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https://www.readbyqxmd.com/read/28622903/cell-saver-for-adult-spinal-deformity-surgery-reduces-cost
#1
Jeffrey L Gum, Leah Yacat Carreon, Michael P Kelly, Richard Hostin, Chessie Robinson, Douglas C Burton, David W Polly, Christopher I Shaffrey, Virginie LaFage, Frank J Schwab, Christopher P Ames, Han Jo Kim, Justin S Smith, R Shay Bess
STUDY DESIGN: Retrospective cohort. OBJECTIVES: To determine if the use of cell saver reduces overall blood costs in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: Recent studies have questioned the clinical value of cell saver during spine procedures. METHODS: ASD patients enrolled in a prospective, multicenter surgical database who had complete preoperative and surgical data were identified. Patients were stratified into (1) cell saver available during surgery, but no intraoperative autologous infusion (No Infusion group), or (2) cell saver available and received autologous infusion (Infusion group)...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28546128/predictive-factors-of-intraoperative-cell-salvage-during-pediatric-scoliosis-surgery-cell-saver-during-scoliosis-surgery-in-children
#2
Daphné Michelet, Florence Julien-Marsollier, Julie Hilly, Thierno Diallo, Christophe Vidal, Souhayl Dahmani
INTRODUCTION: blood saving strategy during spinal surgery in children often includes recombinant erythropoietin (rEPO) and antifibrinolytic therapapy (AFT). The aim of this study was to investigate the efficacy of intraoperative blood salvage in decreasing homologous blood transfusion. MATERIAL AND METHODS: using the prospective data from patients operated during a one year period for scoliosis correction, we calculate the predictable hematocrit at day postoperative 1 without the use of blood salvage and compare it to the target hematocrit transfusion according to patient's status...
May 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28449959/resource-utilization-in-adolescent-idiopathic-scoliosis-surgery-is-there-opportunity-for-standardization
#3
Baron S Lonner, Courtney S Toombs, Justin C Paul, Suken A Shah, Harry L Shufflebarger, John M Flynn, Peter O Newton
INTRODUCTION: Recent healthcare reforms have raised the importance of cost and value in the management of disease. Value is a function of benefit and cost. Understanding variability in resources utilized by individual surgeons to achieve similar outcomes may provide an opportunity for cutting costs though greater standardization. The purpose of this study is to evaluate differences in use of implants and hospital resources among surgeons performing adolescent idiopathic scoliosis (AIS) surgery...
May 2017: Spine Deformity
https://www.readbyqxmd.com/read/28441316/hemolysis-following-intraoperative-cell-salvage-replacement-in-a-scoliosis-patient-with-sickle-cell-trait-a-case-report
#4
Daniel You, Alejandro Peiro Garcia, Fabio Ferri-de-Barros, David Parsons
STUDY DESIGN: Case Report. OBJECTIVE: To describe a novel presentation of acute renal failure associated with hemolysis following intraoperative cell salvage (ICS) in a neuromuscular scoliosis patient with sickle cell trait (SCT). SUMMARY OF BACKGROUND DATA: Hemolysis associated acute renal failure following ICS in patients with SCT has not been previously reported. Sickle cell disease is regarded as a relative contraindication for ICS due to the risk of red blood cell sickling in the hypoxic cell saver reservoir...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28410631/comparison-of-three-caval-reconstruction-techniques-in-orthotopic-liver-transplantation-a-retrospective-review
#5
Tiffany Chan, Kristin DeGirolamo, Stephanie Chartier-Plante, Andrzej K Buczkowski
BACKGROUND: Classic caval reconstruction during liver transplantation involves complete cross-clamping and resection of the recipient inferior vena cava (IVC) followed by donor IVC interposition. Other techniques preserve the IVC, with piggyback (PB) to the hepatic veins or side-to-side (SS) caval anastomosis. Avoidance of cross-clamping may be beneficial for minimizing hemodynamic instability and transfusion requirements. METHODS: Retrospective review of a provincial transplant database (2007-2011)...
