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https://www.readbyqxmd.com/read/29727761/systematic-review-and-meta-analyses-of-tranexamic-acid-use-for-bleeding-reduction-in-prostate-surgery
#1
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Prostate cancer and benign prostatic hyperplasia have an increased incidence with aging. The most effective treatments are radical prostatectomy and transurethral resection of the prostate. To reduce perioperative bleeding in these surgeries, an approach is the use of tranexamic acid (TXA). Studies show that TXA is effective in reducing the blood loss and the need for transfusion in cardiac, orthopedic, and gynecological surgeries. In prostate surgeries, its efficacy and safety have not been established yet...
May 1, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29716640/tranexamic-acid-versus-placebo-to-prevent-blood-transfusion-during-radical-cystectomy-for-bladder-cancer-tact-study-protocol-for-a-randomized-controlled-trial
#2
Rodney H Breau, Luke T Lavallée, Sonya Cnossen, Kelsey Witiuk, Ilias Cagiannos, Franco Momoli, Gregory Bryson, Salmaan Kanji, Christopher Morash, Alexis Turgeon, Ryan Zarychanski, Ranjeeta Mallick, Greg Knoll, Dean A Fergusson
BACKGROUND: Radical cystectomy for bladder cancer is associated with a high risk of needing red blood cell transfusion. Tranexamic acid reduces blood loss during cardiac and orthopedic surgery, but no study has yet evaluated tranexamic acid use during cystectomy. METHODS: A randomized, double-blind (surgeon-, anesthesiologist-, patient-, data-monitor-blinded), placebo-controlled trial of tranexamic acid during cystectomy was initiated in June 2013. Prior to incision, the intervention arm participants receive a 10 mg/kg loading dose of intravenously administered tranexamic acid, followed by a 5 mg/kg/h maintenance infusion...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29570760/the-role-of-aspirin-and-unfractionated-heparin-combination-therapy-immediately-after-total-hip-and-knee-arthroplasty
#3
Ali H Sobh, Denise M Koueiter, Anthony Mells, Matthew P Siljander, Mark S Karadsheh
Aspirin and unfractionated heparin (UH) are accepted options for venous thromboembolism (VTE) prophylaxis after total joint arthroplasty (TJA). The use of aspirin in addition to UH in preventing VTE after TJA has yet to be studied. The primary objective of this study was to determine VTE rates in patients receiving aspirin monotherapy and those receiving aspirin and UH combination therapy immediately following TJA. A TJA database from a single hospital system was retrospectively reviewed to identify all patients who underwent primary hip or knee arthroplasty from 2013 to 2016...
March 23, 2018: Orthopedics
https://www.readbyqxmd.com/read/29567052/the-efficacy-and-safety-of-topical-tranexamic-acid-a-systematic-review-and-meta-analysis
#4
REVIEW
Joshua Montroy, Brian Hutton, Preveshen Moodley, Nicholas A Fergusson, Wei Cheng, Alan Tinmouth, Luke T Lavallée, Dean A Fergusson, Rodney H Breau
Tranexamic acid (TXA) is an effective hemostatic agent used for the reduction of blood loss and transfusion. However, the safety profile of TXA remains in question due to a potential increased risk of venous thromboembolism. By applying TXA topically as opposed to intravenously, systemic absorption may be reduced and unwanted side-effects mitigated. The objective of our review is to investigate the efficacy and safety of topically applied tranexamic acid compared to both placebo, and the intravenous administration...
February 19, 2018: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29564043/postoperative-intravenous-ferric-carboxymaltose-reduces-transfusion-amounts-after-orthopedic-hip-surgery
#5
Sun Ki Kim, Won Yeong Seo, Hee Joong Kim, Jeong Joon Yoo
Background: This retrospective study was performed to determine whether postoperative intravenous ferric carboxymaltose reduces transfusion amounts without influencing clinical outcomes in patients that have undergone hip surgery. Methods: Between May 2014 and April 2016, the authors adopted a new perioperative blood management protocol involving the administration of intravenous ferric carboxymaltose after hip surgeries. One-to-one matching between the 150 patients treated during this period with 150 patients treated before initiation of the new protocol was performed by propensity scoring for age, sex, diagnosis, and type of hip surgery...
March 2018: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29542136/five-year-trends-in-perioperative-red-blood-cell-transfusion-from-index-cases-in-five-surgical-specialties-2011-to-2015
#6
Michael A Mazzeffi, John M See, Brittney Williams, Justin Richards, Darin Zimmerman, Samuel Galvagno, Magali Fontaine, Kenichi Tanaka
BACKGROUND: Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients. STUDY DESIGN AND METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery...
