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transfusion practice variability

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https://www.readbyqxmd.com/read/27900630/current-delivery-of-hyperthermic-intraperitoneal-chemotherapy-with-cytoreductive-surgery-cs-hipec-and-perioperative-practices-an-international-survey-of-high-volume-surgeons
#1
Allison H Maciver, Eisar Al-Sukhni, Jesus Esquivel, Joseph J Skitzki, John M Kane, Valerie A Francescutti
BACKGROUND: Cytoreductive surgery and heated intraperitoneal chemotherapy (CS/HIPEC) is performed for selected indications at a limited number of specialized centers worldwide. Currently there is no standardized approach to the perioperative care process. We sought to capture current practices in the perioperative management of patients who undergo CS/HIPEC at high-volume centers. METHODS: Surgeon members of the American Society of Peritoneal Surface Malignancies working at high-volume CS/HIPEC centers (>10 cases/year) were invited to complete an online survey...
November 29, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27887854/significant-regional-variation-exists-in-morbidity-and-mortality-after-repair-of-abdominal-aortic-aneurysm
#2
Sara L Zettervall, Peter A Soden, Dominique B Buck, Jack L Cronenwett, Phillip P Goodney, Mohammad H Eslami, Jason T Lee, Marc L Schermerhorn
OBJECTIVE: Limited data exist comparing perioperative morbidity and mortality after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) among regions of the United States. This study evaluated the regional variation in mortality and perioperative outcomes after repair of AAAs. METHODS: The Vascular Quality Initiative (VQI) was used to identify patients undergoing open AAA repair and EVAR between 2009 and 2014. Ruptured and intact aneurysms were evaluated separately, and the analysis of intact aneurysms was limited to infrarenal AAAs...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27884018/blood-transfusion-during-radical-chemo-radiotherapy-does-not-reduce-tumour-hypoxia-in-squamous-cell-cancer-of-the-head-and-neck
#3
Liam Welsh, Rafal Panek, Angela Riddell, Kee Wong, Martin O Leach, Mahvash Tavassoli, Durdana Rahman, Maria Schmidt, Tara Hurley, Lorna Grove, Thomas Richards, Dow-Mu Koh, Christopher Nutting, Kevin Harrington, Kate Newbold, Shreerang Bhide
BACKGROUND: Patients with head and neck squamous cell carcinoma (HNSCC) undergoing radical chemo-radiation (CRT) frequently receive transfusion with packed red cells (PRCT) during radiotherapy on the basis that PRCT increases tumour oxygenation and overcomes hypoxia-induced radio-resistance. This is likely to be a significant oversimplification given the fact that tumour hypoxia is the result of several intrinsic and extrinsic factors, including many that are not directly related to serum haemoglobin (Hb)...
November 24, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27878822/wide-variations-in-blood-product-transfusion-practices-among-providers-who-care-for-patients-with-acute-leukemia-in-the-united-states
#4
Alexander B Pine, Eun-Ju Lee, Mikkael Sekeres, David P Steensma, Daniel Zelterman, Thomas Prebet, Amy DeZern, Rami Komrokji, Mark Litzow, Selina Luger, Richard Stone, Harry P Erba, Guillermo Garcia-Manero, Alfred I Lee, Nikolai A Podoltsev, Lisa Barbarotta, Stephanie Kasberg, Jeanne E Hendrickson, Steven D Gore, Amer M Zeidan
BACKGROUND: Transfusion of blood products is a key component of the supportive management in patients with acute leukemia (AL). However high-quality trial evidence and clinical outcome data to support specific transfusion goals for blood products for patients with AL remain limited leading to diverse transfusion practices. The primary objective of this study was to determine the spectrum of transfusion patterns in a variety of care settings among providers who treat AL patients. STUDY DESIGN AND METHODS: A 31-question survey queried providers caring for AL patients about the existence of institutional guidelines for transfusion of blood products, transfusion triggers for hemoglobin (Hb), platelets (PLTs), and fibrinogen in various settings including inpatient and outpatient and before procedures...
