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【Objective】 To investigate the effects of high-dose hyperbaric trioxygen autologous blood therapy (HOT) on oxygenation index (PaO2/FiO2) and serum inflammatory factors in dogs with acute respiratory distress syndrome (ARDS). 【Methods】 Twelve healthy adult beagles were randomly divided into 3 groups (n=4). The blank group was injected with normal saline intravenously. The ARDS model was established by intravenous injection of oleic acid (0.12 mL/kg) in the ARDS group and ARDS+ HOT group. The mark of a successful model is that the oxygen and index (PaO2/FiO2) <300 mmHg. In the ARDS+ HOT group, after the ARDS model was established, 16 G indwelling needle was used to puncture the left femoral vein and connect the line of the HOT device. Venous blood (50 mL/ dog) was collected from the femoral vein under negative pressure to the blood storage bottle (100 mL blood storage bottle), and then the blood collection was stopped and the gas injection switch of the HOT device was turned on. Inject 50 mL of 20ng/dL trioxygen gas into the blood storage bottle. After gas injection, turn the blood storage bottle upside down three times to fully trioxidize the blood and then inject it back into the dog. Repeat this treatment for 10 cycles. PaO2 and PaO2/FiO2 were detected before treatment and at 1, 2, 3, 4, 5 h after treatment. The serum was retained after treatment, and the expressions of inflammatory cytokines (IL-6, IL-8) and myeloperoxidase (MPO) were detected by ELISA. The animals were euthanized, and the gross lung morphology of the dogs was observed at autopsy. The dorsal segment of the left lower lobe of the lung was taken for pathological section HE staining, and the morphological changes of the lung tissue were observed under the microscope. 【Results】 After 5 hours of treatment, the PaO2/FiO2 of blank group was 481.85±35.31, and that of ARDS group was 183.67±20.18, which was significantly lower than that of blank group (P<0.01). The ARDS HOT group was 271.90±21.35, which was significantly higher than the ARDS group (P<0.01). The inflammatory factor IL-6 was (206.49±38.85) pg/mL in the blank group, and (293.12±30.38) pg/mL in the ARDS group, which was significantly higher than that in the blank group (P<0.01). There was a significant difference between the ARDS HOT group and ARDS group (221.56±46.69) pg/mL (P<0.01). The results of inflammatory factor IL-8 detection showed that the IL-8 in ARDS group was increased compared with the blank group (P<0.01); and the IL-8 in ARDS HOT group was decreased compared with ARDS group (P<0.01). Myeloperoxidase MPO test results showed that the blank group was (505.58±73.94) pg/mL, and the ARDS group was (605.69±108.88) pg/mL, which was significantly higher than the blank group (P<0.05). The ARDS HOT group was (476.52±103.85) pg/mL, which was significantly lower than the ARDS group (P<0.05). Microscopic examination of lung pathology showed that the lung tissue injury in ARDS HOT group was significantly reduced compared with ARDS group. 【Conclusion】 HOT can reduce the inflammation and injury of lung in ARDS model dogs through significantly increasing the PaO2/FiO2, down-regulating the expression of MPO, then inhibiting the activity of neutrophils and reducing the levels of IL-6 and IL-8.
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【Objective】 To explore the effect of recovery autologous blood transfusion combined with bilateral internal iliac artery presetting in high-risk patients with hemorrhage during cesarean section. 【Methods】 A total of 162 high-risk patients with hemorrhage who underwent cesarean section from January 2021 to May 2023 in our hospital were prospectively selected and divided into in Groups A, B, and C with 54 cases in each group according to the indications for the method of transfusion. Group A received allogeneic blood transfusion, Group B received autologous blood transfusion, Group C received autologous blood transfusion combined with bilateral internal iliac artery balloon presetting. 【Results】 Intraoperative blood loss (mL) (1 600 vs 1 500 vs 800), postoperative hospital stay(d) (7 vs 7 vs 6) and operative time(min) (107 vs 104.50 vs 77) in group C were all lower than those in group A and B (P0.05); The autologous blood transfusion volume(mL) in group C was lower than that in group B (525.5 vs 261, P0.016 7). 【Conclusion】 Recovery autologous blood transfusion combined with bilateral internal iliac artery balloon presetting in cesarean section for high-risk patients with hemorrhage achieved ideal effects, which can significantly reduce intraoperative blood loss, intraoperative autologous blood transfusion, allogeneic red blood cells and plasma transfusion, as well as the operation time and postoperative hospital stay. In addition, it can improve the coagulation function and hysterectomy, which is conducive to ensuring the safety of maternal and promoting early rehabilitation, and preserving the fertility of patients to a certain extent, which is worthy of further clinical promotion.
