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Blood salvage

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https://www.readbyqxmd.com/read/28323241/the-safety-efficacy-and-cost-effectiveness-of-intraoperative-cell-salvage-in-metastatic-spine-tumour-surgery
#1
Mahmoud Elmalky, Naveed Yasin, Ricardo Rodrigues-Pinto, John Stephenson, Craig Carroll, Glyn Smurthwaite, Rajat Verma, Saeed Mohammad, Irfan Siddique
BACKGROUND CONTEXT: Metastatic spine tumour surgery (MSTS) is associated with substantial blood loss therefore leading to high morbidity and mortality. While intraoperative cell salvage with leucocyte depletion filter (IOCS-LDF) has been studied as an effective mean of reducing blood loss in other surgical settings, including the spine, no study has yet analysed the efficacy of re-infusion of salvaged blood in reducing the need for allogenic blood transfusion in patients who have had surgery for MSTS...
March 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28295356/red-blood-cell-metabolic-responses-to-refrigerated-storage-rejuvenation-and-frozen-storage
#2
Angelo D'Alessandro, Alan D Gray, Zbignew M Sczcepiorkowski, Kirk Hansen, Louise H Herschel, Larry J Dumont
BACKGROUND: Storage of red blood cells (RBCs) under blood bank conditions promotes metabolic modulation within the RBC. This "metabolic storage lesion" may affect the quality and safety of the transfused RBCs. The aim of this study is to determine the metabolic changes in stored RBCs over 42 days of routine storage followed by a US Food and Drug Administration-approved method of rejuvenation, freezing, and preparation for transfusion. STUDY DESIGN AND METHODS: We exploited a mass spectrometry-based metabolomics approach to monitor 42-day-stored citrate phosphate dextrose/AS-1 RBCs (n = 29) that were rejuvenated, glycerolized and frozen, then thawed and deglycerolized, and held for 24 hours at 1 to 6ºC in saline-glucose...
March 10, 2017: Transfusion
https://www.readbyqxmd.com/read/28293381/thrombocytopenia-in-cirrhosis-impact-of-fibrinogen-on-bleeding-risk
#3
Sonali V Thakrar, Susan V Mallett
AIM: To investigate the relationship between baseline platelet count, clauss fibrinogen, maximum amplitude (MA) on thromboelastography, and blood loss in orthotopic liver transplantation (OLT). METHODS: A retrospective analysis of our OLT Database (2006-2015) was performed. Baseline haematological indices and intraoperative blood transfusion requirements, as a combination of cell salvage return and estimation of 300 mls/unit of allogenic blood, was noted as a surrogate for intraoperative bleeding...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28291570/refining-the-indications-for-scapula-tip-in-mandibular-reconstruction
#4
M W Ho, J S Brown, R J Shaw
Mandibular reconstruction in osteoradionecrosis or salvage surgery can often be complicated by the lack of suitable recipient vessels in the ipsilateral neck and the associated requirement for significant extraoral skin reconstruction. The scapula tip with its long vascular pedicle and option of a chimeric soft tissue component offers a versatile reconstructive solution in such cases. This article reports four consecutive cases of mandibular reconstruction with poor ipsilateral vascular options and additional soft tissue requirements in which the scapula tip was justified and preferred...