November 22, 2016: Transfusion
https://www.readbyqxmd.com/read/27842632/a-cross-sectional-study-of-peripartum-blood-transfusion-in-the-eastern-cape-south-africa
#5
K Van den Berg, E M Bloch, A S Aku, M Mabenge, D V Creel, G J Hofmeyr, E L Murphy
BACKGROUND: Obstetric haemorrhage (OH) remains a major contributor to maternal morbidity and mortality. Blood transfusion is critical in OH management; yet, data on peripartum transfusion are lacking. A pilot study reported high rates of peripartum transfusion in a sample of South African (SA) hospitals, which was independently associated with HIV status. OBJECTIVES: To assess the incidence of peripartum transfusion in a sample of Eastern Cape, SA hospitals to evaluate generalisability of preceding study findings...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27741940/observational-studies-should-we-simply-ignore-them-in-assessing-transfusion-outcomes
#6
Kevin Trentino, Shannon Farmer, Irwin Gross, Aryeh Shander, James Isbister
BACKGROUND: As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study method rather than also appraising the key elements of study design. A long-standing debate regarding findings of randomized controlled trials compared with those of observational studies, their strengths and limitations and questions regarding causal inference, has recently come into focus in relation to research assessing patient outcomes in transfusion medicine...
October 14, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27729702/blood-conservation-a-team-sport
#7
REVIEW
Donald S Likosky, Timothy A Dickinson, Theron A Paugh
Cardiac surgery accounts for between 15% and 20% of all blood product utilization in the United States. A body of literature suggests that patients who are exposed to even small quantities of blood have an increased risk of morbidity and mortality, even after adjusting for pre-operative risk. Despite this body of literature supporting a restrictive blood management strategy, wide variability in transfusion rates exist across institutions. Recent blood management guidelines have shed light on a number of potentially promising blood management strategies, including acute normovolemic hemodilution (ANH) and retrograde autologous priming (RAP)...
September 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27693206/randomized-evidence-for-reduction-of-perioperative-mortality-an-updated-consensus-process
#8
Giovanni Landoni, Antonio Pisano, Vladimir Lomivorotov, Gabriele Alvaro, Ludhmila Hajjar, Gianluca Paternoster, Caetano Nigro Neto, Nicola Latronico, Evgeny Fominskiy, Laura Pasin, Gabriele Finco, Rosetta Lobreglio, Maria Luisa Azzolini, Giuseppe Buscaglia, Alberto Castella, Marco Comis, Adele Conte, Massimiliano Conte, Francesco Corradi, Erika Dal Checco, Giovanni De Vuono, Marco Ganzaroli, Eugenio Garofalo, Gordana Gazivoda, Rosalba Lembo, Daniele Marianello, Martina Baiardo Redaelli, Fabrizio Monaco, Valentina Tarzia, Marta Mucchetti, Alessandro Belletti, Paolo Mura, Mario Musu, Giovanni Pala, Massimiliano Paltenghi, Vadim Pasyuga, Desiderio Piras, Claudio Riefolo, Agostino Roasio, Laura Ruggeri, Francesco Santini, Andrea Székely, Luigi Verniero, Antonella Vezzani, Alberto Zangrillo, Rinaldo Bellomo
OBJECTIVE: Of the 230 million patients undergoing major surgical procedures every year, more than 1 million will die within 30 days. Thus, any nonsurgical interventions that help reduce perioperative mortality might save thousands of lives. The authors have updated a previous consensus process to identify all the nonsurgical interventions, supported by randomized evidence, that may help reduce perioperative mortality. DESIGN AND SETTING: A web-based international consensus conference...
August 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27553501/variation-in-red-blood-cell-transfusion-practices-during-cardiac-operations-among-centers-in-maryland-results-from-a-state-quality-improvement-collaborative
#9
J Trent Magruder, Elena Blasco-Colmenares, Todd Crawford, Diane Alejo, John V Conte, Rawn Salenger, Clifford E Fonner, Christopher C Kwon, Jennifer Bobbitt, James M Brown, Mark G Nelson, Keith A Horvath, Glenn R Whitman
BACKGROUND: Variation in red blood cell (RBC) transfusion practices exists at cardiac surgery centers across the nation. We tested the hypothesis that significant variation in RBC transfusion practices between centers in our state's cardiac surgery quality collaborative remains even after risk adjustment. METHODS: Using a multiinstitutional statewide database created by the Maryland Cardiac Surgery Quality Initiative (MCSQI), we included patient-level data from 8,141 patients undergoing isolated coronary artery bypass (CAB) or aortic valve replacement at 1 of 10 centers...
