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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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To investigate the changes of anesthetic drug concentration in plasma during isolation of autologous blood with acute normovolemic hemodiluti-on and its influence on the depth of anesthesia, muscle relaxant effect and blood drug concentration after reinfusion. METHODS: Forty patients of both sexes, aged 20-60 yr, American Society of Anesthesiologists physical status or Ⅱ, hemoglobin (Hb) >120 g / L, hematocrit (Hct) >35%, undergoing eletive multilevel spinal surgery were included, were divided into 2 groups (n=20 each) using a random number table. ANH group (group A): ANH was performed after stable induction of anesthesia, the target Hct value was 28%-30%, and autologous blood was reinfused after the main operation steps. Control group (group C): routine transfusion and infusion treatment. The bispectral index (BIS) and Train-of-Four stimulation (TOF) were observed and recorded at the stable induction of anesthesia (T1), 30 minutes of stable induction (T2), the end of operation (T3), 30 minutes after the end of the operation (T4), 1 hour after the end of the operation (T5) and 2 hours after the end of the operation (T6). The concentrations of propofol and cisatracurium besylate in plasma at T1-T6, stored blood at 1 h (TS1), 2 h (TS2), and before reinfusion (TS3) were detected by Liquid Chromatography-tandem Mass Spectrometry. The extubation time and recovery score at T4-6 hours were recorded. RESULTS: There was no significant difference in propofol between the two groups at each time point (P > 0.05). The plasma concentration of cisatracurium besylate in group A was higher than that in group C at T3 (P0.05). The BIS value at T4 and TOF value at T3 in group A were significantly lower than those in group C. The recovery score of group A was lower than that of group C at T4 (P0.05). CONCLUSION: The plasma concentrations of propofol and cisatracurium besylate were basically unchanged during the in vitro isolation of ANH autologous blood. The plasma concentrations of cisatracurium besylate were only temporarily affected after the main operation steps, but the postoperative muscle relaxation recovery and recovery quality were not significantly affected.
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AIM: To investigate the effects of autotransfusion on immune function and inflammation in patients undergoing cesarean section. METHODS: Ninty patients with high risk hemorrhage (central placenta previa, cicatritic uterus, etc.) who underwent cesarean section were divided into three groups according to the amount of autoblood transfusion, with 30 cases in each group. The control group did not receive autologous blood transfusion, the group with a transfusion volume of 0-400 mL received autologous blood transfusion 0-400 mL, and the group with a transfusion volume of 400-800 mL received autologous blood transfusion 400 -800 mL. Serum levels of HB, RBC, HCT, WBC, CD3
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Background:Transfusion rates in cardiac surgery are high. Aim: To determine if intraoperative autologous blood removal without volume replacement is associated with fewer homologous blood transfusions without increasing acute kidney injury. Setting and Design: Retrospective, comparative study. Materials and Methods: Adult patients undergoing cardiac surgery, excluding those who underwent ventricular assist device surgery, heart transplants, or cardiac surgery without cardiopulmonary bypass were excluded, who had 1–3 units of intraoperative autologous blood removal were compared to patients without blood removal for determination of volume replacement, vasopressor support, acute kidney injury, and transfusions. Results: Autologous blood removal was associated with fewer patients receiving homologous transfusions: intraoperative red cell transfusions fell from 75% (Control) to 48% (1 unit removed), 40% (2 units), and 30% (3 units), P < 0.001. Total intraoperative and postoperative homologous RBC units transfused were lower in the blood removal groups: median (interquartile range) 3 (1, 6) in Control patients and 0 (0, 2), 0 (0, 2) and 0 (0, 1) in the 1, 2, and 3 units removed groups, P < 0.001. Similarly, plasma, platelet, and cryoprecipitate transfusions decreased. After adjustment for confounders, increased amounts of autologous blood removal were associated with increased intravenous fluids, only when 2 units were removed, and trivially increased vasopressor use. However, it was not associated with acidosis or acute kidney injury. Conclusions: Intraoperative autologous blood removal without volume replacement of 1–3 units for later autologous transfusion is associated with decreased homologous transfusions without acidosis or acute kidney injury.
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To evaluate the effect of preoperative colonoscopic autologous blood labeling to localization for laparoscopic colorectal surgery, data of 30 patients with colorectal neoplasms who underwent colonoscopic autologous blood localization followed by laparoscopic surgery in Shanghai East Hospital, Tongji University from January 2019 to January 2021 were retrospectively analyzed. The location of lesions was determined by local red marks on the serosal surface of the colon during laparoscopic surgery. The clarity of staining and whether there was leakage of injected autologous blood were observed. All patients successfully completed the localization of autologous blood under colonoscopy, without bleeding, perforation, fever or other complications. Laparoscopic exploration showed clear sites of autologous blood staining, without staining dispersion or leakage polluting the operation field. Postoperative pathology confirmed that the margin of the specimen was negative. The injection of autologous blood under colonoscopy is a safe and effective preoperative localization method for laparoscopic colorectal neoplasms surgery, which is worthy of clinical recommendation.
