Effect of intraoperative cell salvage on allogeneic blood transfusion requirements, coagulation function and electrolytes in postpartum hemorrhage of cesarean section / 中国输血杂志

【Objective】 To explore the effect of intraoperative cell salvage on allogeneic blood transfusion requirements, coagulation function and electrolytes in postpartum hemorrhage patients. 【Methods】 A study on postpartum hemorrhage patients undergoing cesarean section in the Third Affiliated Hospital of Guangxi Medical University form September 2016 to May 2022 was conducted retrospectively. A total of 137 patients were enrolled and divided into experimental group (n=70) and control group (n=67) according to whether intraoperative cell salvage was used during operation. The blood loss, proportion and volume of allogeneic red blood cells (RBCs) and coagulation component transfusion, hemoglobin (Hb) level, coagulation function, electrolyte, the incidence of complications, proportion of ICU admission, ICU stay and in-hospital stay were compared between the two groups. 【Results】 The proportion of patients receiving allogeneic RBCs in the experimental group and in the control group was 31.4% vs 100.0% (P0.05). 【Conclusion】 This study demonstrated that intraoperative cell salvage could reduce the requirement for allogeneic RBCs without compromising coagulation function in postpartum hemorrhage patients undergoing cesarean section, but the changes of calcium need to be concerned after transfusion.

Research progress on strategies of reducing perioperative blood transfusion in liver transplantation / 器官移植

Massive blood loss and blood transfusion constantly occur in liver transplantation. Over the past two decades, the amount of blood transfusion during the perioperative period has been decreased dramatically along with the continual maturity of liver transplantation techniques. The goal of liver transplantation without blood transfusion has been achieved. Since bleeding and blood transfusion are correlated with poor prognosis after liver transplantation, reducing bleeding and unnecessary blood transfusion has become the key objective during perioperative period of liver transplantation. In this article, adverse effects of allogeneic blood transfusion during perioperative period of liver transplantation, coagulation function monitoring of patients with end-stage liver disease, blood transfusion management of liver transplant recipients and the strategies of reducing perioperative blood transfusion in liver transplantation were summarized, aiming to provide reference for reducing the requirement of blood transfusion during perioperative period of liver transplantation.

Relatedfactors of blood transfusion during total hip arthroplasty / 中国输血杂志

【Objective】 To investigate the related factors of allogeneic blood transfusion (ALBT) in total hip arthroplasty. 【Methods】 Thebasic information, surgical details and laboratory data of 258 patients who underwent total hip arthroplasty in Orthopedics Department of our hospital were collectedfrom the electronic medical record system and laboratorytest system. The factors concerningALBT were obtainedby single factor and multivariate logistic regression analysis. 【Results】 The ALBT rate in this study was 19%, and the differencesin such important factors affecting ALBT as gender, age, intraoperative blood loss, drainage volume, operation duration, preoperative hemoglobin (Hb), preoperative activated partial thromboplastin time (APTT), preoperative prothrombin time (PT) andhypertension between the two groupswere notable (P<0.05). Multivariate regression analysisrevealed that the independent related factors ofALBT were age ≥ 60 years (OR3.577), intraoperative blood loss (OR1.003), drainage volume (OR1.004)and preoperative PT (OR1.888). Preoperative Hb (OR0.94) was a protective factor. 【Conclusion】 Specific and individualized evaluation of ALBT, aimed atreducingunnecessary blood transfusion, can be provided through the analysis of relevant factors.

Clinical Efficacy of Intra-Operative Cell Salvage System in Major Spinal Deformity Surgery

OBJECTIVE: The purpose of this study was to determine the efficacy of intra-operative cell salvage system (ICS) to decrease the need for allogeneic transfusions in patients undergoing major spinal deformity surgeries. METHODS: A total of 113 consecutive patients undergoing long level posterior spinal segmental instrumented fusion (≥5 levels) for spinal deformity correction were enrolled. Data including the osteotomy status, the number of fused segments, estimated blood loss, intra-operative transfusion amount by ICS (Cell Saver®, Haemonetics©, Baltimore, MA, USA) or allogeneic blood, postoperative transfusion amount, and operative time were collected and analyzed.

Preoperative Iron Supplementation and Restrictive Transfusion Strategy in Hip Fracture Surgery

BACKGROUND: Hip fracture surgery (HFS) is often associated with perioperative blood loss, and it frequently necessitates transfusion. However, the hemoglobin (Hb) threshold for transfusion remains controversial in hip fracture patients. We evaluated the usefulness of the restrictive strategy and preoperative intravenous iron supplementation in HFS. METHODS: We retrospectively reviewed the medical records of 1,634 patients (> 60 years of age) who underwent HFS between May 2003 and June 2014 and were followed up for 1 year or more after surgery. We used the liberal transfusion strategy until May 2009 to determine the transfusion threshold; afterwards, we switched to the restrictive transfusion strategy. Patients with the restrictive transfusion strategy (restrictive group) received intravenous iron supplementation before surgery. We compared the transfusion rate, morbidity, and mortality of the restrictive group with those of the patients with the liberal transfusion strategy (liberal group). RESULTS: Preoperative intravenous iron supplementation was not associated with any adverse reactions. The transfusion rate was 65.3% (506/775) in the liberal group and 48.2% (414/859) in the restrictive group (p < 0.001). The mean hospital stay was shorter in the restrictive group (21.5 vs. 28.8 days, p < 0.001). There was no significant difference in the postoperative medical complications including myocardial infarction and cerebrovascular event. Mortality at postoperative 30, 60, and 90 days was similar between the two groups. CONCLUSIONS: Our blood management protocol involving restrictive strategy combined with preoperative intravenous iron supplementation appears to be effective and safe in HFS of elderly patients.

Clinical Efficacy of Intra-Operative Cell Salvage System in Major Spinal Deformity Surgery

OBJECTIVE: The purpose of this study was to determine the efficacy of intra-operative cell salvage system (ICS) to decrease the need for allogeneic transfusions in patients undergoing major spinal deformity surgeries.METHODS: A total of 113 consecutive patients undergoing long level posterior spinal segmental instrumented fusion (≥5 levels) for spinal deformity correction were enrolled. Data including the osteotomy status, the number of fused segments, estimated blood loss, intra-operative transfusion amount by ICS (Cell Saver®, Haemonetics©, Baltimore, MA, USA) or allogeneic blood, postoperative transfusion amount, and operative time were collected and analyzed.RESULTS: The number of patients was 81 in ICS group and 32 in non-ICS group. There were no significant differences in demographic data and comorbidities between the groups. Autotransfusion by ICS system was performed in 53 patients out of 81 in the ICS group (65.4%) and the amount of transfused blood by ICS was 226.7 mL in ICS group. The mean intra-operative allogeneic blood transfusion requirement was significantly lower in the ICS group than non-ICS group (2.0 vs. 2.9 units, p=0.033). The regression coefficient of ICS use was -1.036.CONCLUSION: ICS use could decrease the need for intra-operative allogeneic blood transfusion. Specifically, the use of ICS may reduce about one unit amount of allogeneic transfusion in major spinal deformity surgery.