August 20, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27522492/the-role-of-glycoprotein-iib-iiia-inhibitors-in-acute-coronary-syndromes-and-the-interference-with-anemia
#10
REVIEW
Paolo Emilio Puddu, Loredana Iannetta, Attilio Placanica, Domenico Cuturello, Michele Schiariti, Olivia Manfrini
The role played by glycoprotein (GP) IIb/IIIa inhibitors (GPI) has continuously evolved until the most recent Guidelines whereby they were stepped down from class I to class II recommendation for treating acute coronary syndromes (ACS). GPI compete with a wider use of ADP inhibitors and novel anticoagulant drugs although GPI use has greatly narrowed. However, GPI may still have a role. Several criteria were proposed to define post-PCI anemia which is strictly related to bleeding and transfusion. In ACS, it should be important to define anemia in comparative terms versus baseline levels: ≥ 15% of red blood cell decrease should be a practical cut-off value...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27515056/the-confusion-continues-results-from-an-american-association-for-the-surgery-of-trauma-survey-on-massive-transfusion-practices-among-united-states-trauma-centers
#11
Eric Etchill, Jason Sperry, Brian Zuckerbraun, Louis Alarcon, Joshua Brown, Kevin Schuster, Lewis Kaplan, Greta Piper, Andrew Peitzman, Matthew D Neal
BACKGROUND: Massive transfusion practices have undergone several recent developments. We sought to examine institutional practices guiding hemostatic resuscitation in the setting of massive hemorrhage. STUDY DESIGN AND METHODS: A 37-question online survey was sent to American Association for the Surgery of Trauma members. RESULTS: A total of 191 surgeons from 125 institutions completed the survey. Level I and II centers composed 70 and 18% of responding sites, respectively...
October 2016: Transfusion
https://www.readbyqxmd.com/read/27509167/patient-blood-management-in-europe-surveys-on-top-indications-for-red-blood-cell-use-and-patient-blood-management-organization-and-activities-in-seven-european-university-hospitals
#12
M T Bruun, K Pendry, J Georgsen, P Manzini, M Lorenzi, A Wikman, D Borg-Aquilina, E van Pampus, M van Kraaij, D Fischer, P Meybohm, K Zacharowski, C Geisen, E Seifried, G M Liumbruno, G Folléa, J Grant-Casey, P Babra, M F Murphy
BACKGROUND AND OBJECTIVES: Patient Blood Management (PBM) in Europe is a working group of the European Blood Alliance with the initial objective to identify the starting position of the participating hospitals regarding PBM for benchmarking purposes, and to derive good practices in PBM from the experience and expertise in the participating teams with the further aim of implementing and strengthening these practices in the participating hospitals. METHODS: We conducted two surveys in seven university hospitals in Europe: Survey on top indications for red blood cell use regarding usage of red blood cells during 1 week and Survey on PBM organization and activities...
August 10, 2016: Vox Sanguinis
https://www.readbyqxmd.com/read/27504293/enigmatic-weak-d-antigen-an-experience-in-a-tertiary-care-hospital-of-east-delhi
#13
Anshu Gupta, Shabnam Mirza, Sarbjeet Khurana, Roopali Singh, Sujata Chaturvedi, Bharat Singh
INTRODUCTION: The Rh blood group system is one of the most polymorphic and immunogenic blood group systems in humans. The expression of Rh blood group antigen is complex, among that Rh-D antigen is the most important antigen because of its immunogenicity. It is easy to detect D antigen in most of the cases. Sometimes, variable expression of Rh-D antigen leads to presence of weak forms. Weak D reacts variably with anti D sera and poses a problem in blood banking. Molecular genetics of Rh-D revealed that weak D antigen is a Rh-D phenotype that possesses less numbers of complete D antigens on the surface of red blood cells...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27490594/extracorporeal-membrane-oxygenation-for-cardiac-indications-in-children
#14
Ravi R Thiagarajan
OBJECTIVES: The objectives of this review are to discuss the use of extracorporeal membrane oxygenation following surgery for congenital heart disease, myocarditis and as a bridge to cardiac transplantation. In addition, the latest in circuit equipment, the management of anticoagulation and blood transfusions, and short- and long-term outcomes are reviewed. DATA SOURCE: MEDLINE, PubMed. CONCLUSIONS: The use of extracorporeal membrane oxygenation to support children with heart disease is increasing...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27465524/optimal-transfusion-practices-after-allogeneic-hematopoietic-cell-transplantation-a-systematic-scoping-review-of-evidence-from-randomized-controlled-trials
#15
Grace Christou, Ahbinav Iyengar, Risa Shorr, Alan Tinmouth, Elianna Saidenberg, Dawn Maze, Jason Tay, Christopher Bredeson, David S Allan
BACKGROUND: Integrating evidence from randomized controlled trials (RCTs) into patient care is needed to optimize patient outcomes. Transfusion support during allogeneic hematopoietic cell transplantation (alloHCT) is a cornerstone of essential supportive care, yet optimal transfusion practices remain unclear. STUDY DESIGN AND METHODS: A scoping review of RCTs in alloHCT was conducted and 14 full-length articles on transfusion practice were identified that reported clinical outcomes after alloHCT...
