Anemia is common in the perioperative period and is associated with poor patient outcomes. Remarkably, anemia is frequently ignored until hemoglobin levels drop low enough to warrant a red blood cell transfusion. This simplified transfusion-based approach has unfortunately shifted clinical focus away from strategies to adequately prevent, diagnose, and treat anemia through direct management of the underlying cause(s). While recommendations have been published for the treatment of anemia before e...
Last. Susan M. Goobie(Boston Children's Hospital)H-Index: 24
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PURPOSE OF REVIEW: Research studies pertaining to the management of pediatric non-red cell blood product transfusion is limited. Clinical practices vary within disciplines and regions. Anesthesiologists need evidence-based guidelines to make appropriate and safe decisions regarding transfusion of the 'yellow' blood products for pediatric patients. RECENT FINDINGS: This review outlines clinical indications for transfusion of fresh frozen plasma, cryoprecipitate, platelets, and fibrinogen concentr...
#1Le Chang(Academy of Medical Sciences, United Kingdom)H-Index: 10
#2Ying Yan(Academy of Medical Sciences, United Kingdom)H-Index: 5
Last. Lunan Wang(Peking Union Medical College)H-Index: 15
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Abstract With the outbreak of unknown pneumonia in Wuhan, China in December 2019, a new coronavirus, Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) aroused the attention of the entire world. The current outbreak of infections with SARS-CoV-2 is termed Corona Virus Disease- 2019 (COVID-19). The World Health Organization (WHO) declared COVID-19 in China as a Public Health Emergency of International Concern (PHEIC). Two other corona virus infections-- SARS in 2002–2003 and Middle Eas...
Last. Donat R. Spahn(UZH: University of Zurich)H-Index: 94
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Abstract Background Iron deficiency is frequent in patients undergoing cardiac surgery. The relevance of iron deficiency, however, is ill defined. Therefore, our study aimed to investigate the impact of iron deficiency (ferritin Methods In this prospective observational study, 730 patients undergoing elective cardiac surgery were assigned into four groups according to their iron status and anaemia. Mortality, serious adverse events (SAEs), major cardiac and cerebrovascular events (MACCEs), allog...
Last. Jan-Dirk Studt(UZH: University of Zurich)H-Index: 14
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BACKGROUND This study investigates the impact of preoperative calculated rivaroxaban (RXA) plasma concentration on perioperative red blood cell (RBC) loss. STUDY DESIGN AND METHODS In this retrospective single-center study, we identified patients with RXA intake according to a preoperative determination of RXA levels within 96 hours before surgery. RXA plasma concentration at the beginning of surgery was then calculated from the last RXA intake using a single-compartment pharmacokinetic model wi...
Pediatric cardiac surgery is associated with a substantial risk of bleeding, frequently requiring the administration of allogeneic blood products. Efforts to optimize preoperative hemoglobin, limit blood sampling, improve hemostasis, reduce bleeding, correct coagulopathy, and incorporate blood sparing techniques (including restrictive transfusion practices) are key elements of patient blood management (PBM) programs, and should be applied to the pediatric cardiac surgical population as across ot...
The publication of the Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage-2 (CRASH-2) study and its intense dissemination prompted a renaissance for the use of the antifibrinolytic agent tranexamic acid (TXA) in acute trauma hemorrhage. Subsequent studies led to its widespread u
#2Laurina O. Williams(CDC: Centers for Disease Control and Prevention)H-Index: 9
Last. Mark L. Graber(RTP: Research Triangle Park)H-Index: 26
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As many as 90% of patients develop anemia by their third day in an intensive care unit (ICU). We evaluated the efficacy of interventions to reduce phlebotomy-related blood loss on the volume of blood lost, hemoglobin levels, transfusions, and incidence of anemia. We conducted a systematic review and meta-analysis using the Laboratory Medicine Best Practices (LMBP) systematic review methods for rating study quality and assessing the body of evidence. Searches of PubMed, Embase, Cochrane, Web of S...
#2Angela Sauaia(University of Colorado Denver)H-Index: 57
Last. Ernest E. Moore(University of Colorado Denver)H-Index: 155
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: Essentials TEG-guided therapy has been shown to be valuable in a number of surgical settings. This systematic review and analysis specifically evaluated the effects of TEG-guided therapy. TEG-guided therapy can improve blood product utilization and enhance resource management. Use of TEG improved key patient outcomes, including bleed rate, length of stay and mortality. BACKGROUND: Thromboelastography (TEG 5000 and 6s Thrombelastograph Hemostasis Analyzer; Haemonetics) is a point-of-care system...