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Ectopic pregnancy is a common gynecological acute abdomen disease. Once the pregnant tissue is ruptured, it will rapidly develop into hemorrhagic shock or even death. In recent years, blood transfusion from the body is widely used in the rescue of intra-abdominal hemorrhage of ectopic pregnancy, which can reduce the time of cross matching and blood collection, reduce the risk of allogeneic blood transfusion, and enable patients with hemorrhagic shock to receive timely and effective treatment. Hemolysis caused by autologous blood transfusion is rarely reported. Once hemolysis occurs, if it is not handled in time, severe cases can occur acute renal injury, hyperkalemia, or cardiac arrest or even sudden death. We retrospectively analyzed the diagnosis and treatment of a patient with hemolysis after autologous blood transfusion, suggesting that the adverse reactions of blood transfusion occur not only in allogeneic blood transfusion, but also in autologous blood transfusion. It should be handled reasonably in clinical work to reduce the occurrence of similar complications.
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Objetivo: relatar a vivência de uma equipe interdisciplinar na implantação da técnica de Recuperação Intraoperatória de Sangue em um serviço público de atendimento ao trauma. Método: estudo descritivo, do tipo relato de experiência, desenvolvido no Instituto Dr. José Frota, Fortaleza, Ceará, Brasil. Resultados: a técnica foi implantada no segundo semestre de 2015 no hospital de trauma, e a vivência permitiu listar as atividades da implantação da técnica, como a disponibilização do equipamento, materiais e profissional capacitado; aulas e palestras direcionadas ao corpo clínico e residentes de anestesiologia; identificação de cirurgias com benefício potencial; abordagem direta da enfermagem aos cirurgiões no centro cirúrgico; divulgação sistemática da disponibilidade do método e dos resultados obtidos no hospital, com o apoio da chefia cirúrgica; criação de estratégia de comunicação na interface entre enfermeiros, cirurgiões e anestesistas; e ampliação da equipe de enfermeiros para o atendimento 24 horas. Conclusão: a implantação da técnica de Recuperação Intraoperatória de Sangue no hospital de trauma permitiu identificar critérios para sua utilização e disponibilizar a estratégia de conservação de sangue para todos os procedimentos com benefício potencial, ampliando o uso de forma sistemática. (AU)
Objective: To report the experience of an interdisciplinary team in the implementation of the Intraoperative Blood Recovery technique in a public trauma care service. Methods: Descriptive study, of the experience report type, developed at Instituto Dr. José Frota, Fortaleza, Ceará, Brazil. Results: The technique was implemented in the second half of 2015 at the trauma hospital, and the experience allowed listing the activities of the technique's implementation, such as the availability of equipment, materials and trained professionals; classes and lectures aimed at clinical staff and anesthesiology residents; identification of surgeries with potential benefit; direct nursing approach to surgeons in the operating room; systematic dissemination of the availability of the method and the results obtained in the hospital, with the support of the surgical leadership; creation of a communication strategy at the interface between nurses, surgeons and anesthetists; and expansion of the team of nurses to provide 24-hour care. Conclusion: The implementation of the Intraoperative Blood Recovery technique in the trauma hospital allowed identifying criteria for its use and making this blood conservation strategy available for all procedures with potential benefit, expanding its use in a systematic way. (AU)
Objetivo: Reportar la experiencia de un equipo interdisciplinario en la implementación de la técnica de Recuperación Sanguínea Intraoperatoria en un servicio público de atención traumatológica. Métodos: Estudio descriptivo, del tipo informe de experiencia, desarrollado en el Instituto Dr. José Frota, Fortaleza, Ceará, Brasil. Resultados: La técnica fue implementada en el segundo semestre de 2015 en el hospital de trauma, y la experiencia permitió enumerar las actividades de implementación de la técnica, como la disponibilidad de equipos, materiales y profesionales capacitados; clases y conferencias dirigidas al personal clínico y residentes de anestesiología; identificación de cirugías con beneficio potencial; abordaje directo de enfermería a los cirujanos en el quirófano; difusión sistemática de la disponibilidad del método y los resultados obtenidos en el hospital, con el apoyo del liderazgo quirúrgico; creación de una estrategia de comunicación en la interfaz entre enfermeras, cirujanos y anestesistas; y ampliación del equipo de enfermeras para brindar atención las 24 horas. Conclusión: A implantação da técnica de RIOS no hospital de trauma permitiu identificar criterios para su utilización y disponibilidad es una estrategia de conservación de sangue para todos los procedimientos con beneficio potencial, ampliando o uso de forma sistemática. (AU)
Subject(s)
