Transfusion Alternatives in Transfusion Medicine via MedWorm.com

Iron therapy in patients with chronic kidney disease

Transfusion Alternatives in Transfusion Medicine — Sun, 05 Feb 2012 05:00:00 +0100

SUMMARYIron deficiency, both functional and absolute, is common in patients with chronic kidney disease and in those requiring dialysis. The Renal National Service Framework and National Institute for Health and Clinical Excellence advocate treatment of anemia in patients with chronic kidney disease. Oral iron is often both insufficient and slow to improve hemoglobin levels while intravenous supplementation replenishes and maintains iron stores more effectively. This leads to a reduction in the use of erythropoietin stimulating agents. This reduction in erythropoietin stimulating agents use may be potentially beneficial in certain cases in particularly reducing stroke risk. In contrast, intravenous iron has the potential to improve quality of life, reduce cardiovascular risk and produce co...

Donor disclosure – a donor's right and blood bank's responsibility

Transfusion Alternatives in Transfusion Medicine — Sun, 05 Feb 2012 05:00:00 +0100

This study describes our experiences in counseling donors who were enzyme‐linked immunosorbent assay reactive for viral TTI, and challenges faced in implementing the donor disclosure program in a resource‐limited environment. (Source: Transfusion Alternatives in Transfusion Medicine)

Washing and filtering of cell‐salvaged blood – does it make autotransfusion safer?

Transfusion Alternatives in Transfusion Medicine — Fri, 01 Apr 2011 04:00:00 +0100

SUMMARYAutologous transfusion was first performed in the late 1800s, but it was not until the 1970s that devices were developed that enabled widespread adoption of the practice. Unwashed salvaged blood contains thrombogenic products, cell breakdown products and plasma proteins, and gross chemical, cellular and physical contaminants. Washing and filtering of salvaged blood is routinely performed to remove or reduce these elements. In this paper we review the clinical data supporting the need for washing and filtering of salvaged blood. (Source: Transfusion Alternatives in Transfusion Medicine)

Keyword index

Transfusion Alternatives in Transfusion Medicine — Wed, 23 Mar 2011 17:42:48 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Author index

Transfusion Alternatives in Transfusion Medicine — Wed, 23 Mar 2011 17:42:48 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Poster abstracts

Transfusion Alternatives in Transfusion Medicine — Wed, 23 Mar 2011 17:42:48 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Speaker abstracts

Transfusion Alternatives in Transfusion Medicine — Wed, 23 Mar 2011 17:42:47 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Editorial: recent advances in perioperative volume replacement therapy through a more physiological approach of the high‐risk surgical patient

Transfusion Alternatives in Transfusion Medicine — Sun, 24 Oct 2010 04:37:05 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Can we reduce routine blood ordering in spinal surgery?

Transfusion Alternatives in Transfusion Medicine — Fri, 01 Oct 2010 00:00:00 +0100

In conclusion, less blood can be ordered for spinal surgery, except for cases of neuromuscular scoliosis. The blood units crossmatched for painful back surgery, were more than actually needed. With technological advancement historical blood crossmatching policies may need re‐evaluation. (Source: Transfusion Alternatives in Transfusion Medicine)

Hyperoxia in the treatment of traumatic brain injury and stroke

Transfusion Alternatives in Transfusion Medicine — Fri, 01 Oct 2010 00:00:00 +0100

SUMMARYTraumatic brain injury and acute ischemic stroke are major causes of mortality and morbidity throughout the world. Treatment in both conditions remains partially successful. In recent years, hyperoxia (increased inspired oxygen concentration), both hyperbaric and normobaric, has shown significant promise as treatment modality in these conditions. We review the recent relevant evidence from human trials and discuss the mechanisms involved in the pathophysiology. (Source: Transfusion Alternatives in Transfusion Medicine)

Therapeutic effects of hyperoxic ventilation during shock

Transfusion Alternatives in Transfusion Medicine — Fri, 01 Oct 2010 00:00:00 +0100

SUMMARYDecreased availability of oxygen to metabolizing cells is a major feature of circulatory shock that leads to tissue damage and multiple organ dysfunctions. A wish to alleviate tissue hypoxia underlies the common clinical use of hyperoxic ventilation in shock. Yet, this straightforward approach is met by skepticism that is based on the potential pro‐inflammatory effects of hyperoxia and the acknowledged roles of reactive oxygen species and oxidative stress in tissue injury. A steadily growing body of experimental data indicates that hyperoxia exerts an extensive profile of physiologic and pharmacologic effects that improve tissue oxygenation, exert anti‐inflammatory and antibacterial effects, augment tissue repair mechanisms, and may also decrease oxidative stress during shock. T...