March 10, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28291126/strategies-to-reduce-blood-product-utilization-in-obstetric-practice
#5
Holger Neb, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. RECENT FINDINGS: PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277456/resting-state-bold-mri-for-perfusion-and-ischemia
#6
Hannes Kroll, Greg Zaharchuk, Thomas Christen, Jeremy J Heit, Michael Iv
Advanced imaging techniques including computed tomography (CT) angiography, CT perfusion, magnetic resonance (MR) angiography, MR with diffusion- and perfusion-weighted imaging, and, more recently, resting-state BOLD (Blood Oxygen Level Dependent) functional MRI (rs-fMRI) are increasingly used to evaluate patients with acute ischemic stroke. Advanced imaging allows for identification of patients with ischemic stroke and determination of the size of infarcted and potentially salvageable tissue, all of which yield crucial information for proper stroke management...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28271644/a-case-of-disseminated-infection-with-skin-manifestation-due-to-non-neoformans-and-non-gattii-cryptococcus-in-a-patient-with-refractory-acute-myeloid-leukemia
#7
Sun Seob Park, Hyewon Lee, Weon Seo Park, Sang Hyun Hwang, Sang Il Choi, Mi Hong Choi, Si Won Lee, Eun Jung Ko, Young Ju Choi, Hyeon Seok Eom
Cryptococcus spp. other than Cryptococcus neoformans or Cryptococcus gattii were previously considered saprophytes and thought to be non-pathogenic to humans. However, opportunistic infections associated with non-neoformans and non-gattii species, such as Cryptococcus laurentii and Cryptococcus albidus, have increased over the past four decades. We experienced a case of cryptococcosis caused by non-neoformans and non-gattii spp. in a 47-year-old female with refractory acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation...
January 16, 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/28271049/intracorporeal-dilatation-plus-al-ghorab-corporoglandular-shunt-for-salvage-management-of-prolonged-ischemic-priapism
#8
Andika Afriansyah, Prahara Yuri, Yonas Immanuel Hutasoit
Ischemic priapism (IP) is a urological emergency that requires early intervention in order to prevent irreversible structural and functional changes. The purpose of penile shunt surgery is to passage out ischemic blood in the corpus cavernosum (CC), restoring the normal circulation within these structures. Here, we present our first experience using modification of Al-Ghorab shunt procedure to treat severe and prolonged IP. The Al-Ghorab shunt procedure was modified by the retrograde insertion of a 7/8 Hegar dilator into the opening of the distal cavernous tissue via the original Al-Ghorab incision...
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28258943/anaesthesia-for-abnormally-invasive-placenta-a-single-institution-case-series
#9
N J Taylor, R Russell
BACKGROUND: Abnormally invasive placenta describes a spectrum of disorders resulting in pathological placental implantation. It is associated with the potential for severe maternal haemorrhage and poor fetal outcome. Increasing numbers of women are at risk owing to the rising incidence of uterine surgery and increasing maternal age. We report data over a five-year period describing anaesthetic management of cases of abnormally invasive placenta in a UK tertiary-referral maternity unit and assess how management has developed...
January 23, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28255345/a-specific-dietary-intervention-to-restore-brain-structure-and-function-after-ischemic-stroke
#10
Maximilian Wiesmann, Bastian Zinnhardt, Dirk Reinhardt, Sarah Eligehausen, Lydia Wachsmuth, Sven Hermann, Pieter J Dederen, Marloes Hellwich, Michael T Kuhlmann, Laus M Broersen, Arend Heerschap, Andreas H Jacobs, Amanda J Kiliaan
Occlusion of the middle cerebral artery (MCAo) is among the most common causes of ischemic stroke in humans. Cerebral ischemia leads to brain lesions existing of an irreversibly injured core and an ischemic boundary zone, the penumbra, containing damaged but potentially salvageable tissue. Using a transient occlusion (30 min) of the middle cerebral artery (tMCAo) mouse model in this cross-institutional study we investigated the neurorestorative efficacy of a dietary approach (Fortasyn) comprising docosahexaenoic acid, eicosapentaenoic acid, uridine, choline, phospholipids, folic acid, vitamins B12, B6, C, and E, and selenium as therapeutic approach to counteract neuroinflammation and impairments of cerebral (structural+functional) connectivity, cerebral blood flow (CBF), and motor function...