Operative Blood Salvage , Blood Transfusion, Autologous , Nursing CareABSTRACT
【Objective】 To evaluate the effect of multi-disciplinary patient blood management(PBM) on perioperative blood transfusion in patients with cardiothoracic surgery of gradeⅢ~Ⅳ. 【Methods】 The blood transfusion data and relevant clinical information of adult patients underwent grade Ⅲ~Ⅳ cardiothoracic surgeries before and after PBM (from January 2016 to December 2018)in our hospital were collected using Hospital Information System and Management System of Blood Transfusion Department. Patients were grouped according to three separate12-month periods: 933 cases subjected to conventional blood transfusion practice from Jan. to Dec.2016 as the control group, 1 139 cases experienced initial implement PBM(started on Jan.1, 2017)from Jan. to Dec.2017 as the early PBM group, and 1 411 cases received improved PBM from Jan. to Dec.2018 as the improved PBM group. The perioperative autotransfusion rate, allogeneic transfusion rate, length of hospital stay and hospitalization expenses of the three groups were compared by χ2 test and variance analysis. 【Results】 The comparison results among control group, early PBM group and improved PBM group were as following: 1) The proportion of patients using iron and EPO to treat preoperative anemia were 15.12%(44/291)vs 19.73%(72/365)vs 26.65%(125/469)(P<0.01) and 10.31%(30/291)vs 12.33%(40/365)vs 15.57%(73/469)(P<0.05), respectively. 2) The incidence of autotransfusion were 57.98%(541/933)vs 44.76%(544/1 139)vs 37.00%(522/1 411)(P<0.01). The allogeneic transfusion volume per capita(U) were 351.91±35.85 vs 392.76±43.33 vs 421.75±73.84(P<0.05). The incidence of allogeneic blood transfusion were 18.11%(169/933)vs 17.56%(200/1 139)vs 13.32%(188/1 411)(P<0.01). The allogeneic blood transfusion volume per capita (U) were 6.56±8.33 vs 5.52±6.28 vs 5.56±6.17(P<0.01). 3) The per capita hospital stay (d) and ICU stay (d) were19.54±16.56 vs 16.46±12.06 vs 15.11±10.18 and 4.45±9.31 vs 3.56±6.93 vs 3.26±5.29(P<0.05), respectively. The per capita hospitalization expenses (ten thousand yuan/person) were 10.76±8.39 vs 9.58±7.58 vs 9.13±5.9(P<0.05). 【Conclusion】 The application of PBM in perioperative blood transfusionfor adult cardiothoracic surgery Ⅲ ~ Ⅳcan significantly decrease the incidence of autologous and allogeneic blood transfusion, the length of hospitalstay and hospitalization expenses.
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【Objective】 To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. 【Methods】 The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. 【Results】 The gender, age, operation duration and operation segment of the 2 groups were comparable (P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar (P>0.05). There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP (P>0.05). The postoperative drainage volume (mL) and total dominant blood loss (mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively (P<0.05). 【Conclusion】 The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.
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【Objective】 To explore the effects of intraoperative autologous blood(ABT) transfusion on thrombelastography(TEG) in patients underwent neurosurgical procedures. 【Methods】 96 patients (49 males and 47 females) aged 15~79 years who received neurosurgical procedures in our hospital from November 2018 to November 2020 were retrospectively analyzed and divided into autologous blood transfusion group(Group A, n=52)and allogeneic blood transfusion group(Group B, n=44)according to different blood transfusion strategy in operation. The red blood transfusion status, hemoglobin (Hb), hematocrit (Hct), platelet (Plt), fibrinogen(Fib), prothrombin time (PT), activated partial thromboplastin time(APTT), and TEG parameters [activated clotting time(ACT), coagulation time (K), angle rate of clot formation(Angle), maximum amplitude(MA)] before and 1 day after surgery were compared between the two groups. 【Results】 The amount of average blood transfusion didn′t differ significantly by groups (P>0.05). The incidence of extra allogeneic blood transfusion was 17.3%(9/52) in group A, and the amount of average allogeneic blood transfusion in group A was significantly lower than that in group B(333.3±81.7 vs 639.8±258.2, P<0.05). Before operation, the differences in Hb, Hct, Plt, Fib, PT, APTT, ACT, K, MA and Angle levels between the 2 groups were not statistically significant (P>0.05). One day after operation, the Hb(g/L) (109.4±15.8 vs 97.0±15.1), Hct (%) (32.0±4.3 vs 28.3±6.1), Plt(×109/L)(154.2±54.2 vs 120.7±41.6), Fib(g/L)(2.2±0.5 vs 1.6±0.6), MA(mm)(65.0±7.2 vs 60.7±8.7) and Angle levels(deg)(69.1±5.2 vs 62.6±9.8) in group A were significantly higher than those in group B(P<0.05), and the PT(s)(11.9±1.5 vs 12.8±0.9), APTT(s)(27.4±3.3 vs 30.4±5.4), ACT(s)(111.0±14.9 vs 119.1±12.3) and K levels(min)(87.2±25.7 vs 106.4±28.0) in group A were significantly lower than those in group B (P<0.05). 【Conclusion】 Intraoperative ABT in patients underwent neurosurgical procedures can reduce allogeneic blood transfusion, has less effect on coagulation function and TEG, and is safe and effective.
