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https://www.readbyqxmd.com/read/29214459/the-role-of-intraoperative-cell-salvage-system-on-blood-management-in-major-orthopedic-surgeries-a-cost-benefit-analysis
#1
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/29209789/-novel-aspects-of-the-guidelines-for-hemotherapy-2017-implications-for-anesthesiology
#2
REVIEW
I Pekrul, G Wittmann, P Möhnle
Based on the German Transfusion Law, the periodically updated guidelines "Richtlinien zur Gewinnung von Blut und Blutbestandteilen und zur Anwendung von Blutprodukten" ("Hämotherapierichtlinien") are intended to provide the current knowledge and state of the art of blood transfusion practice in Germany. The novel update 2017 contains relevant changes for blood donation, especially the extension of the exclusion period of persons at risk for sexually transmitted HBV, HCV and HIV diseases to 12 months. Moreover, the guidelines provide several changes relevant to blood transfusion practice in anesthesiology, such as: all autologous hemotherapy procedures including normovolemic hemodilution, cell saver, and autologous blood donation and transfusion require formal registration at the regulatory authority...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29189537/bipolar-sealer-devices-used-in-posterior-spinal-fusion-for-neuromuscular-scoliosis-reduce-blood-loss-and-transfusion-requirements
#3
Christina K Hardesty, Zachary L Gordon, Connie Poe-Kochert, Jochen P Son-Hing, George H Thompson
BACKGROUND: Reducing perioperative blood loss and the need for transfusions in patients undergoing spinal surgery is especially important for those with neuromuscular disorders. These patients require extensive spino-pelvic exposure and are often medically fragile. We have used Amicar to decrease blood loss since 2001. As an effort to further reduce blood loss and transfusions, we use a bipolar sealer device (Aquamantys) as an adjunct to electrocautery. We present the results of our first 64 neuromuscular patients to show the efficacy of the device...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29175569/a-randomized-controlled-trial-of-low-dose-tranexamic-acid-versus-placebo-to-reduce-red-blood-cell-transfusion-during-complex-multilevel-spine-fusion-surgery
#4
Louanne M Carabini, Natalie C Moreland, Ryan J Vealey, John F Bebawy, Tyler R Koski, Antoun Koht, Dhanesh K Gupta, Michael J Avram
BACKGROUND: Multilevel spine fusion surgery for adult deformity correction is associated with significant blood loss and coagulopathy. Tranexamic acid reduces blood loss in high risk surgery, but the efficacy of a low dose regimen is unknown. METHODS: Sixty-one patients undergoing multilevel complex spinal fusion with and without osteotomies were randomly assigned to receive low dose tranexamic acid (10 mg/kg loading dose then 1 mg·kg-1·hr-1 throughout surgery) or placebo...
November 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29129323/haematological-alterations-in-the-cardiac-patient-after-use-of-an-autotransfusion-system
#5
M Luque-Oliveros
OBJECTIVE: There are studies that declare blood recovered with the autotransfusion system that is potentially heparinised and mixed with other drugs, can cause haematological alterations in the patient, according to existing evidence. The proposal was to compare the haematological values of the patients before reinfusing red blood cells from the cell saver and 12h after reinfusion. MATERIAL AND METHODS: Observational analytical study of 479 patients who underwent cardiac surgery where the cell saver was used...
November 9, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29100029/validation-of-an-lc-ms-ms-assay-to-simultaneously-monitor-the-intracellular-active-metabolites-of-tenofovir-emtricitabine-and-lamivudine-in-dried-blood-spots
#6
Amanda P Schauer, Craig Sykes, Mackenzie L Cottrell, Heather Prince, Angela D M Kashuba
The ability to monitor adherence to antiretroviral therapy is critical for the interpretation of outcomes from clinical studies of HIV, and for optimizing patient care. The antiretrovirals tenofovir (TFV), emtricitabine (FTC), and lamivudine (3TC) are commonly included in drug regimens for HIV prevention and treatment. The active form of the drugs tenofovir diphosphate (TFVdp), emtricitabine triphosphate (FTCtp), and lamivudine triphosphate (3TCtp) are found intracellularly in erythrocytes and peripheral blood mononuclear cells (PBMCs)...
