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transfusion practice variability

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https://www.readbyqxmd.com/read/29786044/prognostic-value-of-model-for-end-stage-liver-disease-incorporating-with-serum-sodium-score-for-development-of-acute-kidney-injury-after-liver-transplantation
#1
Yuan Cheng, Guo-Qing Wei, Qiu-Cheng Cai, Yi Jiang, Ai-Ping Wu
Background: Contribution of model for end-stage liver disease incorporating with serum sodium (MELD-Na) score in predicting acute kidney injury (AKI) after orthotopic liver transplantation (OLT) is yet to be identified. This study assessed the prognostic value of MELD-Na score for the development of AKI following OLT. Methods: Preoperative and surgery-related variables of 321 adult end-stage liver disease patients who underwent OLT in Fuzhou General Hospital were collected...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29723675/retroperitoneal-laparoscopic-nephron-sparing-surgery-for-large-renal-angiomyolipoma-our-technique-and-experience-a-case-series-of-41-patients
#2
Xin Liu, Xin Ma, Qiming Liu, Qingbo Huang, Xintao Li, Baojun Wang, Hongzhao Li, Xu Zhang
OBJECTIVES: To introduce a 'kidney priority' strategy in treating large renal angiomyolipoma (RAML) with retroperitoneal laparoscopic nephron sparing surgery (RLNSS). PATIENTS AND METHODS: From 2010 to 2017, 41 patients with large RAML underwent RLNSS. Distinguished from the standard practice, the kidney was preferentially mobilized and separated from the RAML. Subsequently, it was reconstructed. Finally, the RAML was resected from the perinephric fat. The perioperative variables, surgical technique and complications were reviewed...
April 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29714029/a-data-driven-patient-blood-management-strategy-in-liver-transplantation
#3
R A Metcalf, M B Pagano, J R Hess, J Reyes, J D Perkins, M I Montenovo
BACKGROUND AND OBJECTIVES: Blood utilization during liver transplant has decreased, but remains highly variable due to many complex surgical and physiologic factors. Previous models attempted to predict utilization using preoperative variables to stratify cases into two usage groups, usually using entire blood units for measurement. We sought to develop a practical predictive model using specific transfusion volumes (in ml) to develop a data-driven patient blood management strategy. MATERIALS AND METHODS: This is a retrospective evaluation of primary liver transplants at a single institution from 2013 to 2015...
May 1, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29606583/cost-analysis-of-enhanced-recovery-after-surgery-in-microvascular-breast-reconstruction
#4
Christine Oh, James Moriarty, Bijan J Borah, Kristin C Mara, William S Harmsen, Michel Saint-Cyr, Valerie Lemaine
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways have been shown in multiple surgical specialties to decrease hospital length of stay (LOS) after surgery. ERAS in breast reconstruction has been found to decrease hospital LOS and inpatient opioid use. ERAS protocols can facilitate a patient's recovery and can potentially increase the quality of care while decreasing costs. METHODS: A standardized ERAS pathway was developed through multidisciplinary collaboration...
March 2, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29572858/red-blood-cell-transfusion-in-perioperative-pediatric-anesthesia-a-survey-of-current-practice-in-germany
#5
Eva Wittenmeier, Claudius Troeber, Ulrike Zier, Irene Schmidtmann, Nina Pirlich, Karin Becke, Tim Piepho
BACKGROUND: Little is known about the current practice of the perioperative transfusion of red blood cells (RBCs) in pediatric patients. This study was performed to evaluate the practice of RBC transfusion in German pediatric anesthesia. STUDY DESIGN AND METHODS: An online survey was conducted among members of the German Society of Anesthesiology and Intensive Care. Participants were asked to indicate the hemoglobin (Hb) thresholds for starting RBC transfusion in six cases of different bleeding situations in pediatric anesthesia...
March 23, 2018: Transfusion
https://www.readbyqxmd.com/read/29554046/the-evolution-of-pediatric-transfusion-practice-during-combat-operations-2001-2013
#6
Jeremy W Cannon, Lucas P Neff, Heather F Pidcoke, James K Aden, Philip C Spinella, Michael A Johnson, Andrew P Cap, Matthew A Borgman
BACKGROUND: Hemostatic resuscitation principles have significantly changed adult trauma resuscitation over the past decade. Practice patterns in pediatric resuscitation likely have changed as well; however, this evolution has not been quantified. We evaluated pediatric resuscitation practices over time within a combat trauma system. METHODS: The Department of Defense Trauma Registry was queried from 2001 to 2013 for pediatric patients (<18 years). Patients with burns, drowning, and missing injury severity score were excluded...