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Abstract Objective To prospectively compare the clinical and laboratorial aspects of patients undergoing spine deformity surgery, using the acute normovolemic hemodilution technique with tranexamic acid, versus a control group with tranexamic acid alone, and to evaluate the influence of hemodilution in intraoperative bleeding and the need for homologous transfusion. Materials and Methods Comparative prospective study with patients aged between 12 and 65 years undergoing spine deformity surgery with the acute normovolemic hemodilution technique associated with tranexamic acid versus a control group to which only tranexamic acid (15 mg/kg) was administered. Laboratorial exams were performed and analyzed in three different moments. Results A total of 30 patients were included in the present study: 17 in the hemodilution group, and 13 in the control group. The mean duration of the surgery in the hemodilution group was longer. The number of levels submitted to surgery ranged from 7 to 16 in the hemodilution group, and from 4 to 13 in the control group. Osteotomy, predominantly of the posterior kind, was performed in 20 patients. There was more intraoperative bleeding in the control group. All patients were stable during the procedures. Only 6 participants needed homologous blood transfusion, mostly from the control group (p > 0.05). Conclusion There was no significant difference between the two groups regarding the need for blood transfusion and intraoperative bleeding. The severity of the deformity was the main determinant for homologous blood transfusion.
Resumo Objetivo Comparar de modo prospectivo os parâmetros clínicos e laboratoriais dos pacientes submetidos a hemodiluição normovolêmica aguda associada ao ácido tranexâmico com um grupo de controle que recebeu apenas ácido tranexâmico, durante cirurgia de correção de deformidades da coluna, e avaliar a influência da técnica de hemodiluição no sangramento perioperatório e a necessidade de transfusão de sangue homólogo. Materiais e Métodos Estudo prospectivo comparativo, com pacientes entre 12 e 65 anos submetidos a cirurgia para correção de deformidades da coluna vertebral, com a técnica de hemodiluição normovolêmica aguda associada ao ácido tranexâmico, versus grupo de controle com ácido tranexâmico isolado na dose de 15 mg/kg. Exames laboratoriais foram feitos e analisados em três momentos de avaliação diferentes. Resultados Participaram deste estudo 30 pacientes: 17 no grupo de hemodiluição e 13 no grupo de controle. O tempo médio de cirurgia foi maior para o grupo de hemodiluição. O número de níveis operados variou entre 7 e 16 no grupo de hemodiluição, e entre 4 e 13 no grupo de controle. Fez-se osteotomia, predominantemente posterior, em 20 pacientes. O valor médio de sangramento intraoperatório foi maior no grupo de controle. Os parâmetros clínicos se mantiveram estáveis durante todos os procedimentos. Apenas 6 pacientes necessitaram de transfusão sanguínea homóloga, a maioria dos quais pertencia ao grupo de controle (p > 0,05). Conclusão Não houve diferença significativa entre os dois grupos quanto à necessidade de transfusão e sangramento intraoperatório. A gravidade da deformidade foi o principal fator determinante da transfusão.
