ABSTRACT
Background: Blood transfusion requirement during neonatal open heart surgeries is universal. Homologous blood transfusion (HBT) in pediatric cardiac surgery is used most commonly for priming of cardiopulmonary bypass (CPB) system and for postoperative transfusion. To avoid the risks associated with HBT in neonates undergoing cardiac surgery, use of autologous umbilical cord blood (AUCB) transfusion has been described. We present our experience with the use of AUCB for neonatal cardiac surgery. Designs and Methods: Consecutive neonates scheduled to undergo cardiac surgery for various cardiac diseases who had a prenatal diagnosis made on the basis of a fetal echocardiography were included in this prospective observational study. After a vaginal delivery or a cesarean section, UCB was collected from the placenta in a 150-mL bag containing 5 mL of citrate–phosphate–dextrose–adenine-1 solution. The collected bag with 70–75 mL cord blood was stored at 2°C–6°C and tested for blood grouping and infections after proper labeling. The neonate's autologous cord blood was used for postcardiac surgery blood transfusion to replace postoperative blood loss. Results: AUCB has been used so far at our institute in 10 neonates undergoing cardiac surgery. The donor exposure in age and type of cardiac surgery-matched controls showed that the neonates not receiving autologous cord blood had a donor exposure to 5 donors (2 packed red blood cells [PRBCs], including 1 for CPB prime and 1 for postoperative loss, 1 fresh frozen plasma, 1 cryoprecipitate, and 1 platelet concentrate) compared to 1 donor for the AUCB neonate (1 PRBC for the CPB prime). Postoperative blood loss was similar in both the groups of matched controls and study group. Values of hemoglobin, total leukocyte count, platelet counts, and blood gas parameters were also similar. Conclusions: Use of AUCB for replacement of postoperative blood loss after neonatal cardiac surgery is feasible and reduces donor exposure to the neonate. Its use, however, requires a prenatal diagnosis of a cardiac defect by fetal echo and adequate logistic and psychological support from involved clinicians and the blood bank.
ABSTRACT
Background: To study the changes in haemogram and coagulation profile in patients undergoing autologous and homologous blood transfusion and suitability of the technique of autologous blood transfusion in routine blood bank management.Methods: Patients who were waiting to undergo elective surgical procedures were randomly distributed in two groups, Group A: Autologous blood transfusion, with or without haemodilution: wherein pre-operative period a predicted volume of blood was collected and Group B: Homologous blood transfusion: where required blood was arranged from Blood Bank. The cardiovascular status, the haemogram and the coagulation profile were recorded at various stages.Results: Out of 240 patients registered only 43 could fulfil the basic requirements only 25 could be motivated in each group. In Group A cases were of age group 51-60 years while it was 41-50 years in Group B. Male:Female ratio was 2:1. 47 Units were retransfused to Group A patients, Group B cases received 45 blood transfusions. In Group A patients 8% cases showed mild hypotention and 1% showed mild hypersensitivity to Haemacel. In Group B, 40% cases showed transfusion reactions. Fall in Hb was lesser in Group A (2.4) on first and (1.7) on second postoperative day compared to Group B (3.3) on first and (2.7) on second postoperative day. The haematocrit levels declined more sharply after operation in Group B (7) rather than Group A (10.4).Conclusions: Advantage of avoiding transfusion reactions, major changes in blood parameters, entry of infections proves Autologous blood transfusion to be the safest, cost effective and easy form of transfusion therapy
ABSTRACT
Objective To investigate the effect of predeposit autotransfusion in operation of the patients with lumbar disc protrusion.Methods Fifty patients of transfusion with lumbar disc protrusion were assigned into two groups by stratified sampling randomly,30 patients whose blood were predeposited before operation in experimental group,and the other 20 patients whose blood were not predeposited before operation in control group.The blood loss,the blood requirements during operations,the hemotological routine indexes and the complications related to blood transfusion were compared respectively.Results The blood loss of experimental group [ (720 ± 665 ) ml ] perioperative period was lower than that of control group [ ( 1060 ± 558 ) ml ],but there was no significant difference between two groups (P ＞ 0.05 ).All the patients in experimental group went through perioperative period safely without allogenic blood transfusion.Hemoglobin,red blood cell and white blood cell were not significantly different between two groups before and after operation for 3,7 days (P＞ 0.05 ),the platelet count after operation for 7 days was significantly different between two groups (P ＜ 0.05).No complication was observed in experimental group but 1 case with complication was observed in control group.Conclusions Predeposit autotransfusion is an effective to avoid homologous blood transfusion and its complications for the patients with lumbar disc protrusion.Furthermore,the clinical effect is not significantly different between the predeposit autotransfusion patients and the allogenic blood transfusion patients.