March 14, 2018: Transfusion
https://www.readbyqxmd.com/read/29536685/-application-of-damage-control-orthopedics-for-the-treatment-of-severe-multiple-fractures
#7
Teng-Fei Zhu, Wen-Guo Zhao, Han-Lin Zheng, Jia-Xiang Wu
OBJECTIVE: To investigate the application effect of damage control orthopedics for the treatment of severe multiple fractures. METHODS: From January 2014 to December 2016, 23 patients with severe multiple fractures were treated with the damage control orthopedics (DCO), included 14 males and 9 females with an average age of (41.57±8.29) years old ranging from 28 to 60 years old; the NISS averaged(27.70±5.44) points ranging from 18 to 40 points. As the control group, 27 patients with severe multiple fractures were treated by the early total care(ETC) technology from Jan...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29520878/analysis-of-the-impact-of-race-on-blood-transfusion-in-pediatric-scoliosis-surgery
#8
Keila M Maher, Kwadwo Owusu-Akyaw, Jingzhu Zhou, Mary Cooter, Allison K Ross, Robert K Lark, Brad M Taicher
INTRODUCTION: Surgical correction of pediatric scoliosis is associated with significant blood loss. Minimizing estimated blood loss and blood transfusion is beneficial as transfusions have been associated with increased morbidity, including risk of surgical site infections, longer hospitalizations, and increased cost. Although there is evidence that African-American or Black adults are more likely to require intraoperative blood transfusion compared with Caucasian or White adults, the reasons for this difference are unclear...
April 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29451943/dual-diagnosis-and-total-hip-arthroplasty
#9
Mitchell R Klement, Brian T Nickel, Abiram Bala, Colin T Penrose, Cynthia L Green, Samuel S Wellman, Michael P Bolognesi, Thorsten M Seyler
The co-occurrence of a mental illness and a substance abuse disorder (SUD) is common and has been referred to as a "dual diagnosis" (DD). Although studies have independently investigated mental illness alone and SUD alone, few have examined the effects of these entities combined on complications. A search of the Medicare database from 2005 to 2012 identified 2000 DD patients who underwent total hip arthroplasty (THA). They were compared with 86,976 patients with mental illness only and 590,689 controls (no mental illness or SUD)...
February 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29402715/does-parkinson-disease-increase-the-risk-of-perioperative-complications-after-total-hip-arthroplasty-a-nationwide-database-study
#10
Jared M Newman, Nipun Sodhi, Sarah E Dalton, Anton Khlopas, Richard P Newman, Carlos A Higuera, Michael A Mont
BACKGROUND: Parkinson disease (PD) is the second most common neurodegenerative disorder in the United States, affecting over 1 million people. As part of the disease process, PD can cause poor bone quality and other musculoskeletal problems that can affect a patient's quality of life. With advances in treatment, PD patients can be more active and may be candidates for total hip arthroplasty (THA). However, there is a paucity of literature on the outcomes of THA in PD patients. Therefore, the purpose of this study was to evaluate the perioperative outcomes of PD patients who underwent THA...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29389749/trauma-and-transfusion-in-the-geriatric-patient
#11
Corey S Scher
PURPOSE OF REVIEW: The percentage of people over the age of 65 is growing rapidly and anesthesiologists must develop a medical understanding that is comprehensive to meet the unique medical needs of this population. The changing physiology of an elderly population makes them extremely vulnerable to trauma and the administration of blood products. Although most of these cases involve orthopedic attention, it is not less dangerous as a blunt trauma case. RECENT FINDINGS: This article addresses some of the main concerns for the anesthesiologists of providing a hemostatic resuscitation in the geriatric population...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29335914/accuracy-and-trending-of-non-invasive-hemoglobin-measurement-during-different-volume-and-perfusion-statuses
#12
Abdelmoneim Adel, Wael Awada, Bassant Abdelhamid, Heba Omar, Omnia Abd El Dayem, Ahmed Hasanin, Ashraf Rady
The evolution of non-invasive hemoglobin measuring technology would save time and improve transfusion practice. The validity of pulse co-oximetry hemoglobin (SpHb) measurement in the perioperative setting was previously evaluated; however, the accuracy of SpHb in different volume statuses as well as in different perfusion states was not well investigated. The aim of this work is to evaluate the accuracy and trending of SpHb in comparison to laboratory hemoglobin (Lab-Hb) during acute bleeding and after resuscitation...
January 15, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29318944/prevalence-of-iron-deficiency-in-a-total-joint-surgery-population
#13
Jonathan H Waters, Peter Johnson, Mark H Yazer
BACKGROUND: Iron deficiency without anemia has been associated with decreases in functional work capacity and fatigue. The aim of this study was to determine the prevalence of iron deficiency without anemia in a preoperative cohort of orthopedic patients and to determine if iron deficiency is a condition which warrants inclusion into a prehabilitation program prior to surgery. METHODS: One hundred consecutive patients going through preoperative testing for total joint replacement were enrolled in the study...