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Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Scoliosis , Spine , Blood Transfusion, Autologous , Hemodilution/methods , HemorrhageABSTRACT
Objective@#To analyze the association of stored autologous blood transfusion (SABT) with tumor recurrence in PCa patients after radical prostatectomy and explore the application of SABT in this surgical procedure.@*METHODS@#Forty-five PCa patients underwent radical prostatectomy in our hospital in recent five years, of whom, 20 received SABT (group A) and the other 25 allogeneic blood transfusion (group B) intraoperatively. After surgery, we followed up the patients regularly for 3－66 months by examination of the levels of total PSA (tPSA) and free PSA (fPSA), digital rectal examination (DRE), and MRI to observe the biochemical recurrence of the tumor. We compared the data obtained between the two groups of patients.@*RESULTS@#In group A, 8 cases were in stages T1a－T1b and 12 in stages T2a－T2c, and in group B, 14 cases were in stages T1a－T1b and 11 in stages T2a－T2c. The volume of transfused blood was 800 ml in group A and 400－1 200 ml in group B. No statistically significant differences were observed between the two groups in the operation time, intraoperative blood loss or postoperative Gleason scores (P > 0.05), nor in the tPSA level or the results of DRE and MRI at 12, 24, 36, 48 and over 48 months (P > 0.05).@*CONCLUSIONS@#SABT is safe for PCa patients undergoing radical prostatectomy and does not increase the tumor recurrence rate after surgery.
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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
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La hemorragia obstétrica representa un desafío para el equipo médico, aportando con importante morbilidad y mortalidad a las pacientes embarazadas.El manejo adecuado, precoz y expedito beneficia el logro de resultados favorables para la madre e hijo; es por esto que debemos reconocer activamente aquellas pacientes en riesgo de presentar un sangrado obstétrico significativo.Presentamos el primer caso reportado en Chile de una paciente embarazada con mala inserción placentaria, sometida a cesárea y decómo se realizó el manejo del sangrado intraoperatorio, con énfasis en el uso de Cell Saver como técnica ahorradora de sangre.(AU)
Obstetric hemorrhage is a challenge for the medical team, contributing with significant morbidity and mortality to the pregnant patient.An appropriate, early, and expeditious management eases the achievement of favourable results for mother and son. We must recognizeactively those patients at risk of a significant obstetric bleeding.We present the first case report in Chile of a pregnant patient with abnormal placentation, undergoing a caesarean section and howbleeding was handled during the surgery, with emphasis on the use of a Cell Saver device as a blood-saving technique.(AU)
Subject(s)
Humans , Female , Pregnancy , Cesarean Section , Hemorrhage , Placenta Accreta , Blood Transfusion , Chile , ObstetricsABSTRACT
Objective To observe the clinical efficacy and safety of acute hypervolemic hemodilution (AHH) in combination with controlled hypotension (CH)and autologous blood transfusion (ABT)on spinal surgery. Methods For this study,we enrolled 50 patients undergoing spinal surgery and randomly divided them into two groups.The experimental group received AHH in combination with CH and ABT,while the control group received none of the above treatments.We compared the parameters such as hemodynamics,blood routine and coagulation, the amount of intraoperative bleeding,autologous and allogeneic blood transfusion volume,and regional cerebral oxygen saturation (rSO2)between the two groups.Results In the experimental group CVP increased,while invasive artery blood pressure, HCT, Hb, PLT and the amount of allogeneic blood transfusion decreased significantly compared with those of the control group (P＜0.05).As for the mean intraoperative blood loss, APTT,PT,TT,FIB and rSO2,there were no significant differences between the two groups (P＞0.05). Conclusion AHH in combination with CH and ABT can reduce the amount of allogeneic blood transfusion and has no adverse effect on hemodynamics,blood coagulation or cerebral oxygenation in spinal surgery patients.It is a safe and effective blood protection procedure during spinal surgery.
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Objective To explore the effects of autologous blood transfusion on coagulation function,in-flammatory factors and immune function in patients with traumatic brain injury.Methods 85 patients taken autologous blood transfusion were selected as the observation group,30 cases with allogeneic blood transfusion were taken as control group.The blood transfusion volume,perioperative hematocrit,prothrombin time and postoperative complications were observed and compared between the two groups.Results In the observation group,the total amount of autologous blood transfusion in the observation group was 36 338mL,averaged (427.5 ± 28.3)mL,the total amount of allogeneic blood transfusion was 8 747 mL,averaged (102.9 ± 12.7) mL,and the autologous blood accounted for 80.6% of the total transfusion.61 patients only transfused autolo-gous blood,accounting for 71.8%.In the control group,the total allogeneic blood transfusion volume was 15 918 mL,averaged (530.6 ± 22.8)mL,the consumption of banked blood in the observation group was signifi-cantly less than that in the control group (P< 0.05).The levels of platelet (PLT) and plasma fibrinogen (FIB)in the control group increased significantly at 3 d after operation compared with those before operation (P<0.05);while activated partial thromboplastin time (APTT) began to decrease significantly at 3 d after operation (P<0.05);the prothrombin time (PT) and thrombin time (TT)decreased significantly at 7 d after operation(P<0.05),and the level of PLT and FIB in the observation group began to increase significantly at 1 d after operation (P<0.05).PT,APTT and TT were significantly reduced 1 d after operation.Compared with the control group,the level of PLT and FIB in each phase of the observation group was significantly high-er than that of the control group (P<0.05),and the PT,APTT and TT were significantly lower than those in the control group (P<0.05).After operation,the level of pro-inflammatory factors in the observation group was significantly lower than that of the control group.The level of anti inflammatory factors and immune function were significantly higher than that of the control group (P<0.05),and the incidence of complications in the observation group was 2.4%(2/85),which was significantly lower than 16.7%(5/30)of the control group,and the difference was statistically significant (P<0.05).Conclusion Autologous blood transfusion has the advantages of rapidness,timeliness and safety in the operation for patients with brain trauma.It is helpful to save blood,reduce the effect of trauma and blood transfusion on blood coagulation function and im-mune function,and reduce the risk of blood transfusion complications and postoperative infection,which is worth of clinical application.
