Transfusion Alternatives in Transfusion Medicine via MedWorm.com

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)