October 31, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29050721/acute-kidney-injury-secondary-to-cell-saver-in-posterior-spinal-fusion
#7
Anas A Minkara, Albert Y Lin, Michael G Vitale, David P Roye
BACKGROUND: Autologous blood transfusion, commonly referred to as cell saver, is frequently used in spinal fusion to salvage red blood cells because of the risk of significant intraoperative blood loss. This case report describes a case of acute kidney injury (AKI) secondary to cell saver use. Our objective is to increase the knowledge about the process of red blood cell salvage and this exceedingly rare complication. METHODS: Chart and renal biopsy results for a single case were reviewed and reported in this retrospective study...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29050714/when-does-intraoperative-blood-loss-occur-during-pediatric-scoliosis-correction
#8
Sean Wahlquist, Montri Wongworawat, Scott Nelson
BACKGROUND: The purpose of our study was to assess the relationship between amount of blood loss and surgical stage in pediatric patients undergoing posterior spinal fusion for deformity correction to determine: (1) when the highest rate of blood loss occurred; (2) what percentage of total blood loss occurred during deformity correction and closure; and (3) how to predict remaining blood loss during a procedure. Blood loss following exposure and placement of the final pedicle screw is often underestimated, which may result in lack of sufficient blood product availability...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29027940/zika-virus-persistently-and-productively-infects-primary-adult-sensory-neurons-in-vitro
#9
Brianna K Swartwout, Marta G Zlotnick, Ashley E Saver, Caroline M McKenna, Andrea S Bertke
Zika virus (ZIKV) has recently surged in human populations, causing an increase in congenital and Guillain-Barré syndromes. While sexual transmission and presence of ZIKV in urine, semen, vaginal secretions, and saliva have been established, the origin of persistent virus shedding into biological secretions is not clear. Using a primary adult murine neuronal culture model, we have determined that ZIKV persistently and productively infects sensory neurons of the trigeminal and dorsal root ganglia, which innervate glands and mucosa of the face and the genitourinary tract, respectively, without apparent injury...
October 13, 2017: Pathogens
https://www.readbyqxmd.com/read/28960338/a-new-approach-for-fat-removal-in-a-discontinuous-autotransfusion-device-concept-and-evaluation
#10
T F Seyfried, M Gruber, M T Pawlik, S Kasper, R J Mandle, E Hansen
BACKGROUND: Fat present during blood salvage in orthopaedic or cardiac surgery can pose a risk of fat embolism and should be eliminated before transfusion. Based on observations of central fat accumulation at the bottom of Latham bowls, a fat reduction program was developed using two volume displacements, where blood temporarily is removed and respun in the bowl to force the fat through the RBC sediment. MATERIALS AND METHODS: Pooled ABO-matched RBC and FFP were adjusted to a haematocrit of 10%, and human fat tissue added to a concentration of 1·25 vol%...
September 27, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28937313/shed-blood-separation-and-cell-saver-an-integral-part-of-miecc-shed-blood-separation-and-its-influence-on-the-perioperative-inflammatory-response-during-coronary-revascularization-with-minimal-invasive-extracorporeal-circulation-systems-a-randomized-controlled
#11
Adrian Bauer, Harald Hausmann, Jan Schaarschmidt, Martin Scharpenberg, Dirk Troitzsch, Peter Johansen, Hans Nygaard, Thomas Eberle, J Michael Hasenkam
OBJECTIVE: The postoperative systemic inflammatory response after cardiopulmonary bypass (CPB) is still an undesirable side-effect after cardiac surgery. It is most likely caused by blood contact with foreign surfaces and by the surgical trauma itself. However, the recirculation of activated shed mediastinal blood is another main cause of blood cell activation and cytokine release. Minimal invasive extracorporeal circulation (MiECC) comprises a completely closed circuit, coated surfaces and the separation of suction blood...
