ABSTRACT
Introduction: Over the past 20 years, extensive research has been conducted on blood transfusion and the hazards arising from them, as well as on safest maximum storage duration for blood derivatives. Blood transfusion rates in patients with and-stage renal disease may have declined markedly after the discovery and use of erythropoietin in the mid-1980s, but is still remains a standard of care. Since several biochemical changes take place in stored blood, physicians should be alert when transfusing blood in end-stage renal disease patients, who are, theoretically at least, at higher risk of complications. Methods and Results: This study were designed to investigate changes in storer blood over time (every 10 days from 0 to 40 days). Changes in sodium, potassium, chloride, total calcium, lactate, pH, partial pressure of carbon dioxide, bicarbonate and hematocrit, as well as the degree of hemolysis, were recorded. The findings show a significant increase in potassium, lactate, partial pressure of carbon dioxide and hematocrit and a reduction in chloride, pH and bicarbonate. The serum levels of sodium initially increased (up to day 20) and then declined. Conclusions: In conclusion, stored blood undergoes significant changes, which can be life-threatening, especially + when the transfusions are massive or in patients with end-stage renal disease, who are more sensitive to significant K or acid overload.
ABSTRACT
CONTEXT: Fournier's gangrene (FG) is a rapidly progressing acute gangrenous infection of the anorectal and urogenital area. AIMS: The objectives of this study were to investigate patients with FG and to determine risk factors that affect mortality. SETTINGS AND DESIGN: Retrospective clinical study. MATERIALS AND METHODS: Clinical presentations and outcomes of surgical treatments were evaluated in 68 patients with FG. Statistical Analysis Used: Chi-square, Student's t -test, and logistic regression test. RESULTS: Mean age of patients was 54 and female-to-male ratio was 9:59. Among the predisposing factors, diabetes mellitus (DM) was the most common ( n =24, 35.3%), and sepsis on admission was detected in 31 (45.6%) and 15 (22.1%) patients, respectively. Seven (10.3%) patients died. Using logistic regression test, Fournier's Gangrene Severity Index (FGSI)> 9, DM and sepsis on admission were found as prognostic factors. CONCLUSIONS: FG has a high mortality rate, especially in patients with DM and sepsis. An FGSI value> 9 indicates high mortality rate.