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Perioperative anaemia

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https://www.readbyqxmd.com/read/29756690/preoperative-predictive-model-for-acute-kidney-injury-after-elective-cardiac-surgery-a-prospective-multicentre-cohort-study
#1
Raquel Callejas, Alfredo Panadero, Marc Vives, Paula Duque, Gemma Echarri, Pablo Monedero
BACKGROUND: Predictive models of CS-AKI include emergency surgery and patients with haemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. METHODS: A prospective, multicentre, observational study was designed. Data were collected from 942 patients undergoing cardiac surgery, after excluding emergency surgery and patients with an intraaortic balloon pump...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29743022/predictors-of-major-complications-after-elective-abdominal-surgery-in-cancer-patients
#2
Claudia M Simões, Maria J C Carmona, Ludhmila A Hajjar, Jean-Louis Vincent, Giovanni Landoni, Alessandro Belletti, Joaquim E Vieira, Juliano P de Almeida, Elisangela P de Almeida, Ulysses Ribeiro, Ana L Kauling, Celso Tutyia, Lie Tamaoki, Julia T Fukushima, José O C Auler
BACKGROUND: Patients undergoing abdominal surgery for solid tumours frequently develop major postoperative complications, which negatively affect quality of life, costs of care and survival. Few studies have identified the determinants of perioperative complications in this group. METHODS: We performed a prospective observational study including all patients (age > 18) undergoing abdominal surgery for cancer at a single institution between June 2011 and August 2013...
May 9, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29734830/impact-of-postoperative-haemoglobin-on-length-of-stay-post-fractured-hip-repair-in-patients-with-standardised-perioperative-management
#3
Siu-Wai Choi, Frankie K L Leung, Tak-Wing Lau, Gordon T C Wong
INTRODUCTION: Perioperative blood transfusion is not without risk and effort should be made to limit patients' exposure to allogeneic blood. However, there is conflicting data regarding the impact of anaemia on postoperative recovery in patients with repaired hip fractures. It is hypothesised that for a given baseline functional status and fracture type, lower postoperative haemoglobin will increase rehabilitation time and prolong total length of hospital stay. METHODS: This is a retrospective study on data collected prospectively on patients entered into the Clinical Pathway aged >65 years admitted to Queen Mary Hospital (QMH) with a fractured neck of femur during 2011-2013...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29661416/anaemia-and-red-blood-cell-transfusion-in-intracranial-neurosurgery-a-comprehensive-review
#4
REVIEW
A Kisilevsky, A W Gelb, M Bustillo, A M Flexman
Both anaemia and blood transfusion are associated with poor outcomes in the neurosurgical population. Based on the available literature, the optimal haemoglobin concentration for neurologically injured patients appears to be in the range of 9.0-10.0 g dl-1 , although the individual risks and benefits should be weighed. Several perioperative blood conservation strategies have been used successfully in neurosurgery, including correction of anaemia and coagulopathy, use of antifibrinolytics, and intraoperative cell salvage...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29532438/ferric-carboxymaltose-a-review-in-iron-deficiency
#5
Lesley J Scott
Intravenous ferric carboxymaltose (Ferinject® ; Injectafer® ) is a colloidal solution of nanoparticles which consist of a polynuclear iron (III)-(oxyhydr)oxide core stabilized by carboxymaltose and may be given as a single high-dose, 15-min infusion. This article reviews the clinical use of ferric carboxymaltose in various patient populations with iron deficiency (ID) [± anaemia] and briefly summarizes its pharmacological properties. Based on extensive experience in the clinical trial and real-world settings, ferric carboxymaltose is an effective and generally well tolerated treatment for rapidly replenishing iron stores and correcting anaemia in patients with ID (± anaemia) of various aetiologies, including patients with chronic heart failure (CHF), chronic kidney disease, inflammatory bowel disease or perioperative anaemia, and women with ID during pregnancy, postpartum or associated with heavy uterine bleeding...
March 2018: Drugs
https://www.readbyqxmd.com/read/29484934/routine-blood-group-and-antibody-screening-prior-to-emergency-laparoscopy
#6
J Barrett-Lee, J Vatish, M Vazirian-Zadeh, P Waterland
Introduction Studies show that rates of blood transfusion associated with general surgical laparoscopy are low. Currently, there are no national guidelines in the UK regarding blood group and antibody screening (G&S) for patients undergoing emergency laparoscopy. The aim of this study was to assess whether using G&S before emergency laparoscopic general surgery routinely is worthwhile by identifying rates of perioperative transfusion. Methods Data were collected retrospectively on all emergency laparoscopic procedures at a single district general hospital between January 2014 and 31 December 2016...