January 10, 2018: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/29306243/tnf-%C3%AE-and-tgf-%C3%A3-level-after-intraoperative-allogeneic-red-blood-cell-transfusion-in-orthopedic-operation-patients
#14
Hamed Hassani, Alireza Khoshdel, Seyed Reza Sharifzadeh, Mohamad Foad Heydari, Shaban Alizadeh, Ali Noroozi Aghideh
Background/aim: Blood transfusion is associated with immunosuppression, referred to as transfusion-related immunomodulation (TRIM). In this study, for the first time, changes in the concentration of TGF-ß and TNF-α were measured postoperatively in orthopedic patients with intraoperational allogeneic red blood cell transfusion. Considering the use of packed cell units with different ages, it is possible to suggest the more appropriate product for clinical applications.Materials and methods: Two groups of 35 orthopedic surgery patients (with or without transfusion as case and control groups, respectively) were involved...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29287123/interventions-to-improve-the-outcomes-of-frail-people-having-surgery-a-systematic-review
#15
REVIEW
Daniel I McIsaac, Tim Jen, Nikhile Mookerji, Abhilasha Patel, Manoj M Lalu
BACKGROUND: Frailty is an important prognostic factor for adverse outcomes and increased resource use in the growing population of older surgical patients. We identified and appraised studies that tested interventions in populations of frail surgical patients to improve perioperative outcomes. METHODS: We systematically searched Cochrane, CINAHL, EMBASE and Medline to identify studies that tested interventions in populations of frail patients having surgery. All phases of study selection, data extraction, and risk of bias assessment were done in duplicate...
2017: PloS One
https://www.readbyqxmd.com/read/29261547/intravenous-iron-for-treatment-of-anemia-in-the-3-perisurgical-phases-a-review-and-analysis-of-the-current-literature
#16
Frank Peters, Ines Ellermann, Andrea U Steinbicker
Anemia is a common comorbidity throughout the entire hospital stay. Treatment options include intravenous (IV) iron, oral iron, erythropoietin, and red blood cell (RBC) transfusions. IV iron has gained in popularity with the implementation of patient blood management programs. A variety of studies have been performed to investigate the use of IV iron in preoperative, perioperative, and postoperative settings. An objective review on these studies has yet to be performed. The current narrative review provides an overview of trials investigating IV iron use in the preoperative, perioperative, and postoperative settings...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29249226/tranexamic-acid-prophylaxis-in-hip-and-knee-joint-replacement
#17
Matthias Goldstein, Carsten Feldmann, Hinnerk Wulf, Thomas Wiesmann
BACKGROUND: The antifibrinolytic agent tranexamic acid (TXA) is widely used for the prevention and treatment of hyperfibrinolytic states, such as in severe polytrauma. It can also be used for the systemic prevention of hemorrhage in elective orthopedic procedures. In this review, we assess the efficacy and risks of the prophylactic administration of tranexamic acid before major endoprosthetic surgery of the hip and knee. METHODS: This review is based on pertinent articles retrieved by a selective literature search in the PubMed and Cochrane Library databases...
December 1, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29214459/the-role-of-intraoperative-cell-salvage-system-on-blood-management-in-major-orthopedic-surgeries-a-cost-benefit-analysis
#18
Altuğ Duramaz, Mustafa Gökhan Bilgili, Berhan Bayram, Nezih Ziroğlu, Erdem Edipoğlu, Halil Nadir Öneş, Cemal Kural, Mustafa Cevdet Avkan
INTRODUCTION: The aim of this study was to compare the efficiency and cost of cell salvage systems with allogeneic blood transfusions in patients who had major elective orthopedic surgeries. MATERIALS AND METHODS: Consecutive 108 patients who had intraoperative cell saver (CS) performed routinely constitute the study group. In control group, consecutive 112 patients who were operated without intraoperative CS were investigated. Hemoglobin (Hb) level less than 8 mg/dL was regarded as the absolute transfusion indication...
December 6, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29141358/-effect-of-different-tourniquet-releasing-strategy-on-blood-loss-in-total-knee-arthroplasty
#19
Y Li, M Lu, H Tian, Z J Li, K Zhang
Objective: To explore the influences on peri-operative blood loss and postoperative blood transfusion in primary total knee arthroplasty when using different methods to release the pneumatic tourniquet. Methods: From January 2015 to December 2016, 484 patients with osteoarthritis were enrolled, undergoing primary unilateral total knee arthroplasty in the Orthopedics Department of Peking University Third Hospital. Retrospective data was used, and all the patients had been operated on by three independent working groups...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29094483/impact-of-intraoperative-blood-salvage-on-monocyte-subsets-alteration-and-intracellular-tumor-necrosis-factor-%C3%AE-production
#20
Hagen Bomberg, Thomas Volk, Andreas Biedler, Sven O Schneider
Intraoperative salvaged blood is used to reduce allogeneic blood transfusion in orthopedic surgery patients. However, salvaged blood reinfusion may lead to immune reactions. Salvaged and venous blood from 20 patients undergoing hip arthroplasty was processed. The salvaged samples were mixed with patients' venous blood and incubated in absence or presence of lipopolysaccharide. SAMPLES: Venous: venous patient blood (n = 20). Native: mixed salvaged native blood (n = 20). Filtered: mixed salvaged leukocyte filtered blood (n = 20)...
March 2018: Journal of Biomedical Materials Research. Part A
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