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Objective To observe the effects of tetramethylpyrazine on intraoperative autotransfusion of blood quality , analysis of ligustrazine in autotransfusion of clinical value of blood quality control.Methods 68 patients undergoing elective surgery in our hospital from February 2015 to May 2016 were selected as the research object,and were randomly divided into control group and experimental group,each group of 34 cases.Two groups of patients in the intraoperative autologous blood transfusion and the control group according to conventional autologous transfusion in operation ,test group of patients with intravenous injection of ligustrazine injection in the recovery of blood before adding ligustrazine injection in the recovery process of blood.The two groups were collected before blood transfusion,observe the morphology of red blood cells, red blood cell fragments under the microscope and compared;the two groups were collected after reinfusion of blood two hours,one and five days in peripheral venous blood, the determination of superoxide dismutase (SOD), malondialdehyde (MDA), T lymphocyte subsets level of two groups were compared before and after one and five days. Results The erythrocyte deformability and erythrocyte debris of the two groups were higher than those before operation (P<0.05).The blood red blood cell deformability and the number of red blood cell debris in the blood transfusion group were significantly higher than those in the control group Significantly lower than the control group (P<0.05).The levels of SOD were significantly lower at two hours and one day after operation than those before operation, and the serum SOD was still lower than that before operation in the control group,The SOD in the experimental group was significantly higher at two hours, one and five days in the control group,MDA was lower than the control group(P<0.05).The CD3 +,CD4 +, CD4 +/CD8 +levels were significantly lower at two hours and one day after operation than those before operation (P<0.05).CD3 +,CD4 +and CD4 +/CD8 +in the control group were still lower than those in the control group at five days after operation(P<0.05),the levels of CD3 +, CD4 +, CD4 +/CD8 +were significantly higher in the experimental group than those in the control group at two hours,one and five days after treatmen (P <0.05).There was no significant difference between the two groups in the incidence of adverse reactions.Conclusion The addition of preoperative intravenous injection of ligustrazine,blood recovery process,can effectively protect the transfusion of red blood cell integrity,reduce the effect of transfusion of blood and blood antioxidant capacity in patients with T lymphocyte immune function ,to improve the quality of blood transfusion patients has important clinical value .
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Objective To investigate the effects of autologous blood transfusion and allogeneic blood transfusion on postoperative complications and outcome of patients underwent craniotomy with traumatic brain injury.Methods All transfusional cases underwent emergency craniotomy with trau-matic brain injury from January,2012 to June,201 6,1 61 males and 38 females,ASA physical statusⅠ-Ⅳ,were respectively analyzed and divided into autologous blood group (n = 108)and allogeneic blood group (n =91)based on whether or not using cell salvage.The restrictive transfusion strategy was applied in the two groups and the red blood cells were infused to maintain the hemoglobin concen-tration at 70-100 g/L.The incidence of postoperative complications and adverse transfusion reaction were analyzed and the clinical outcome was judged by Glasgow outcome score (GOS).Results The incidence of postoperative complications (33% vs.56%,P <0.01 )and adverse transfusion reaction (5% vs.14%,P <0.05)of the autologous blood group were lower than that in the allogeneic blood group,and the clinical outcome was better (P <0.01).Logistic regression analysis showed that allo-genetic transfusion (OR =1.953,95%CI 1.381-2.529)was an independent risk factor of postopera-tive complications.Conclusion The use of autologous blood transfusion in patients with traumatic brain injury can reduce the incidence of postoperative complications and the risk of blood transfusion and improve clinical outcome.