April 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28389617/a-dedicated-spanish-language-line-increases-enrollment-of-hispanics-into-prehospital-clinical-research
#6
Nerses Sanossian, Lauren Rosenberg, David S Liebeskind, Sidney Starkman, Marc Eckstein, Samuel Stratton, Franklin D Pratt, Scott Hamilton, May Kim-Tenser, Latisha K Sharma, Lucas Restrepo, Miguel Valdes-Suieras, Robin Conwit, Jeffrey L Saver
BACKGROUND AND PURPOSE: Novel methods are needed to reduce the disparity of Hispanic enrollment in stroke clinical trials. Prehospital enrollment using a dedicated Spanish language line may help overcome this bias. METHODS: Subjects or legally authorized representatives provided information on race and ethnicity for all cases enrolled in the FAST-MAG clinical trial (Field Administration of Stroke Therapy-Magnesium), a prehospital phase 3 randomized study of intravenous magnesium for neuroprotection...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#7
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28299184/revisiting-blood-transfusion-and-predictors-of-outcome-in-cardiac-surgery-patients-a-concise-perspective
#8
REVIEW
Carlos E Arias-Morales, Nicoleta Stoicea, Alicia A Gonzalez-Zacarias, Diana Slawski, Sujatha P Bhandary, Theodosios Saranteas, Eva Kaminiotis, Thomas J Papadimos
In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement...
2017: F1000Research
https://www.readbyqxmd.com/read/28274048/evaluation-of-cyclosporine-a-with-%C3%AE-tcp-in-the-treatment-of-human-infra-bony-defects-a-randomized-controlled-pilot-study
#9
Jyotsna Amalakara, Krishnajaneya Reddy, Haritha Avula, Ashank Mishra, Butchibabu Kalakonda, Ruchi Pandey
INTRODUCTION: Cyclosporine A (CsA), an immunosuppressant, is considered a life saver drug in organ transplant cases. It has also been tested in animal and human studies for periodontal applications as it selectively inhibits T lymphocyte proliferation, Interleukin-2 (IL-2) and other cytokine production, without any effect on T suppressor cells, thereby suppressing the cell mediated immunity and suppressing the inflammation. Inflammatory and immunological responses have been found to be decreased and bone formation is found to be increased in immunosuppressed animals...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28144579/microvascular-response-to-transfusion-in-elective-spine-surgery
#10
J Matthias Walz, Ottokar Stundner, Federico P Girardi, Bruce A Barton, Aimee R Koll-Desrosiers, Stephen O Heard, Stavros G Memtsoudis
AIM: To investigate the microvascular (skeletal muscle tissue oxygenation; SmO2) response to transfusion in patients undergoing elective complex spine surgery. METHODS: After IRB approval and written informed consent, 20 patients aged 18 to 85 years of age undergoing > 3 level anterior and posterior spine fusion surgery were enrolled in the study. Patients were followed throughout the operative procedure, and for 12 h postoperatively. In addition to standard American Society of Anesthesiologists monitors, invasive measurements including central venous pressure, continual analysis of stroke volume (SV), cardiac output (CO), cardiac index (CI), and stroke volume variability (SVV) was performed...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28094033/vancomycin-added-to-the-wash-solution-of-the-cell-saver-effect-on-bacterial-contamination
#11
A Perez-Ferrer, E Gredilla-Díaz, J de Vicente-Sánchez, R Navarro-Suay, F Gilsanz-Rodríguez
OBJECTIVES: The aim of this study is to test whether the addition of a low-dose of antibiotic (vancomycin) to the wash solution (saline) of the cell-saver reduces the incidence of bacterial contamination of the autologous red blood cell (RBCs) concentrate recovered. MATERIAL AND METHOD: Experimental, randomized, double-blind, parallel group study performed on 20 consecutive patients scheduled for posterior spinal fusion surgery. Intraoperative bleeding was processed through a cell-saver: HaemoLite(®) 2+, in which the RBCs were washed according to randomization group, with saline (control group) or saline+10μg/ml(-1) vancomycin (vanco group)...
April 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27994257/changes-in-cerebral-oxygenation-during-transfusion-therapy
#12
Mumin Hakim, Dmitry Tumin, David P Martin, Walter Samora, Allan C Beebe, Jan E Klamar, Ashley B Hodge, Joseph D Tobias
This study assesses the effects of transfusion of autologous or allogeneic blood on cerebral and tissue oxygenation during spinal surgery. Packed red blood cell transfusions are indicated to improve oxygen delivery to tissues. There are limited data demonstrating changes in tissue oxygenation with blood administration. Tissue (deltoid) and cerebral oxygenation were monitored using near-infrared spectroscopy during spinal surgery in patients. As indicated, cell saver or allogeneic blood was administered. Tissue and cerebral oxygenation were recorded before and after transfusion...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27850236/597-reinfusion-of-cell-saver-for-up-to-24-hours-post-collection-does-not-increase-risk-of-infection
#13
Elizabeth Nocera, L Eugene Daugherty, Ronald Angona, Hongyue Wang, Brena Tesini, George Alfieris, Jill Cholette
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27692949/does-moderate-hypothermia-really-carry-less-bleeding-risk-than-deep-hypothermia-for-circulatory-arrest-a-propensity-matched-comparison-in-hemiarch-replacement
#14
Jeffrey E Keenan, Hanghang Wang, Brian C Gulack, Asvin M Ganapathi, Nicholas D Andersen, Brian R Englum, Yamini Krishnamurthy, Jerrold H Levy, Ian J Welsby, G Chad Hughes
BACKGROUND: Moderate (MHCA) versus deep (DHCA) hypothermia for circulatory arrest in aortic arch surgery has been purported to reduce coagulopathy and bleeding complications, although there are limited data supporting this claim. This study aimed to compare bleeding-related events after aortic hemiarch replacement with MHCA versus DHCA. METHODS: Patients who underwent hemiarch replacement at a single institution from July 2005 to August 2014 were stratified into DHCA and MHCA groups (minimum systemic temperature ≤20°C and >20°C, respectively) and compared...