Effects of administration of iron isomaltoside 1000 in patients with chronic heart failure. A pilot study

Transfusion Alternatives in Transfusion Medicine — Fri, 01 Oct 2010 00:00:00 +0100

SUMMARYIntravenous iron preparations have shown benefit in patients with chronic heart failure (CHF) and iron deficiency. Iron isomaltoside 1000 (Monofer) is a novel intravenous iron compound with low immunological activity of the isomaltoside and low free‐iron‐related toxicity. The primary objective of this open‐label, non‐comparative, multicenter pilot study was to test the safety of iron isomaltoside 1000 in patients with CHF and anemia. In addition, its effect on markers of iron deficiency, anemia and on quality of life was assessed. Twenty patients with CHF and iron deficiency anemia attended six visits during the 8‐week study period. Iron isomaltoside 1000 was infused at baseline (mean dose 868 mg, range 650–1000 mg). No treatment‐related adverse reactions, no acute...

The effects of hyperoxic ventilation in the treatment of myocardial infarction

Transfusion Alternatives in Transfusion Medicine — Fri, 01 Oct 2010 00:00:00 +0100

SUMMARYEveryone supports the use of oxygen therapy to treat hypoxia secondary to acute myocardial infarction. However, the literature is confusing on the subject of supplemental oxygenation of patients with normal oxygen saturation and uncomplicated acute myocardial infarction, despite the fact that controlled randomized human studies have failed to support the need for supplemental oxygen in the uncomplicated patient. Both normobaric and hyperbaric oxygen must be recognized as a vasoactive substance and thus be considered a drug to which the patient may have an adverse response, particularly in patients whose oxygen saturation is 95% or greater, for example, coronary vasoconstriction.The level of evidence for the use of normobaric oxygenation in uncomplicated acute myocardial infarction p...

The role of the glycocalyx in transvascular fluid shifts

Transfusion Alternatives in Transfusion Medicine — Thu, 30 Sep 2010 23:00:00 +0100

SUMMARY (Source: Transfusion Alternatives in Transfusion Medicine)

Perioperative optimization of oxygen delivery

Transfusion Alternatives in Transfusion Medicine — Thu, 30 Sep 2010 23:00:00 +0100

SUMMARY (Source: Transfusion Alternatives in Transfusion Medicine)

Metabolic effects of plasma expanders

Transfusion Alternatives in Transfusion Medicine — Thu, 30 Sep 2010 23:00:00 +0100

SUMMARY (Source: Transfusion Alternatives in Transfusion Medicine)

Hyperchloremic acidosis during plasma expansion

Transfusion Alternatives in Transfusion Medicine — Thu, 30 Sep 2010 23:00:00 +0100

SUMMARY (Source: Transfusion Alternatives in Transfusion Medicine)

Editorial: should we be more balanced, more ‘starched’ and more optimized?

Transfusion Alternatives in Transfusion Medicine — Thu, 30 Sep 2010 23:00:00 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Tissue oxygenation parameters to guide fluid therapy

Transfusion Alternatives in Transfusion Medicine — Tue, 31 Aug 2010 23:00:00 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Hemodynamic parameters to guide fluid therapy

Transfusion Alternatives in Transfusion Medicine — Mon, 19 Jul 2010 23:00:00 +0100

The clinical determination of the intravascular volume can be extremely difficult in critically ill and injured patients as well as those undergoing major surgery. This is problematic as fluid loading is considered the first step in the resuscitation of hemodynamically unstable patients. Yet, multiple studies have demonstrated that only about 50% of hemodynamically unstable patients in the ICU and operating room respond to a fluid challenge. Cardiac filling pressures including the central venous pressure and pulmonary artery occlusion pressure have traditionally been used to guide fluid management. However, studies performed over the last 30 years have demonstrated that cardiac filling pressures are unable to predict fluid responsiveness. Over the last decade a number of studies have been ...

