ABSTRACT
Objective Although intraoperative cell salvage (ICS) has been widely used to reduce the demand for allogeneic blood transfusion, patients who use ICS approach still have not completely avoided chances of blood transfusion. This study aims to investigate the rate of allogeneic red blood cell(RBC) transfusion in patients receiving ICS, and to evaluate irrationality of allogeneic RBC transfusion and its risk factors.Methods Medical records of all patients associated with ICS approach from January 2013 to July 2014 were retrospectively reviewed. Theoretical hemoglobin level after reinfusion of salvaged RBC at the end of operations was estimated. Irrational transfusion was defined as initiating allogeneic transfusion with theoretical hemoglobin above 100 g/L. The clinical variables, including the surgical department, gender, age, body weight, ratio of blood loss to estimated blood volume(EBV), salvaged blood volume and preoperative hemoglobin level were subsequently compared between patients who received rational transfusion and those did not. Logistic regression was performed to identify the risk factors for irrationality of allogeneic RBC transfusion in these patients.Results Of 1487 patients with ICS approach in this study, the rate of allogeneic RBC transfusion was 31.4%(467/1487), and the rate of irrational allogeneic RBC transfusion was 26.0% (341/1313). Patients with irrational transfusion were younger (t=4.656, P<0.001), with lower body weight (t=3.910, P<0.001) and slightly lower preoperative HGB level (t=2.822, P=0.005) than those with rational transfusion, but had significantly larger salvaged blood volume (U=-10.926, P<0.001) and higher ratio of blood loss to EBV (U=-17.067, P<0.001), disregarding whether they preoperatively met anemia criteria or not (U=-1.396, P=0.163). Preoperative hemoglobin level (OR=1.975, P=0.005) and the ratio of blood loss/EBV (OR=5.392, P<0.001) were independent risk factors leading to the irrational allogeneic RBC transfusion.Conclusions The irrationality of allogeneic RBC transfusion existed in ICS patients, which may be associated with the preoperative hemoglobin level and the ratio of blood loss to EBV. Determining the HGB levels before transfusion is required to avoid unnecessary blood administration. Doctors should keep their knowledge in blood management updated and improve their awareness of rational transfusion for a better patients care.
ABSTRACT
<p><b>OBJECTIVE</b>To study the effects of local vibration on blood-lipids and whole blood viscosity.</p><p><b>METHODS</b>The total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), whole blood viscosity, apolipoprotein (Apo-), red blood cell (RBC), platelet (PLT), mean corpuscular volume (MCV), serum-protein, postprandial blood sugar (PBS), and serum-protein of experimental and control workers were detected. The difference of the means and abnormal rates of two groups were compared.</p><p><b>RESULTS</b>The means of TG, TC, HDL in exposed group [(1.01 +/- 0.85), (3.25 +/- 0.61), (1.14 +/- 0.20) mmol/L respectively] were significantly lower than that of control group [(1.89 +/- 1.47), (3.87 +/- 0.82), (1.22 +/- 0.26) mmol/L, respectively, P < 0.01 or P < 0.05]. Apo-A was also decreased [(1.13 +/- 0.29) g/L vs (1.23 +/- 0.16) g/L, P < 0.01]. The mean of whole blood viscosity were significantly increased in exposed group [(2.76 +/- 0.42) mPa.s vs (2.54 +/- 0.33) mPa.s, P < 0.01]. The abnormal rate of Apo-A was significantly higher in exposed group (23.30%) than that in control (4.50%, P < 0.01).</p><p><b>CONCLUSION</b>Local vibration may induce decrease in blood lipids, increase in blood viscosity and changes in some other blood parameters.</p>