Last. Volkmar Falk(Humboldt University of Berlin)H-Index: 104
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Summary Background Anaemia and iron deficiency are frequent in patients scheduled for cardiac surgery. This study assessed whether immediate preoperative treatment could result in reduced perioperative red blood cell (RBC) transfusions and improved outcome. Methods In this single-centre, randomised, double-blind, parallel-group controlled study, patients undergoing elective cardiac surgery with anaemia (n=253; haemoglobin concentration (Hb) Findings Between Jan 9, 2014, and July 19, 2017, 1006 p...
#2E Verburgh(UCT: University of Cape Town)H-Index: 6
Last. Vernon J. Louw(UCT: University of Cape Town)H-Index: 13
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Blood transfusions come with risks and high costs, and should be utilized only when clinically indicated. Decisions to transfuse are however not always well informed, and lack of clinician knowledge and education on good clinical transfusion practices contribute to the inappropriate use of blood. Low and middle-income countries in particular take much strain in their efforts to address blood safety challenges, demand-supply imbalances, high blood costs as well as high disease burdens, all of whi...
Background null Many patients with myelodysplastic syndromes (MDS) receive red cell transfusions to relieve symptoms associated with anemia, with transfusions triggered by hemoglobin level. It is not known if patients' quality of life (QOL) improves after transfusion, nor if peri-transfusion QOL assessment (PTQA) can guide future transfusion decisions. null Study design and methods null We conducted a prospective pilot study of adults with MDS at three centers. Participants, who had to have hemo...
Last. Salwa Hindawi(KAU: King Abdulaziz University)H-Index: 11
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Abstract null null Background null The Coronavirus- 19 disease pandemic had a significant impact on the blood supply around the world. Physical distancing measures and many other factors contribute to this impact. Misinformation about methods of disease transmission and lack of knowledge among potential blood donors may contribute to this. null null null Aim null To assess the knowledge and awareness of blood donors about COVID-19 as well as their reasons and fears that prevent them from donatin...
Patient blood management (PBM) has been proposed as a standard of care in modern perioperative medicine. PBM-related interventions usually are implemented as bundles, but randomized controlled trials on the implementation of PBM as a bundle are missing. This special article focuses on the current evidence and controversies in the clinical practice of PBM and on emerging data related to specific PBM-related interventions in patients undergoing cardiac surgery. Strong evidence for many PBM-related...
BACKGROUND AND OBJECTIVES: Shortage of blood during the severe acute respiratory syndrome-COV-2 (SARs-COV-2) pandemic impacted transfusion practice null The primary aim of the study is to assess management of acute haemolytic crisis (AHC) in glucose-6-phosphate dehydrogenase(G6PD)- deficient children during SARs-COV-2 pandemic, and then to assess blood donation situation and the role of telemedicine in management null METHODS: Assessment of G6PD-deficient children attending the Emergency Departm...
About 15 years ago, Patient Blood Management (PBM) emerged as a new paradigm in perioperative medicine and rapidly found support of all major medical societies and government bodies. Blood products are precious, scarce and expensive and their use is frequently associated with adverse short- and long-term outcomes. Recommendations and guidelines on the topic are published in an increasing rate. The concept aims at using an evidence-based approach to rationalize transfusion practices by optimizing...
Objectives We evaluated how the Severe Acute Respiratory disease from Coronavirus 2 (SARS-CoV-2) epidemic impacted transfusion services, transfusion support required by Covid-19 patients and their clinical outcome. Background In Italy, the first confirmed case of SARS-CoV-2 infection was registered on 21 February 2020. As of 20 April, about 250 000 cases were registered, 1143 of which were in the province of Pescara. Methods We compared transfusion services provided by the blood centre of Pescar...
#1Ian Kracalik(CDC: Centers for Disease Control and Prevention)H-Index: 4
#2Sanjida Mowla(ORISE: Oak Ridge Institute for Science and Education)H-Index: 1
Last. Sridhar V. Basavaraju(CDC: Centers for Disease Control and Prevention)H-Index: 21
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INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare services worldwide. However, little has been reported regarding the impact on blood utilization. We quantified the impact of COVID-19 on blood utilization and discards among facilities reporting to the National Healthcare Safety Network Hemovigilance Module. METHODS: Facilities continuously reporting data, during January 2016-June 2020, on transfused and discarded blood components, stratified by component typ...