June 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29533256/use-of-survey-and-delphi-process-to-understand-trauma-anesthesia-care-practices
#7
Catherine M Kuza, Monica S Vavilala, Rebecca M Speck, Richard P Dutton, Maureen McCunn
BACKGROUND: Few trauma guidelines evaluate and recommend anesthesiology practices and there are no trauma anesthesia-specific guidelines. There is no information on how anesthesiologists perceive clinical practice patterns. Our objective was to understand the perceptions of anesthesiologists regarding trauma anesthesia practices. METHODS: A survey assessing anesthesia management of trauma patients was distributed to 21,491 anesthesiologists. A subset of 10 of these questions was subsequently reviewed by a trauma anesthesiology focus group through a 3-round web-based Delphi process...
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29488289/intraoperative-blood-transfusion-in-pediatric-patients-undergoing-renal-transplant-effect-of-renal-graft-size
#8
Rakan I Odeh, Martin Sidler, Teresa Skelton, Fadi Zu'bi, Naimet K Naoum, Ibraheem Abu Azzawayed, Fahad A Alyami, Armando J Lorenzo, Walid A Farhat, Martin A Koyle
In pediatric RT, donor allograft size often exceeds the expected recipient norms, especially in younger recipients. An "oversize" graft might not only present a technical- and space-related challenge, but may possibly lead to increased demands in perioperative volume requirements due to the disparity between donor and recipient in renal blood flow. We evaluated transfusion practices at a single tertiary institution with special consideration of kidney graft size, hypothesizing that oversize graft kidneys might lead to a quantifiable increased need of blood transfusion in smaller recipients...
May 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29459342/hemoglobin-thresholds-and-red-blood-cell-transfusion-in-adult-patients-with-moderate-or-severe-traumatic-brain-injuries-a-retrospective-cohort-study
#9
Amélie Boutin, Lynne Moore, Robert S Green, Ryan Zarychanski, Mete Erdogan, François Lauzier, Shane English, Dean A Fergusson, Michael Butler, Lauralyn McIntyre, Michaël Chassé, Paule Lessard Bonaventure, Caroline Léger, Philippe Desjardins, Donald Griesdale, Jacques Lacroix, Alexis F Turgeon
PURPOSE: We aimed to evaluate the association between transfusion practices and clinical outcomes in patients with traumatic brain injury. MATERIAL AND METHODS: We conducted a retrospective cohort study of adult patients with moderate or severe traumatic brain injury admitted to the intensive care unit (ICU) of a level I trauma center between 2009 and 2013. The associations between hemoglobin (Hb) level, red blood cell (RBC) transfusion and clinical outcomes were estimated using robust Poisson models and proportional hazard models with time-dependent variables, adjusted for confounders...
January 31, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29455308/fluid-therapy-and-outcome-a-prospective-observational-study-in-65-german-intensive-care-units-between-2010-and-2011
#10
Christian Ertmer, Bernhard Zwißler, Hugo Van Aken, Michael Christ, Fabian Spöhr, Axel Schneider, Robert Deisz, Matthias Jacob
BACKGROUND: Outcome data on fluid therapy in critically ill patients from randomised controlled trials may be different from data obtained by observational studies under "real-life" conditions. We conducted this prospective, observational study to investigate current practice of fluid therapy (crystalloids and colloids) and associated outcomes in 65 German intensive care units (ICUs). In total, 4545 adult patients who underwent intravenous fluid therapy were included. The main outcome measures were 90-day mortality, ICU mortality and acute kidney injury (AKI)...
February 17, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29438816/the-effect-of-tranexamic-acid-in-unilateral-and-bilateral-total-knee-arthroplasty-in-the-south-asian-population-a-retrospective-cohort-study
#11
Syed Hamza Mufarrih, Azeem Tariq Malik, Nada Qaisar Qureshi, Riaz Hussain Lakdawala, Muhammad Umar Rabbani, Arif Ali, Shahryar Noordin
INTRODUCTION: Together with evidence of higher bleeding tendencies, the vulnerability of the South-Asian population to anemia secondary to a higher prevalence of hemoglobinopathies and micronutrient deficiencies merits further exploration of the effects of tranexamic acid on this population. Additionally, limited access to self-care facilities and certain sociocultural beliefs and practices may not be conducive to a speedy recovery from surgical complications. The aim of this study is to investigate the effects of intraoperative administration of tranexamic acid during total knee arthroplasty when considering the South-Asian population...
April 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29435899/do-drains-contribute-to-pancreatic-fistulae-analysis-of-over-5000-pancreatectomy-patients
#12
R El Khoury, C Kabir, V K Maker, M Banulescu, M Wasserman, A V Maker
INTRODUCTION: Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was associated with fistula formation. METHODS: Demographic, perioperative, and patient outcome data were captured from the most recent annual NSQIP pancreatic demonstration project database, including components of the fistula risk score...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29395830/labile-plasma-iron-as-an-indicator-of-patient-adherence-to-iron-chelation-treatment
#13
Orna Steinberg-Shemer, Joanne Yacobovich, Miriam Cohen, Ioav Z Cabantchik, Hannah Tamary
Poor adherence of transfusion-dependent patients to chelation treatment is often the cause of persistent iron overload and ensuing morbidity. However, a tool to assess patient compliance with therapy is lacking in clinical practice. Labile plasma iron (LPI, the redox-active component of non-transferrin bound iron) has been studied as an indicator of systemic iron overload and of chelation efficacy, and may particularly reflect recent iron equilibrium. We considered the use of LPI as a potential indicator for recent chelation treatment in 18 transfusion-dependent pediatric patients...