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Introducción: Los pacientes sometidos a cirugía cardiaca son candidatos a recibir múltiples transfusiones sanguíneas homólogas por causas como el sangrado; el desarrollo de estrategias de conservación sanguínea (ECS) ha permitido proteger al paciente y limitar el riesgo de enfermedades infectocontagiosas, inmunológicas e inflamatorias. Objetivo: Analizar el efecto de las estrategias de conservación sanguínea sobre la transfusión de hemoderivados en los pacientes sometidos a cirugía cardiaca con derivación cardiopulmonar. Material y métodos: Estudio no experimental, exploratorio y transversal. Muestra no probabilística (n = 105) incluyó a pacientes adultos y pediátricos sometidos a cirugía cardiopulmonar con circulación extracorpórea (CEC) que utilizaron las ECS. Recolección de datos con cédula ex profeso de las variables demográficas, hematológicas y transfusionales, CEC, ECS. Datos analizados con frecuencias, porcentajes, medidas de tendencia central y de dispersión; así como prueba de Pearson, U de Mann Whitney y T de Student; significancia p < 0.05. Resultados: Prevalecieron las valvulopatías (42%), cirugías correctivas (98%), tipo de sangre O+. Se recuperaron 120,511 ml de sangre, en promedio 1,161 ml por paciente. Tiempo de CEC relacionado con volumen sangre transfundido (r = 0.318, p = 0.000). Mayor número ECS en la cirugía correctiva (Z = -2.467, p = 0.014), en pacientes con cirugías previas se recupera un mayor volumen (t = 2.072, p = 0.039), cantidad de sangre transfundida durante la CEC es mayor en la bomba centrífuga (t = -4.022, p = 0.000), pero no hay diferencias por sexo (t = 1.488, p = 0.137). La hemoglobina y hematocrito antes y después de la CEC fue semejante (p > 0.05). Conclusiones: Las ECS son una excelente opción de uso para evitar la transfusión homóloga, ya que logran recuperar una gran cantidad de sangre autóloga, potencializándose sus beneficios. (AU)
Background: Patients undergoing cardiac surgery are eligible to receive multiple blood transfusions counterparts for reasons such as bleeding; the development of blood conservation strategies (BCS) has protected the patient and limit the risk of infectious, immunologic and inflammatory diseases. Objective: To analyze the effect of blood conservation strategies on blood transfusion in patients undergoing cardiac surgery with cardiopulmonary bypass. Material and methods: Non-experimental, exploratory and transversal study. Probabilistic sample (n = 105) included adult and pediatric patients undergoing ardiopulmonary surgery with extracorporeal circulation (ECC) using the BCS. Data collection with charter expressly demographic, blood transfusion and variables, ECC, BCS. Data analyzed using frequencies, percentages, measures of central tendency and dispersion; and Pearson test, Mann Whitney and tudent t; significance p < 0.05. Results: A prevalence of valvular heart disease (42%), corrective surgeries (98%), blood type O+. 120,511 ml blood was recovered 1,161 ml per patient. ECC time related to transfused blood volume (r = 0.318, p = 0.000). BCS largest number in corrective surgery (Z = 2467, p = 0.014) in patients with previous surgeries increased volume (t = 2.072, p = 0.039), amount of blood transfused during ECC is recovered is greater in the pump centrifuge (t = 4,022, p = 0.000), but no sex differences (t = 1.488, p = 0.137). Hemoglobin and hematocrit before and after ECC was similar (p > 0.05). Conclusions: The BCS is an excellent choice for use to avoid homologous transfusion, and who manage to recover a large amount of autologous, enhancing its benefits. (AU)
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Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cardiovascular Diseases , Tri-Ponderal Mass Index , Heart Diseases , Heart Diseases/surgeryABSTRACT
Autologous blood transfusion (ABT) has been gradually attracting more attention due to the increasingly prominent problem of blood transfusion safety and blood shortage in recent years. With the rapid development of blood conservation techniques, blood component separation technology, blood transfusion medicine and a constant increase in clinical needs, ABT technology has been expanded and innovated to a large degree. In this study, the development of preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH), intraoperative and postoperative autotransfusion, and other new technologies and theories are reviewed and existing questions are analyzed. Challenges and applications are also discussed in order to provide reference for peers.
