschan
BACKGROUND: Blood salvage systems help to minimize intraoperative transfusion of allogenic blood. So far no data is available on the use of argatroban for anticoagulation of such systems. We conducted an ex-vivo trial to evaluate the effectiveness of three different argatroban doses as compared to heparin and to assess potential residual anticoagulant in the red cell concentrates. METHODS: With ethical approval and individual informed consent, blood of 23 patients with contraindications for use of blood salvage systems during surgery was processed by the Continuous-Auto-Transfusion-System (C...
2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27398896/indications-and-outcomes-of-cell-saver-in-adolescent-scoliosis-correction-surgery-a-systematic-review
#14
Nicholas Stone, Vandit Sardana, Paul Missiuna
STUDY DESIGN: Systematic Review. OBJECTIVE: To determine the indications and outcomes for intraoperative cell salvage during adolescent scoliosis correction surgery by systematically reviewing all available evidence. SUMMARY OF BACKGROUND DATA: Several blood conservation strategies exist to minimize the consequences of blood loss due to scoliosis correction surgery. The utility of intraoperative cell salvage has been contested in the literature with respect to benefits and cost...
July 7, 2016: Spine
https://www.readbyqxmd.com/read/27312044/preoperative-warming-and-undesired-surgical-and-anesthesia-outcomes-in-pediatric-spinal-surgery-a-retrospective-cohort-study
#15
Matthias Görges, Nicholas C West, Wesley Cheung, Guohai Zhou, Firoz Miyanji, Simon D Whyte
BACKGROUND: Underbody forced air warming is a method commonly used for intraoperative temperature maintenance in children. We previously reported that preoperative forced air warming of children undergoing spinal surgery substantially reduces the incidence and duration of intraoperative hypothermia (<36°C). OBJECTIVE: The aim of this study was to evaluate the effects of preoperative warming before spinal deformity surgery on surgical site infection rate, length of hospitalization, and bleeding (estimated blood loss and incidence of cell salvaged and/or allogeneic packed red blood cell transfusions)...
September 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27227909/experience-of-intraoperative-cell-salvage-in-surgical-correction-of-spinal-deformity-a-retrospective-review-of-124-patients
#16
Changsheng Yang, Jianru Wang, Zhaomin Zheng, Zhongmin Zhang, Hui Liu, Hua Wang, Zemin Li
The effect of intraoperative cell salvage (ICS) in surgical correction of spinal deformity remained controversial. This study was to quantitatively demonstrate its effect. In all, 124 patients having ICS in surgical correction of spinal deformity were included. These patients would be divided into 3 groups. Group 1-blood loss less than 15 mL/kg; group 2-between 15 and 37.5 mL/kg; and group 3-more than 37.5 mL/kg. The mean blood loss was 37.2 mL/kg and patients received 872.2 mL salvaged blood on average...
May 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27154806/a-decision-model-and-cost-analysis-of-intra-operative-cell-salvage-during-hepatic-resection
#17
Madeline Lemke, Gareth Eeson, Yulia Lin, Jordan Tarshis, Julie Hallet, Natalie Coburn, Calvin Law, Paul J Karanicolas
BACKGROUND: Intraoperative cell salvage (ICS) can reduce allogeneic transfusions but with notable direct costs. This study assessed whether routine use of ICS is cost minimizing in hepatectomy and defines a subpopulation of patients where ICS is most cost minimizing based on patient transfusion risk. METHODS: A decision model from a health systems perspective was developed to examine adoption and non-adoption of ICS use for hepatectomy. A prospectively maintained database of hepatectomy patients provided data to populate the model...
May 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27066789/avoiding-allogenic-blood-transfusions-in-endoscopic-angiofibroma-surgery
#18
Hisham Wasl, Jessica McGuire, Darlene Lubbe
BACKGROUND: Surgical approaches for many tumours are often limited by blood loss, exposure and risk to vital anatomical structures. Therefore, the standard of care for certain skull base tumours has become endoscopic transnasal resection. Other surgical disciplines often use cell salvage techniques, but review of the otolaryngology literature revealed very few case reports. This study investigated the value and safety of salvage-type autologous blood transfusion during the endoscopic resection of juvenile nasopharyngeal angiofibromas (JNA)...
2016: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27036602/perioperative-blood-conservation-strategies-for-major-spine-surgery
#19
REVIEW
Oliver M Theusinger, Donat R Spahn
BACKGROUND: Orthopedic surgery, especially spine and spinal deformity surgery, may be associated with high perioperative blood loss. In order to reduce the risk of excessive blood loss and unnecessary blood transfusions, strategies such as Patient Blood Management including goal-directed coagulation management have been developed. RECENT FINDINGS: Adverse effects of allogeneic blood transfusions have been shown for most surgical fields including orthopedic surgery...
March 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27027415/technique-for-reliable-sentinel-node-biopsy-in-squamous-cell-carcinomas-of-the-floor-of-mouth
#20
Sandro J Stoeckli, Thomas Huebner, Gerhard F Huber, Martina A Broglie
BACKGROUND: Applicability of sentinel node biopsy (SNB) for tumors of the floor of mouth (FOM) is controversial. METHODS: Prospective evaluation of the accuracy of gamma-probe-guided superselective neck dissection of the preglandular triangle of level I for SNB in FOM squamous cell carcinoma (SCC) after preoperative lymphoscintigraphy and single photon emission CT (SPECT)/CT. RESULTS: In total, 22 sentinel lymph nodes were harvested in level I...
September 2016: Head & Neck
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