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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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【Objective】 To explore the effect of autologous platelet-rich plasma (PRP) in the treatment of refractory wounds after radical breast cancer resection. 【Methods】 The clinical data of 8 patients with refractory wound healing after radical resection of breast cancer, who received autologous PRP treatment at the South District Wound Treatment Center from November 2020 to May 2021, were collected, including age, sex, wound location, wound area/depth, TNM staging, surgical method, postoperative pathology, chemotherapy conditions, PRP treatment, etc. Wound healing time and scar hyperplasia (vascular distribution, color, softness, thickness, itching, pain, etc.) were observed after PRP treatment. The efficacy of autologous PRP was analyzed and evaluated retrospectively based on the above data. 【Results】 The wounds of 8 patients healed smoothly, and the granulation tissue of the wound was relatively matured and completely covered by the crawling epidermis. The wound healing time was 14 to 26 (20.6±3.6) days, and all patients had not developed scar hyperplasia. 【Conclusion】 The efficacy of autologous PRP treatment of refractory wounds after radical breast cancer resection is fast and effective, and can eliminate scar hyperplasia, which is worthy of clinical promotion.
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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)
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Recuperación de Sangre Operatoria , Transfusión de Sangre Autóloga , Atención de EnfermeríaRESUMEN
Objective To evaluate the efficacy and risks of autologous blood patch pleurodesis in patients with persistent air leak(PAL)after lung resection. Methods A total of 97 patients with PAL after lung resection in Beijing Shijitan Hospital from October 2014 to October 2019 were retrospectively reviewed,including 53 treated by autologous blood patch pleurodesis and 44 by the conventional way.The therapeutic effect,adverse reactions and complications were analyzed. Results All the patients with PAL were cured with autologous blood patch pleurodesis.Most air leaks(81.1%)ceased within 48 hours after treatment,and the left 18.9% patients got cured after a repeat.The mean tube retention time and the mean in-hospital stay were 8.4 days and 10.0 days in the autologous blood patch pleurodesis group and 13.5 days and 15.3 days in the conventional treatment group.A prolonged drainage time(P=0.00)and in-hospital stay(P=0.00)were observed in the conventional treatment group.No severe complications were observed except two patients developed slight fever and cutaneous emphysema. Conclusion In our experience,the autologous blood patch pleurodesis is an effective way with low risk of adverse reactions in the treatment of PAL.
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Humanos , Drenaje , Tiempo de Internación , Pulmón , Pleurodesia , Estudios RetrospectivosRESUMEN
@#AIM: To explore the effects of internal limiting membrane transplantation, inverted internal limiting membrane flap and autologous blood filling in treatment of idiopathic macular hole(IMH)and the influence on macular structure and choroidal thickness.<p>METHODS: Clinical data of patients with IMH who were treated in the hospital between January 2017 and December 2019 were retrospectively analyzed. All patients were treated with standard vitrectomy combined with internal limiting membrane stripping and gas-liquid exchange. On this basis, patients treated with internal limiting membrane transplantation(28 cases, 29 eyes), inverted internal limiting membrane flap(26 cases, 28 eyes)and autologous blood filling(25 cases, 25 eyes)were included in the internal limiting membrane transplantation group, inverted internal limiting membrane flap group and autologous blood filling group, respectively. The situation of hole closure and shape of the closed hole were observed. The best corrected visual acuity(BCVA), hole photoreceptors inner segment/outer segment ellipsoid zone(EZ)and external limiting membrane(ELM)defect diameter, perimeter of foveal avascular zone(PERIM), superficial capillary plexus(SCP)blood flow density, subfoveal choroidal thickness(SFCT), temporal choroidal thickness(TCT)and nasal choroidal thickness(NCT)were determined. <p>RESULTS: All patients in the 3 groups successfully completed the surgery. The BCVA of internal limiting membrane transplantation group and inverted internal limiting membrane flap group was better than that of autologous blood filling group at 3mo after surgery(<i>P</i><0.05). There were no significant differences in macular hole closure rate and ellipsoid closure rate among the 3 groups(<i>P</i>>0.05). However, there were significant differences in morphological classification of the closed macular hole(<i>P</i><0.05), and the proportion of U-shaped hole was the highest in inverted internal limiting membrane flap group. The diameters of EZ defect and ELM defect of internal limiting membrane transplantation group and inverted internal limiting membrane flap group were smaller than those of autologous blood filling group at 3mo after surgery(<i>P</i><0.05). There were no significant differences in PERIM, SCP blood flow density, SFCT, TCT and NCT among the 3 groups before and after surgery(<i>P</i>>0.05). <p>CONCLUSION:Internal limiting membrane transplantation, inverted internal limiting membrane flap and autologous blood filling can restore the closure of the macular hole. However, internal limiting membrane transplantation and inverted internal limiting membrane flap can better restore the macular structure and improve visual acuity, compared with autologous blood filling.
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【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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Platelet-rich plasma (PRP) is becoming a new hope for wound healing, and has been widely concerned by both doctors and patients. To provide standardized and quality controled PRP products for clinical treatment is the premise to ensure the efficacy. This expert consensus was led by theWorking Party on Clinical Transfusion Management, Chinese Society of Blood Transfusion, and was jointly compiled by blood transfusion experts from tertiary A general hospitals with PRP preparation experience across the country. In this paper, the personnel, apparatus, consumables, methods and environmental conditions of PRP preparation were widely and deeply discussed, and the guidelines for PRP preparation were formed to guide the medical and nursing personnel to prepare PRP products with quality control scientifically and normatively, furthermore provide reference for the standardized clinical application of PRP technology.
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AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T
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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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Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Escoliosis , Columna Vertebral , Transfusión de Sangre Autóloga , Hemodilución/métodos , HemorragiaRESUMEN
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
RESUMEN
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)