Intraoperative fluid losses revisited

Transfusion Alternatives in Transfusion Medicine — Mon, 31 May 2010 23:00:00 +0100

SUMMARY (Source: Transfusion Alternatives in Transfusion Medicine)

Crystalloids versus colloids: the end of an old debate?

Transfusion Alternatives in Transfusion Medicine — Mon, 31 May 2010 23:00:00 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Granulocyte mobilization, collection and transfusion – where do we stand?

Transfusion Alternatives in Transfusion Medicine — Mon, 31 May 2010 23:00:00 +0100

SUMMARY (Source: Transfusion Alternatives in Transfusion Medicine)

Maintenance of normal hematocrit in high‐risk thyroid surgery without allogeneic blood transfusion: a case report

Transfusion Alternatives in Transfusion Medicine — Mon, 31 May 2010 23:00:00 +0100

ABSTRACT (Source: Transfusion Alternatives in Transfusion Medicine)

Maintenance of normal hematocrit in high-risk thyroid surgery without allogeneic blood transfusion: a case report

Transfusion Alternatives in Transfusion Medicine — Thu, 13 May 2010 23:00:00 +0100

We report a case of subtotal thyroidectomy for a large simple multinodular goiter using planned blood-conservation techniques tailored to the patient that resulted in maintenance of a normal hematocrit throughout the perioperative period. The patient received oral hematinics preoperatively, while acute normovolemic hemodilution and other techniques were used to minimize intraoperative blood loss. The outcome was an optimized hematocrit preoperatively, minimal blood loss intraoperatively, and hematocrit which remained optimal on the third postoperative day and 3 weeks postoperatively. No allogeneic blood was used at any stage. This suggests that maintenance of normal hematocrit can be regarded as an achievable goal in high-risk surgery through blood-conservation techniques. Avoiding allogen...

Safety of retransfusion of filtered shed blood in 1819 patients after total hip or knee arthroplasty

Transfusion Alternatives in Transfusion Medicine — Thu, 13 May 2010 23:00:00 +0100

In this study, few adverse events were detected during retransfusion. The frequency of serious (0.1%) and minor (3.5%) adverse events was similar to other smaller clinical studies. Based on the low incidence of side effects in this large cohort of orthopedic patients, postoperative cell salvage with such a retransfusion system is considered to be safe. (Source: Transfusion Alternatives in Transfusion Medicine)

Preoperative anemia in elective cardiac surgery: prevalence, risk factors, and influence on postoperative outcome

Transfusion Alternatives in Transfusion Medicine — Thu, 13 May 2010 23:00:00 +0100

In conclusion, our data seem to indicate that preoperative anemia has a high prevalence among elective cardiac surgical patients and increases postoperative morbidity. Therefore, we need to address two specific areas about preoperative anemia in these patients: early recognition and evaluation, and appropriate and timely treatment. (Source: Transfusion Alternatives in Transfusion Medicine)

Granulocyte mobilization, collection and transfusion – where do we stand?

Transfusion Alternatives in Transfusion Medicine — Thu, 13 May 2010 23:00:00 +0100

Bacterial and fungal infections are the main cause of morbidity and mortality in neutropenic patients. The transfusion of granulocytes to restore host defenses in severely neutropenic patients has been studied for a long time. However, inadequate dosage of granulocytes and inconsistent efficacy has limited the usage of these transfusions in the past. Recently, the use of mobilizing agents such as granulocyte colony-stimulating factor has renewed interest in these treatment modalities. Some studies have shown a benefit in neutropenic patients transfused with high doses of granulocyte concentrates. A number of tests of granulocyte function can be performed in vitro to assess the quality of granulocyte concentrates, which may be useful to optimize granulocyte collection and storage. Such stud...

