Transfusion alternatives in transfusion medicine : TATM最新文献

{"title":"Editorial: should we be more balanced, more ‘starched’ and more optimized?: EDITORIAL","authors":"P. Coriat","doi":"10.1111/J.1778-428X.2010.01138.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01138.X","url":null,"abstract":"","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2010-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01138.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Recent advances in perioperative volume replacement therapy through a more physiological approach of the high-risk surgical patient","authors":"P. Linden","doi":"10.1111/J.1778-428X.2010.01142.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01142.X","url":null,"abstract":"","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"83-84"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01142.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic parameters to guide fluid therapy: HEMODYNAMIC PARAMETERS TO GUIDE FLUID THERAPY","authors":"P. Marik","doi":"10.1111/J.1778-428X.2010.01133.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01133.X","url":null,"abstract":"SUMMARY \u0000The 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 reported that have used heart–lung interactions during mechanical ventilation to assess fluid responsiveness. Specifically, the pulse pressure variation derived from analysis of the arterial waveform, the stroke volume variation derived from pulse contour analysis and the variation of the amplitude of the pulse oximeter plethysmographic waveform have been shown to be highly predictive of fluid responsiveness. While the left ventricular end-diastolic area as determined by transesophageal echocardiography is a more accurate measure of preload than either the central venous pressure or pulmonary artery occlusion pressure, it does not predict fluid responsiveness as well as the dynamic indices. This paper reviews the evolution and accuracy of methods for assessing fluid responsiveness in patients in the ICU and operating room.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"102-112"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01133.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crystalloids versus colloids: the end of an old debate?: CRYSTALLOIDS VERSUS COLLOIDS","authors":"J. Boldt","doi":"10.1111/J.1778-428X.2010.01139.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01139.X","url":null,"abstract":"SUMMARY \u0000 \u0000The ‘ideal’ plasma substitute for volume replacement remains a matter of dispute. Merits and demerits of colloids versus crystalloids for volume replacement have been discussed very emotionally. Are we any wiser concerning the crystalloid/colloid problem? Recently published meta-analyses or evidence-based medicine analyses appear to be less helpful to solve this problem. Conflicting results from different studies are most likely as a result of variations in clinical protocols, selection of patients, criteria for blood or volume administration. With their conflicting results more questions arise than answers are given.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"118-126"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01139.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the glycocalyx in transvascular fluid shifts: GLYCOCALYX AND FLUID SHIFTS","authors":"M. Paptistella, D. Chappell, K. Hofmann-Kiefer, T. Kammerer, P. Conzen, M. Rehm","doi":"10.1111/J.1778-428X.2010.01143.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01143.X","url":null,"abstract":"SUMMARY \u0000 \u0000Perioperative fluid management and fluid shifting have been main topics of debate in the recent years. Liberal fluid application is still a common practice and fluid overload believed to be a minor problem. Recent studies, however, have shown that liberal fluid management facilitates fluid shifts into the interstitial space especially in the context of major abdominal surgery. Consequently, the integrity of the vascular barrier is a rediscovered target of research. The endothelial glycocalyx, which covers the endothelial cells on the luminal side of every healthy vessel, plays a key role concerning the barrier properties of healthy blood vessels. Together with bound plasma proteins the glycocalyx forms the endothelial surface layer with a thickness of about 1 µm. With these packed proteins, this layer has its own colloid osmotic force. Damage of the endothelial glycocalyx can lead to protein extravasation and tissue edema. The endothelial glycocalyx is also important concerning leukocyte and platelet adhesion and shear-stressed nitric oxide-release and therefore, very probably, with regard to the pathophysiology of diseases like sepsis and ischemia/reperfusion injury. The purpose of this review is to elucidate the physiological and functional impact of the endothelial glycocalyx in transvascular fluid shifts.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"92-101"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01143.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue oxygenation parameters to guide fluid therapy: OXYGEN-DERIVED PARAMETERS AND FLUID THERAPY","authors":"B. Vallet, E. Futier, E. Robin","doi":"10.1111/J.1778-428X.2010.01140.