April 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29444561/committed-to-be-fit-the-value-of-preoperative-care-in-the-perioperative-medicine-era
#7
Javier Ripollés-Melchor, Franco Carli, Miquel Coca-Martínez, Macarena Barbero-Mielgo, José M Ramírez-Rodríguez, José A García-Erce
In the era of perioperative medicine, important advances have been made in the perioperative care of patients, usually within those known as enhanced recovery after surgery (ERAS) protocols. These have led to a decrease in postoperative complications and the duration of hospital stays; however, there is still a lack of preoperative care, which could make perioperative medicine more prominent. Elderly patients, malnourished, anemic and ones with a low physical function before surgery are likely to have sub-optimal recovery from surgery...
May 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29426622/atypical-hemolytic-uremic-syndrome-an-unusual-postoperative-complication
#8
S Mota, C Filipe, A L Almeida
INTRODUCTION AND OBJECTIVES: Thrombotic thrombocytopenic purpura and atypical haemolytic uremic syndrome (aHUS) are acute, rare, life-threatening thrombotic microangiopathies that require swift management. We report a case of acute microangiopathic haemolytic anaemia (MAHA) presenting in perioperative setting. CLINICAL CASE: After hepatic pericystectomy for hydatid cyst, a 46-year-old female developed MAHA, thrombocytopenia and acute renal failure in the immediate postoperative period...
February 6, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29320992/caesarean-delivery-related-blood-transfusion-correlates-in-a-tertiary-hospital-in-southwest-nigeria
#9
Fatimat M Akinlusi, Kabiru A Rabiu, Idayat A Durojaiye, Adeniyi A Adewunmi, Tawaqualit A Ottun, Yusuf A Oshodi
BACKGROUND: Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. METHODS: A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011...
January 10, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29233628/xanthogranulomatous-pyelonephritis-in-a-paediatric-cohort-1963-2016-outcomes-from-a-large-single-center-series
#10
I Stoica, F O'Kelly, M B McDermott, F M J Quinn
BACKGROUND: Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic destructive granulomatous inflammation of the kidney. It was first described in 1916, and is thought to affect 6/1000 cases of pyelonephritis. Its manifestations are varied, and with a limited number of cases in the literature, the optimal diagnosis and management of XGP in the paediatric cohort is still unknown. MATERIAL AND METHODS: The medical records of children who were diagnosed and treated for XGP at the current unit during the period 1963-2016, inclusive, were retrospectively reviewed...
November 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29171354/haematology-and-coagulation-profiles-in-cats-with-congenital-portosystemic-shunts
#11
Caitlin E Tzounos, Michael S Tivers, Sophie E Adamantos, Kate English, Alan L Rees, Vicky J Lipscomb
Objectives The objectives of this study were, first, to report the haematological parameters and coagulation times for cats with a congenital portosystemic shunt (CPSS) and the influence of surgical shunt attenuation on these parameters; and, second, to identify any association between prolongation in coagulation profiles and incidence of perioperative haemorrhage. Methods This was a retrospective clinical study using client-owned cats with a CPSS. Signalment, shunt type (extra- or intrahepatic), degree of shunt attenuation (complete or partial), haematological parameters, prothrombin time (PT) and activated partial thromboplastin time (aPTT) test results, and occurrence of any perioperative clinical bleeding complications were recorded for cats undergoing surgical treatment of a CPSS at the Royal Veterinary College, UK, between 1994 and 2011...
December 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29124853/intracorporeal-robot-assisted-radical-cystectomy-together-with-an-enhanced-recovery-programme-improves-postoperative-outcomes-by-aggregating-marginal-gains
#12
Wei Shen Tan, Mae-Yen Tan, Benjamin W Lamb, Ashwin Sridhar, Anna Mohammed, Hilary Baker, Senthil Nathan, Timothy Briggs, Melanie Tan, John D Kelly
OBJECTIVE: To assess the cumulative effect of an enhanced recovery after surgery (ERAS) pathway and minimally invasive robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) in comparison with open radical cystectomy (ORC) on length of hospital stay (LOS) and peri-operative outcomes. MATERIALS AND METHODS: Between February 2009 and October 2017, 304 radical cystectomy cases were performed at a single institution (ORC, n = 54; robot-assisted radical cystectomy [RARC], n = 250)...
November 10, 2017: BJU International
https://www.readbyqxmd.com/read/29090267/perioperative-patient-blood-management-programme-multidisciplinary-recommendations-from-the-patient-blood-management-initiative-group
#13
Daniela Filipescu, Răzvan Bănăţeanu, Mircea Beuran, Traean Burcoş, Dan Corneci, Dan Cristian, Mircea Diculescu, Alina Dobrotă, Gabriela Droc, Dănuţ Isacoff, Doina Goşa, Ioana Grinţescu, Anca Lupu, Liliana Mirea, Corina Posea, Oana Stanca, Mihai Ştefan, Dana Tomescu, Cristina Tudor, Daniela Ungureanu, Gabriel Mircescu
Patients with untreated anaemia or iron deficiency who undergo surgical procedures have an increased risk for mortality and morbidity. Patient Blood Management programmes address this issue worldwide and try to improve patient outcomes through a complex set of measures targeting anaemia correction, minimisation of bleeding and improvement of anaemia tolerance, in all phases of perioperative care. The Patient Blood Management Initiative Group is a multidisciplinary team of physicians from specialties including anaesthesiology, nephrology, surgery, orthopaedics, haematology, gastroenterology and transfusion medicine...