January 23, 2018: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/29386154/assesment-of-predictor-variables-and-clinical-consequences-associated-with-surgical-site-infection-in-tertiary-care-setting-karachi-pakistan
#14
Anum Tariq, Huma Ali, Farya Zafar, Ali Akbar Sial, Kamran Hameed, Mehwish Rizvi, Rabia Bushra, Saima Salim, Zeb-Un Nisa, Ghazala R Naqvi, Saba Zubair
Among the well-known Health care-associated infections (HAIs), surgical site infections (SSIs) contribute to considerable high mortality and morbidity rate, substantial prolongation in hospitalization period and extra expenses in terms of treatment cost. This study was aimed to evaluate the predictive variables associated with surgical site infections, and their clinical consequences. This was a prospective, cross sectional study conducted in the surgical department of tertiary care setting in Karachi, Pakistan...
January 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29384892/hemoglobin-levels-across-the-pediatric-critical-care-spectrum-a-point-prevalence-study
#15
Nabil E Hassan, Diann E Reischman, Robert K Fitzgerald, Edward Vincent S Faustino
OBJECTIVES: To determine the prevailing hemoglobin levels in PICU patients, and any potential correlates. DESIGN: Post hoc analysis of prospective multicenter observational data. SETTINGS: Fifty-nine PICUs in seven countries. PATIENTS: PICU patients on four specific days in 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients' hemoglobin and other clinical and institutional data...
January 30, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29335914/accuracy-and-trending-of-non-invasive-hemoglobin-measurement-during-different-volume-and-perfusion-statuses
#16
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/29318985/a-randomised-controlled-trial-and-economic-evaluation-of-intraoperative-cell-salvage-during-caesarean-section-in-women-at-risk-of-haemorrhage-the-salvo-cell-salvage-in-obstetrics-trial
#17
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29300236/contemporary-risk-factors-and-outcomes-of-transfusion-associated-circulatory-overload
#18
Nareg H Roubinian, Jeanne E Hendrickson, Darrell J Triulzi, Jerome L Gottschall, Michael Michalkiewicz, Dhuly Chowdhury, Daryl J Kor, Mark R Looney, Michael A Matthay, Steven H Kleinman, Donald Brambilla, Edward L Murphy
OBJECTIVES: Transfusion-associated circulatory overload is characterized by hydrostatic pulmonary edema following blood transfusion. Restrictive transfusion practice may affect the occurrence and severity of transfusion-associated circulatory overload in critically ill patients. We sought to examine contemporary risk factors and outcomes for transfusion-associated circulatory overload. DESIGN: Case-control study. SETTING: Four tertiary care hospitals...
April 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29250794/blood-use-in-hematologic-malignancies-a-nationwide-overview-in-sweden-between-2000-and-2010
#19
Jingcheng Zhao, Jenny Rydén, Agneta Wikman, Rut Norda, Simon J Stanworth, Henrik Hjalgrim, Gustaf Edgren
BACKGROUND: Patients with hematologic malignancies receive large numbers of blood transfusions, and transfusion practices for this patient group are increasingly being scrutinized by randomized controlled trials. However, no studies so far have presented current transfusion statistics on a population level for this patient group. STUDY DESIGN AND METHODS: A retrospective descriptive study was conducted that was based on the Scandinavian Donations and Transfusions Database (SCANDAT2), which includes data on all blood donations and transfusions in Sweden and Denmark since the 1960s...
February 2018: Transfusion
https://www.readbyqxmd.com/read/29227848/development-and-evaluation-of-an-improved-laparoscopic-myomectomy-adopting-intracapsular-rotary-cut-procedures
#20
Shi-Lin Zhong, Li-Ping Zeng, Huan Li, Rui-Fang Wu
OBJECTIVES: To develop and evaluate the efficacy and feasibility of Intracapsular Rotary-cut Procedure (IRCP) in laparoscopic myomectomy (LM). STUDY DESIGN: It is a retrospective study conducted in Peking University Shenzhen Hospital (PUSH) in Shenzhen, China. A total of 96 patients who were treated with LM because of big and moderate size of myomas in PUSH from January 2013 and December 2015 were enrolled in this study. Among them 35 were managed with IRCP -integrated LM as the study group, while the other 61 were treated with normal LM as the control group...
February 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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