2017: Theranostics
https://www.readbyqxmd.com/read/28253327/osteoprotegerin-levels-in-st-elevation-myocardial-infarction-temporal-profile-and-association-with-myocardial-injury-and-left-ventricular-function
#11
Christian Shetelig, Shanmuganathan Limalanathan, Jan Eritsland, Pavel Hoffmann, Ingebjørg Seljeflot, Jon Michael Gran, Pål Aukrust, Thor Ueland, Geir Øystein Andersen
BACKGROUND: Elevated levels of osteoprotegerin (OPG) have been associated with adverse outcomes in ST-elevation myocardial infarction (STEMI). However, the role of OPG in myocardial injury and adverse remodeling in STEMI patients remains unclear. The aims of this observational cohort study were to evaluate: 1) the temporal profile of OPG during STEMI, 2) possible associations between OPG measured acutely and after 4 months, with infarct size, adverse left ventricular (LV) remodeling, microvascular obstruction (MVO) and myocardial salvage and 3) the effect of heparin administration on OPG levels...
2017: PloS One
https://www.readbyqxmd.com/read/28238873/cell-salvage-used-in-scoliosis-surgery-is-it-really-effective
#12
REVIEW
Jia-Ming Liu, Bi-Qi Fu, Wen-Zhao Chen, Jiang-Wei Chen, Shan-Hu Huang, Zhi-Li Liu
BACKGROUND: Scoliosis surgery is usually associated with large volume of intraoperative blood loss and cell salvage is commonly used to filter and retranfusion autologous blood to patients. However, the efficacy of using cell salvage in scoliosis surgery is still controversial. OBJECTIVE: The purpose of this study is to make clear that intraoperative use of cell salvage is effective to decrease the volume of perioperative allogenic blood transfusion in scoliosis surgery...
February 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28217292/oxygen-or-cooling-to-make-a-decision-after-acute-ischemia-stroke
#13
REVIEW
Wen-Cao Liu, Xin-Chun Jin
The presence of a salvageable penumbra, a region of ischemic brain tissue with sufficient energy for short-term survival, has been widely agreed as the premise for thrombolytic therapy with tissue plasminogen activator (tPA), which remains the only United States Food and Drug Administration (FDA) approved treatment for acute ischemia stroke. However, the use of tPA has been profoundly constrained due to its narrow therapeutic time window and the increased risk of potentially deadly hemorrhagic transformation (HT)...
October 2016: Medical Gas Research
https://www.readbyqxmd.com/read/28201958/blood-infusion-and-the-risk-of-haemorrhage-in-patients-undergoing-cardiac-surgery-with-extracorporeal-circulation
#14
Manuel Luque-Oliveros, María Ángeles García-Carpintero, Omar Cauli
PURPOSE: Patients undergoing cardiac surgery with extracorporeal circulation (ECC) frequently present haemorrhages as a complication associated with high morbidity and mortality. One of the factors that influences this risk is the volume of blood infused during surgery. The objective of this study was to determine the optimal volume of autologous blood that can be processed during cardiac surgery with ECC. We also determined the number of salvaged red blood cells to be reinfused into the patient in order to minimize the risk of haemorrhage in the postoperative period...
February 13, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28197273/clinical-and-surgical-strategies-for-avoiding-or-reducing-allogeneic-blood-transfusions
#15
Antonio Alceu Dos Santos, Jose Francisco Baumgratz, Jose Henrique Andrade Vila, Rodrigo Moreira Castro, Rodrigo Freire Bezerra
Blood transfusions have still been used as a standard therapy to treat severe anemia. Current evidences point to both excessive allogeneic blood consumption and decreased donations, which result in reduced stocks in blood banks. Several studies have increasingly suggested a more restrictive transfusion practice for blood products. Currently, a number of autologous blood conservation protocols in surgeries have been noted. We report a case of severe anemia with 2.9 g/dL hemoglobin, which was successfully handled without using the standard therapy to treat anemia with hemotransfusions...