December 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27671218/anesthetic-management-of-transapical-off-pump-mitral-valve-repair-with-neochord-implantation
#15
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/27591910/reinfusate-heparin-concentrations-produced-by-two-autotransfusion-systems
#16
Willem Frederik Buys, Mathilde Buys, Andrew Ian Levin
OBJECTIVES: Cell saver reinfusate ideally should contain low, clinically insignificant heparin concentrations. The American Association of Blood Banks has defined the clinically insignificant threshold as 0.5 IU/mL. Furthermore, there is uncertainty about the meaning of cell saver "heparin elimination rates." These concerns prompted the authors' independent investigation of reinfusate heparin concentrations of devices used in their institution. It was hypothesized that cell saver reinfusates contain clinically insignificant heparin concentrations...
June 15, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27575038/factors-that-predict-blood-loss-after-bernese-periacetabular-osteotomy
#17
Eduardo N Novais, Patrick M Carry, Lauryn A Kestel, Jason Koerner, Gee Mei Tan
Although strategies to reduce bleeding and avoid allogeneic transfusion have been described, there is controversy about the factors associated with blood loss after Bernese periacetabular osteotomy. This study was conducted to determine risk factors for postoperative blood loss. After institutional review board approval was obtained, a retrospective review was conducted of 41 young patients who underwent periacetabular osteotomy for symptomatic acetabular dysplasia over a 3-year period. Of these patients, two-thirds donated blood before surgery...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27574548/living-donor-liver-transplantation-for-high-model-for-end-stage-liver-disease-score-what-have-we-learned
#18
Hany Dabbous, Mohammad Sakr, Sara Abdelhakam, Iman Montasser, Mohamed Bahaa, Hany Said, Mahmoud El-Meteini
AIM: To assess the impact of model for end-stage liver disease (MELD) score on patient survival and morbidity post living donor liver transplantation (LDLT). METHODS: A retrospective study was performed on 80 adult patients who had LDLT from 2011-2013. Nine patients were excluded and 71 patients were divided into two groups; Group 1 included 38 patients with a MELD score < 20, and Group 2 included 33 patients with a MELD score > 20. Comparison between both groups was done regarding operative time, intra-operative blood requirement, intensive care unit (ICU) and hospital stay, infection, and patient survival...
August 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27557459/implementation-of-a-tranexamic-acid-protocol-to-reduce-blood-loss-during-cranial-vault-remodeling-for-craniosynostosis
#19
David T Martin, Heike Gries, Nick Esmonde, Brian Diggs, Jeffrey Koh, Nathan R Selden, Martin Schreiber, Anna A Kuang
OBJECTIVE: Pediatric cranial vault remodeling for repair of craniosynostosis is associated with significant blood loss and transfusion requirements. Beginning in 2011, the authors evaluated the impact tranexamic acid (TXA) on blood loss and blood product transfusion for children less than 15 months of age undergoing primary surgical repair of nonsyndromic single suture craniosynostosis. METHODS: Following institutional review board approval, the authors performed a retrospective study of all children undergoing surgical correction of craniosynostosis at Oregon Health & Science University from 2005 to 2015...
September 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27503696/infection-is-not-a-risk-factor-for-perioperative-and-postoperative-blood-loss-and-transfusion-in-revision-total-hip-arthroplasty
#20
Jaiben George, Matthew Sikora, Jessica Masch, Mario Farias-Kovac, Alison K Klika, Carlos A Higuera
BACKGROUND: Septic hip revisions are associated with greater complications and higher costs than aseptic revisions. It is unclear whether blood loss and transfusion requirements are different in septic and aseptic revisions. We hypothesized that the blood loss and transfusion are dependent on the complexity of the revision surgery and patient's general health rather than the presence of infection. METHODS: We retrospectively reviewed 626 revision total hip arthroplasties in 547 patients between 2009 and 2013...
January 2017: Journal of Arthroplasty
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