Challenges of meeting the future blood transfusion requirement in England and Wales. Autologous blood transfusion could become an adjunct to the UK blood transfusion program in the future

Transfusion Alternatives in Transfusion Medicine — Thu, 13 May 2010 23:00:00 +0100

As a resource, allogeneic blood has never been more in demand than it is today. Escalating elective surgery, an aging population, periodic shortages arising from a fall in supply, old and emerging threat of transfusion-transmissible infections and spiraling costs because of various safety introductions have all conspired to ensure that allogeneic blood remains very much a vital but limited asset to the National Health Service. However, there are increasing demands for alternatives/complementary strategies to allogeneic blood transfusion. Autologous transfusion, predeposit autologous donation, acute normovolemic hemodilution and perioperative cell salvage is reliable, cost-effective, safe, does not involve type and screen, not associated with isoimmunization to foreign proteins, is indicate...

Speaker abstracts

Transfusion Alternatives in Transfusion Medicine — Wed, 31 Mar 2010 23:00:00 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Keyword index

Transfusion Alternatives in Transfusion Medicine — Wed, 24 Mar 2010 00:00:00 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Author index

Transfusion Alternatives in Transfusion Medicine — Wed, 24 Mar 2010 00:00:00 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Poster abstracts

Transfusion Alternatives in Transfusion Medicine — Wed, 24 Mar 2010 00:00:00 +0100

(Source: Transfusion Alternatives in Transfusion Medicine)

Prediction of transfusion requirements in surgical patients: a review

Transfusion Alternatives in Transfusion Medicine — Fri, 23 Oct 2009 23:00:00 +0100

Preoperative estimation of transfusion requirements in patients scheduled for surgery is critical to optimize blood management, including costs, and to appropriately select patients who can benefit from alternatives to allogeneic blood transfusion. Three groups of methods for transfusion requirement prediction have been developed. The simplest methods are those that identify patients at risk of requiring transfusion support on the basis of the surgical procedure they are scheduled for and one or two clinical parameters. Preoperative hemoglobin concentration (or red blood cell mass) and age are the most reliable parameters that have emerged from the studies. A second group of methods includes approaches based on the calculation of a risk score obtained by totaling predefined values assigned...

Erythropoietin and iron therapy in patients with renal failure

Transfusion Alternatives in Transfusion Medicine — Fri, 16 Oct 2009 23:00:00 +0100

Anemia, which is a common complication of chronic kidney disease (CKD), may significantly impair quality of life, increase cardiovascular risk and reduce long-term survival if left untreated. Today, erythropoiesis-stimulating agents (ESAs) are the main tool for anemia correction; they can be differentiated on the basis of mean serum half life on short- and long-acting molecules, the latter requiring longer administration intervals. According to international guidelines, the target hemoglobin to be obtained by treatment is between 11 and 12 g/dL. In general, the intravenous route is more convenient for hemodialysis patients, whereas the subcutaneous one is preferable in all other CKD patients. ESA dose requirements are rarely predictable in the individual patient and thus need to be titrate...

Donor safety issues in high-dose platelet collection using the latest apheresis systems

Transfusion Alternatives in Transfusion Medicine — Mon, 20 Jul 2009 23:00:00 +0100

The practice of high-yield or double-dose platelet (DDP) collection through automated apheresis is gradually increasing. Very few studies have examined donor safety issues in DDP collection. The present study highlights the process of DDP donor selection as well as the product quality and donor safety issues on 67 donors. All procedures were performed following the departmental standard operating procedure. We observed a significantly higher mean platelet yield with the Amicus separator than the Fresenius separator (5.4 × 1011vs. 5.1 × 1011, P = 0.03). The Fresenius separator processed a mean blood volume of 3974 mL and collected a mean platelet amount of 444.9 mL, and these were significantly higher when compared with Amicus (P < 0.0001). Mean values of procedure-related parameters, suc...

Managing situations of acute blood loss with limited resources

Transfusion Alternatives in Transfusion Medicine — Tue, 16 Jun 2009 04:00:00 +0100

Death from acute blood loss is a common event in many parts of the world. Most of the half-million-plus maternal deaths worldwide are due to postpartum hemorrhage. While a state of general nonreportage exists in under-resourced countries, it is clear that shortage of blood and trained clinical manpower are important causes of mortality, even for those lucky few who do make it to hospital. These factors and methods of resuscitation are considered in this review of the clinical scene and simple techniques available to treat hemorrhagic shock in under-resourced countries. (Source: Transfusion Alternatives in Transfusion Medicine)