October 2016: Transfusion
https://www.readbyqxmd.com/read/27453372/interhospital-variability-in-perioperative-red-blood-cell-ordering-patterns-in-united-states-pediatric-surgical-patients
#16
Rachel M Thompson, Cary W Thurm, David H Rothstein
OBJECTIVE: To evaluate perioperative red blood cell (RBC) ordering and interhospital variability patterns in pediatric patients undergoing surgical interventions at US children's hospitals. STUDY DESIGN: This is a multicenter cross-sectional study of children aged <19 years admitted to 38 pediatric tertiary care hospitals participating in the Pediatric Health Information System in 2009-2014. Only cases performed at all represented hospitals were included in the study, to limit case mix variability...
October 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27444377/-single-donor-protocol-transfusion-practices-and-multiple-transfusion-risk-factors-in-neonatal-intensive-care-unit
#17
C Dollat, C Pierron, A Keslick, E Billoir, A François, P-H Jarreau
In France since 2002, the single-donor transfusion protocol, using four pediatric units from the same adult donor's packed red blood cells (PRBCs) in multiply transfused newborns, is recommended in preterm neonates to reduce the risks of infection and alloimmunization. This protocol is controversial, however, because it causes the transfusion of stored blood, which could have adverse consequences. Before the new recommendations of the French Haute Autorité de santé (National authority for health) in 2015, we conducted a national practice survey in 63 neonatal intensive care units (NICU) and a retrospective study of the characteristics of 103 children transfused within our unit, to better target beneficiaries...
September 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27377529/red-blood-cell-transfusion-in-the-postoperative-care-of-pediatric-cardiac-surgery-survey-on-stated-practice
#18
Jean-Sébastien Tremblay-Roy, Nancy Poirier, Thierry Ducruet, Jacques Lacroix, Karen Harrington
The optimal red blood cell transfusion threshold for postoperative pediatric cardiac surgery patients is unknown. This study describes the stated red blood cell transfusion practice of physicians who treat postoperative pediatric cardiac surgery patients in intensive care units. A scenario-based survey was sent to physicians involved in postoperative intensive care of pediatric cardiac surgery patients in all Canadian centers that perform such surgery. Respondents reported their red blood cell transfusion practice in four postoperative scenarios: acyanotic or cyanotic cardiac lesion, in a neonate or an infant...
October 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27312015/transfusion-premedication-practices-among-pediatric-health-care-practitioners-in-canada-results-of-a-national-survey
#19
Ziad Solh, Anthony K C Chan, Nancy M Heddle
BACKGROUND: Although not supported by strong evidence, premedication (pretransfusion medication) is commonly prescribed to patients who have had a transfusion reaction. The research questions were: 1) What are Canadian pediatric practitioners' views and practices regarding premedication and 2) what are barriers to reducing premedication overuse in pediatrics? STUDY DESIGN AND METHODS: An online survey targeted hematology/oncology, emergency medicine, general surgery, intensive care, and cardiac intensive care practitioners in all 16 Canadian pediatric tertiary hospitals...
September 2016: Transfusion
https://www.readbyqxmd.com/read/27226791/natural-killer-cells-for-therapy-of-leukemia
#20
REVIEW
Garnet Suck, Yeh Ching Linn, Torsten Tonn
Clinical application of natural killer (NK) cells against leukemia is an area of intense investigation. In human leukocyte antigen-mismatched allogeneic hematopoietic stem cell transplantations (HSCT), alloreactive NK cells exert powerful anti-leukemic activity in preventing relapse in the absence of graft-versus-host disease, particularly in acute myeloid leukemia patients. Adoptive transfer of donor NK cells post-HSCT or in non-transplant scenarios may be superior to the currently widely used unmanipulated donor lymphocyte infusion...
March 2016: Transfusion Medicine and Hemotherapy
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