ABSTRACT
Autologous Blood Transfusion (ABT) is the safest type of blood transfusion for the operator and the patient. The preoperative donation technique had already been reduced the homologous blood requirements successfully. Homologous Blood Transfusion (HBT) brings more risks in complications such as transmission of diseases, anaphylactic reactions, haemolitic reactions etc. This was a parallel study, comparing one group receiving ABT and a second group receiving HBT where in both groups were performed spine surgery. The parameter used was the hemoglobin(Hb) and hematocrit(Ht) content preoperatively (after donation of ABT) and after transfusion, total days in hospitalization after surgery. Another purpose of this study was also to achieve understandings in using ABT by considering the total patients who finally required additional HBT. There were 74 patients with diagnosis of spine fracture, tuberculous spondylitis, scoliosis, spinal stenosis and spondylolisthesis. In the ABT group the average age was 33,9 ± 14 years old and the HBT group was 29,1 ± 11,5 years old. Both groups consisted of 21 males and 16 females. Body weight of the ABT group was 55,3 ± 11,1 kg and the HBT group 52,8 ± 9,7 kg. Amount of donations preoperatively in ABT was 798,6 ± 170 cc. There were 12 patients (32,4%) where the donated blood amount preoperatively did not match up the requests. There were eight patients (21,6%) in the ABT group that required additional HBT of about 550 cc. Three patients (8,1%) of the ABT group received transfusion that did not match the indications (blood loss < 15% of the total blood volume). The Hb and Ht content preoperatively (after donation) of the ABT group significantly was less than the HBT group (p= 0,001). Hb content after transfusion in the ABT group was not significantly less than the HBT group (p = 0,30). Hospitalization days after surgery were significantly higher in the HBT group (p = 0,000). In conclusions : there was 21,6% of the ABT group with the preoperative donation technique that finally required additional HBT. Also there was no difference in the Hb and Ht content preoperatively and post transfusion in the ABT and HBT group, whereas hospitalization days after surgery were higher in the group receiving HBT than in the group receiving ABT.
Subject(s)
Laminectomy , Spine , Blood Transfusion, Autologous , Blood TransfusionABSTRACT
Objective To observe the changes of hemorheology after acute hypervolemic hemodilution (AHH), and provide theoretic basis for clinical rationally using artificial plasma substitutes. Methods 90 patients undergoing hip joint operation were randomly divided into 3 groups (each group containing 30 patients), which received intravenous infusion of 6% hydroxyethyl starch (HES), 4% gelofusine or ringer's solution at 20ml/kg, respectively before operation. The whole blood viscosity, plasma viscosity, Hct, index of RBC aggregation and index of RBC deformation were measured before and after hemodilution. Resutls Hemodynamics was stable after AHH, and the amounts of perioperatively blood transfusion in the patients received colloid solution were obviously less than those in the patients received crystalloid solution. The whole blood viscosity, Hct and index of RBC aggregation significantly decreased after AHH in all the patients, and index of RBC deformation markedly increased in the patients after AHH with 6% HES. Conclusion AHH could effectively maintain hemodynamics stable, improve hemorheological condition and perfusion of microcirculation, enhance the tolerance of blood loss, and reduce homologous blood transfusion. Colloid solution was better than crystalloid solution for AHH.
ABSTRACT
OBJECTIVE: We applied intraoperative autotransfusion (IAT) as a method of decreasing or avoiding homologous blood transfusions during urological cancer surgery and assessed the availability of the IAT. PATIENTS AND METHODS: IAT was performed in 7 patients with bladder cancer who underwent retropubic radical cystectomy (Cx group) and in 4 patients with prostate cancer who underwent radical prostatectomy (Px group). Blood shed in operation fields was collected and processed with an IAT device. The volume of blood loss, homologous blood transfused, and autologous blood transfused during surgery were assessed. RESULTS: In the Cx group, intraoperative blood loss ranged from 1,086 to 2,673 ml (mean: 1,757 ml), and homologous blood transfusions ranged from 0 to 1,000 ml (mean: 457 ml). Autologous blood was processed by IAT device and the amount transfused ranged from 380 to 980 ml (mean: 607 ml). Two patients did not require homologous blood transfusion. In the Px group, intraoperative blood loss ranged from 1,160 to 1,550 ml (mean: 1,356 ml). Autologous blood was processed by IAT device and the amount transfused ranged from 540 to 990 ml (mean: 745 ml). None of the patients required homologous blood transfusion. CONCLUSION: IAT is a feasible method of reducing or avoiding homologous blood transfusion in radical cystectomy and retropubic radical prostatectomy.