September 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28876566/a-survey-of-selected-key-areas-of-management-of-south-african-neurosurgical-patients
#12
C H Daniel, M D du Trevou
BACKGROUND: Previous surveys of neurosurgical patient management, including a South African (SA) survey conducted in 2001, confirmed the existence of significant dissimilarities in management on national and international levels. This survey aimed to determine current SA neurosurgical patient management and to compare this with international trends. METHOD: Questionnaires in multiple choice question (MCQ) and free text entry format covering key areas of neurosurgical practice were emailed to SA neurosurgeons following ethics approval...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28856967/comparative-evaluation-of-blood-salvage-techniques-in-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass
#13
Serdar Gunaydin, Craig Robertson, Ali Baran Budak, Terence Gourlay
BACKGROUND: The primary objective of this study was to test and compare the efficacy of currently available intraoperative blood salvage systems via a demonstration of the level of increase in percentage concentration of red blood cells (RBC), white blood cells 9WBC) and platelets (Plt) in the end product. METHODS: In a prospective, randomized study, data of 80 patients undergoing elective cardiac surgery with cardiopulmonary bypass in a 6-month period was collected, of which the volume aspirated from the surgical field was processed by either the HemoSep Novel Collection Bag (Advancis Surgical, Kirkby-in-Ashfield, Notts, UK) (N=40) (Group 1) or a cell- saver (C...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28816299/-application-of-intraoperative-cell-salvage-combined-with-leukocyte-depletion-filter-on-radical-nephrectomy-for-renal-carcinoma-with-inferior-vena-cava-tumor-thrombus-2-case-reports
#14
H Zeng, X Y Rong, X Q Zhang, X Y Guo
Intraoperative cell salvage (IOCS) has been widely used to reduce allogeneic blood transfusion and prevent blood transfusion related complications during surgery. However, due to the risk of transfusion related reaction, contamination, and immunological reaction, its use for tumor patients has been controversial and limited. To explore the feasibility of the application of IOCS in cancer patients, we reported 2 cases of renal cell carcinoma (RCC) with tumor embolism in IVC that underwent radical nephrectomy,and inferior caval venous thrombectomy receiving IOCS combined with leukocyte depletion filter (LDF) from August 2016 to November 2016 in our hospital...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28764282/nature-s-benefaction-as-a-life-saver-for-an-avulsed-tooth-an-in-vitro-study
#15
Saumya Navit, Niharika Shahi, Suleman Abbas Khan, Anshul Sharma, Vartika Singh, Ratna Priya Mishra, Pragati Navit, Prerna Sharma
INTRODUCTION: Dentoalveolar trauma is a very common and avulsion is the most frequent injury. Treatment of choice following avulsion is immediate reimplantation. However, in cases where this might not be possible the prognosis of reimplanted teeth can be improved by the selection of an appropriate storage media. Prevention of ankylosis and replacement resorption depends more on the potential of storage media to maintain cell viability rather than the extraalveolar time period. AIM: To compare and evaluate the efficacy of different storage media in maintaining the viability of Periodontal Ligament (PDL) cells in an avulsed tooth...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28660135/perioperative-blood-management-strategies-for-patients-undergoing-total-knee-replacement-where-do-we-stand-now
#16
REVIEW
Tzatzairis Themistoklis, Vogiatzaki Theodosia, Kazakos Konstantinos, Drosos I Georgios
Total knee replacement (TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions (ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28622903/cell-saver-for-adult-spinal-deformity-surgery-reduces-cost
#17
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
#18
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
#19
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
#20
Daniel You, Alejandro Peiro-Garcia, Fabio Ferri-de-Barros, David Parsons
MINI: Intraoperative cell salvage (ICS) is used to reduce blood loss in scoliosis spinal fusion. We report one case of hemolysis induced acute renal failure following ICS. This is the first reported case of acute renal failure associated with hemolysis following ICS in a scoliosis patient with sickle cell trait. STUDY DESIGN: Case report. OBJECTIVE: To describe a novel presentation of acute renal failure associated with hemolysis after intraoperative cell salvage (ICS) in a neuromuscular scoliosis patient with sickle cell trait (SCT)...
November 15, 2017: Spine
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