Subject(s)
Humans , Blood Transfusion, Autologous , Hemodilution , Perioperative CareABSTRACT
Objective To investigate the clinical effect of modified storage type of autologous blood transfu-sion combined with shed blooding retransformation technique after OrthoPAT for artificial total knee arthroplasty. Methods 70 patients with total knee replacement were randomly divided into observation group and control group, 35 cases in each group.The observation group was treated with the modified storage autotransfusion combined shed blooding retransformation technique after OrthoPAT,while the control group was given conventional allogeneic blood transfusion.The hemoglobin values and blood coagulation function of the two groups at immediately before anesthesia and surgery,10min before autologous blood transfusion and after reinfusion of 15min,after 6h and 24h of surgery were recorded,and the drainage blood total value,allogeneic blood transfusion measurement issues and transfusion rate after 24h were recorded.Results The hemodynamics of the two groups were stable at each time,there were no difference at urine volume (all P >0.05).The coagulation conditions were normal of the two groups at each time,there were no statistically significant differences between the two groups (all P >0.05).The average volume and homologous blood transfusion rate in the observation group were (126.3 ±6.5)mL,1 /35,which were significantly lower than those in the control group [(476.4 ±10.6)mL,2 /35],the differences were statistically significant (t =10.73,χ2 =6.31,all P <0.05).The incidence rate of postoperative complication of the observation group was 5.7%,which was signifi-cantly lower than 22.9% of the control group,the difference between the two groups was statistically significant (χ2 =4.93,P <0.05).Conclusion The improved storage type of autologous blood transfusion combined with shed bloo-ding retransformation technique after OrthoPAT has exact effect for artificial total knee arthroplasty,the incidence of adverse reactions is low,as well as the low blood transfusion rate.
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Objective To investigate the effects of autologous blood transfusion and acute normovolemic hemodilution inflamma‐tory response in patients with spinal surgery .Methods 60 patients with spinal surgery ,were randomly divided into the control group ,autologous blood transfusion group ,acute normovolemic hemodilution group ,20 cases in each group .The control group in in‐traoperative bleeding time and blood input variants of inventory .Autologous blood transfusion group was used in combination with intraoperative autologous blood recovery unit ,lose banked blood hemoglobin was low .Acute normovolemic hemodilution group via peripheral vein input must first crystal liquid or gel liquid ,then through internal jugular vein slowly pulled out the body′s blood into the special bags containing anticoagulant ,swing machine through blood kept shaking ,input when appropriate .Preoperative(T1) , After surgery 2 h(T2) ,6 h(T3) ,12 h(T4) and 24 h(T5) blood at each time point 5 mL ,detect the WBC ,IL‐6 ,TNF‐α.Records with and without postoperative complications .Results WBC in autologous blood transfusion group and acute normovolemic he‐modilution group were higher than that of preoperative ,difference was statistically significant(P<0 .05);In T2 -T5 ,serum IL‐6 , TNF‐a and the WBC concentration compared with the basis of their respective value(T1) increased significantly ,but were signifi‐cantly lower than control group ,the difference was statistically significant(P< 0 .05) .Postoperative follow‐up of the autologous blood transfusion group and acute normovolemic hemodilution group and no complications .Conclusion The autologous blood trans‐fusion group and acute normovolemic hemodilution group could effectively reduce the intraoperative and postoperative systemic in‐flammatory response ,which obviously save blood resources .
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Objective To explore and evaluate the changes of hemorheology and fracture healing in patients undergoing spinal operation with intraoperative autologuous blood transfusion.Methods A total of 80 patients underwent internal fixation of spine in our hospital from January 2012 to December 2014 were selected in this study.Digital random table method were utilized for dividing them into two groups.Autologous blood transfusion was used in group A,allogeneic blood transfusion was applied in group B.Blood viscosity,plasma viscosity,hematocrit,fibrinogen,erythrocyte sedimentation rate (ESR) and the level of sICAM-1,sVCAM-1 were collected and compared 1,4,8,12 weeks after the operation.Fesults Concentrated red cell and plasma volume infusion in group A was lower than that in group B,the level of sICAM-1,sVCAM-1 1,4,8,12 weeks after operation in group A were significantly lower than that in group B.There was no delayed fracture healing patients in group A,but there was 3 patients with delayed fracture healing in group B (P＜0.05).Blood viscosity,plasma viscosity,hematocrit,fibrinogen,erythrocyte and ESR 1,4,8,12 weeks after the operation compared in both group were not statistically significant (P＞0.05).Conclusion Autologous blood transfusion is not only a safe and effective method for blood transfusion,but also can improve the tissue blood supply,reduce inflammation,and conducive to fracture healing.