April 2016: Cardiology Research
https://www.readbyqxmd.com/read/28195859/metallosis-identified-via-intraoperative-cell-salvage-a-case-report
#16
Lauren M Parker, Mark H Yazer, Jonathan H Waters
Intraoperative cell salvage, whereby shed surgical blood is recovered for autologous reinfusion, is frequently used during hip arthroplasty because of the potential for significant blood loss. The following cases describe 2 instances in which chromium and cobalt particles from patients' metal-on-metal hip implants were identified within the blood recovery system. Results of heavy metal testing during the second case suggest that the use of a leukocyte reduction filter effectively reduces metal concentrations to below normal circulating levels...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28193445/endovascular-management-for-peripheral-arterial-trauma-the-new-norm
#17
Anand Ganapathy, Ahmed F Khouqeer, S Robb Todd, Joseph L Mills, Ramyar Gilani
BACKGROUND: Endovascular therapy is well studied in atraumatic conditions; and there appears to be a growing interest in its application to traumatic injuries. The objective of this study is to compare open and endovascular techniques in the management of peripheral arterial trauma. METHODS: This is a retrospective review of patients admitted to a Level I Trauma Center sustaining injuries to the subclavian, axillary, superficial femoral, and popliteal arteries. Demographics, surgical interventions, complications, and clinical outcomes were evaluated in patients requiring open or endovascular repair between 2009 and 2015...
February 4, 2017: Injury
https://www.readbyqxmd.com/read/28188434/bloodless-reperfusion-with-the-oxygen-carrier-hboc-201-in-acute-myocardial-infarction-a-novel-platform-for-cardioprotective-probes-delivery
#18
Jose M García-Ruiz, Carlos Galán-Arriola, Rodrigo Fernández-Jiménez, Jaume Aguero, Javier Sánchez-González, Ana García-Alvarez, Mario Nuno-Ayala, Gregory P Dubé, Zafiris Zafirelis, Gonzalo J López-Martín, Juan A Bernal, Enrique Lara-Pezzi, Valentín Fuster, Borja Ibáñez
Reperfusion, despite being required for myocardial salvage, is associated with additional injury. We hypothesize that infarct size (IS) will be reduced by a period of bloodless reperfusion with hemoglobin-based oxygen carriers (HBOC) before blood-flow restoration. In the pig model, we first characterized the impact of intracoronary perfusion with a fixed volume (600 ml) of a pre-oxygenated acellular HBOC, HBOC-201, on the healthy myocardium. HBOC-201 was administered through the lumen of the angioplasty balloon (i...
March 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28183681/relapse-of-hodgkin-lymphoma-after-autologous-transplantation-time-to-rethink-treatment
#19
REVIEW
Yogesh Jethava, Guru Subramanian Guru Murthy, Mehdi Hamadani
Relapse of Hodgkin lymphoma after autologous hematopoietic cell transplantation (autologous HCT) is a major therapeutic challenge. Its management, at least in younger patients, traditionally involves salvage chemotherapy aiming to achieve disease remission followed by consolidation with allogeneic hematopoietic cell transplantation (allogeneic HCT) in eligible patients. The efficacy of salvage therapy is variable and newer combination chemotherapy regimens have improved the outcomes. Factors such as shorter time to relapse after autologous HCT and poor performance status have been identified as predictors of poor outcome...
February 1, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28177171/increased-survivability-of-ischemic-skin-flap-tissue-in-flk-1-mice-by-pellino-1-intervention
#20
Chandra K Rednam, Rickesha L Wilson, Vaithinathan Selvaraju, Muhammad T Rishi, Mahesh Thirunavukkarasu, Vladimir Coca-Soliz, Rajesh Lakshmanan, J Alexander Palesty, David W McFadden, Nilanjana Maulik
OBJECTIVE: Reduced skin flap survival due to ischemia is a serious concern during reconstructive cosmetic surgery. The absence of vascular endothelial growth factor (VEGF) and its receptors during ischemia may lead to flap failure. We identified Pellino-1 (Peli1), a 46-kDa protein, as a proangiogenic molecule and is directly regulated by VEGF. Therefore, we hypothesized that Peli1 acts downstream of Flk-1/VEGFR2 and aids in skin flap survival during ischemia. METHODS: Scratch and matrigel assays were performed to observe cell proliferation, migration and tube formation in vitro...
February 8, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
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