October 2017: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29082529/patient-blood-management-knowledge-and-practice-among-clinicians-from-seven-european-university-hospitals-a-multicentre-survey
#14
P M Manzini, A M Dall'Omo, S D'Antico, A Valfrè, K Pendry, A Wikman, D Fischer, D Borg-Aquilina, S Laspina, E C M van Pampus, M van Kraaij, M T Bruun, J Georgsen, J Grant-Casey, P S Babra, M F Murphy, G Folléa, K Aranko
BACKGROUND AND OBJECTIVES: The aim of this survey was to evaluate the knowledge about Patient Blood Management (PBM) principles and practices amongst clinicians working in seven European hospitals participating in a European Blood Alliance (EBA) project. MATERIALS AND METHODS: A web-based questionnaire was sent to 4952 clinicians working in medical, surgery and anaesthesiology disciplines. The responses were analysed, and the overall results as well as a comparison between hospitals are presented...
January 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29025609/blood-loss-in-trochanteric-fractures-multivariate-analysis-comparing-dynamic-hip-screw-and-gamma-nail
#15
Mario Ronga, Daniele Bonzini, Marco Valoroso, Giuseppe La Barbera, Jacopo Tamini, Mario Cherubino, Paolo Cherubino
INTRODUCTION: Anaemia in patients with trochanteric fracture is associated with increased morbidity and mortality and it is an independent risk factor for functional mobility of patients. Several authors have reported the blood loss following operative treatment comparing different fixation systems but few authors have evaluated many associated variables that could influence the perioperative blood loss. PURPOSE: To evaluate the blood loss in patients that had their trochanteric fracture stabilized with dynamic hip screw (DHS) or Gamma nail...
October 2017: Injury
https://www.readbyqxmd.com/read/28951117/impact-of-packed-red-blood-cells-and-fresh-frozen-plasma-given-during-radical-cystectomy-and-urinary-diversion-on-cancer-related-outcome-and-survival-an-observational-cohort-study
#16
Marc A Furrer, Adrian Fellmann, Marc P Schneider, George N Thalmann, Fiona C Burkhard, Patrick Y Wuethrich
BACKGROUND: The relationship between blood transfusion and cancer-related outcome and mortality is controversial. OBJECTIVE: To assess if perioperative administration of packed red blood cell (PRBC) and fresh frozen plasma (FFP) units affects disease progression and survival after radical cystectomy for bladder cancer. DESIGN, SETTING, AND PARTICIPANTS: We conducted an observational single-centre cohort study of a consecutive series of 885 bladder cancer patients, between 2000 and 2015...
September 23, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28940923/blood-conservation-in-cardiac-surgery
#17
REVIEW
G Blaudszun, A Butchart, A A Klein
This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia...
September 21, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28940786/cornerstones-of-patient-blood-management-in-surgery
#18
REVIEW
A Butcher, T Richards
Pre-operative anaemia and perioperative red blood cell transfusion carry significant consequence when it comes to surgical outcomes. The establishment of patient-centred clinical pathways has been designed to harness and endorse good transfusion practice, termed the three pillars of patient blood management (PBM). These focus on the timely and appropriate management of anaemia, prevention of blood loss and restrictive transfusion where appropriate. This article reviews the current evidence and ongoing research in the field of PBM in surgery...
April 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/28901992/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-elderly
#19
Sibylle Kozek-Langenecker, Christian Fenger-Eriksen, Emmanuel Thienpont, Giedrius Barauskas
: The risk for postoperative venous thromboembolism (VTE) is increased in patients aged more than 70 years and in elderly patients presenting with co-morbidities, for example cardiovascular disorders, malignancy or renal insufficiency. Therefore, risk stratification, correction of modifiable risks and sustained perioperative thromboprophylaxis are essential in this patient population. Timing and dosing of pharmacoprophylaxis may be adopted from the non-aged population. Direct oral anti-coagulants are effective and well tolerated in the elderly; statins may not replace pharmacological thromboprophylaxis...
February 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28772331/-pre-operative-evaluation-of-patients-undergoing-total-joint-arthroplasty-what-is-essential
#20
Holger Haas, Christian D Weber
Background A thorough pre-operative evaluation is required prior to total joint arthroplasty (TJA). The objective of screening is to identify patient- and procedure-related risk constellations. Pre-operative diagnostic measures are vital in order to anticipate, reduce or even eliminate threats to patient safety. Furthermore, the clinical and radiographical workup may confirm the indication and type of surgical procedure, but this is not the subject of this article. Objective An overview of the current literature on pre-operative diagnostic principles is presented...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
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