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01140.X","url":null,"abstract":"SUMMARY \u0000 \u0000Because tissue hypoxia is a key trigger for organ dysfunction, adequacy of oxygen delivery (DO2) to tissue oxygen metabolic demand is essential during the perioperative period. Optimization of DO2, using either or both fluid loading and inotropic support, to prevent tissue hypoxia in relation to increased oxygen consumption (VO2), could improve outcome. In this context, the use of central venous oxygen saturation (ScvO2), which reflects important changes in the DO2/VO2 relationship and of central venous-to-arterial carbon dioxide difference [P(cv-a)CO2], to address adequacy of oxygen utilization, has shown promising results. The threshold value for ScvO2 at which the risk of impaired tissue oxygenation can be discarded might remain out of reach and the complementary use of P(cv-a)CO2 would provide help to adjust the right DO2 to both VO2 and CO2 production. When applying this dual view, and increasing cardiac output to lower P(cv-a)CO2 below 6 mmHg, the adapted ScvO2 is closer to 73% or 75%.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"113-117"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01140.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative fluid losses revisited","authors":"C. Svensen","doi":"10.1111/J.1778-428X.2010.01141.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01141.X","url":null,"abstract":"SUMMARY \u0000Intravenous fluid therapy is an essential element of surgical procedures. However, consensus regarding the optimal volume and composition of fluid is still lacking. Despite increasing evidence that aggressive crystalloid-based resuscitation is associated with several complications large volumes are still used peroperatively. The aim of this paper is to investigate the pathophysiology behind fluid losses and how to best administer peroperative fluids in appropriate amounts.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"37 1","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01141.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63397330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granulocyte mobilization, collection and transfusion - where do we stand?","authors":"R. Moog","doi":"10.1111/J.1778-428X.2010.01131.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01131.X","url":null,"abstract":"SUMMARY \u0000 \u0000Bacterial 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 studies that have examined granulocyte function in concentrates focused on the assessment of viability, chemotaxis, phagocytosis and oxidative burst and showed that granulocyte colony-stimulating factor-mobilized granulocytes can be stored prior to transfusion. Evidence-based benefit of granulocyte transfusion is still lacking and randomized controlled studies are necessary to prove the efficacy of granulocyte transfusion in the era of improved antibacterial and antifungal agents.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2010-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01131.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative anemia in elective cardiac surgery: prevalence, risk factors, and influence on postoperative outcome: PREOPERATIVE ANEMIA IN CARDIAC SURGERY","authors":"M. Muñoz, D. Ariza, S. Gómez‐Ramírez, P. Hernández, J. García-Erce, S. Leal-Noval","doi":"10.1111/J.1778-428X.2010.01126.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01126.X","url":null,"abstract":"SUMMARY \u0000 \u0000Preoperative anemia in patients undergoing cardiac surgery is associated with a higher transfusion risk and poorer outcomes. This retrospective study was undertaken to assess the prevalence of preoperative anemia and its associated risk factors, as well as its influence on postoperative outcomes, in 576 patients undergoing elective cardiac surgery (52.3% with cardiopulmonary bypass) for myocardial revascularization, valve replacement, coronary + valve, or miscellaneous pathology at a single institution. Perioperative data were reviewed according to the presence or absence of preoperative anemia (hemoglobin < 13 g/dL for men, hemoglobin < 12 g/dL for women). Overall, 210 patients (36.5%) presented with anemia. Logistic regression analysis revealed that age, chronic kidney disease, and consumption of proton pump inhibitors histamine H2 receptor antagonists and diuretics were independent risk factors for the presence of preoperative anemia. Postoperatively, anemic patients received transfusions and inotropic support and stayed longer than 4 days in the recovery unit more frequently than non-anemic patients, but there were no differences in the composite outcome variable (stroke, myocardial infarction, renal failure or death). 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.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"47-56"},"PeriodicalIF":0.0,"publicationDate":"2010-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01126.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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","authors":"Erhabor Osaro, C. Njemanze","doi":"10.1111/J.1778-428X.2010.01132.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2010.01132.X","url":null,"abstract":"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 transfusiontransmissible 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 indicated in patients with rare blood groups or complex red cell antibodies, comes handy for some religious sect like the Jehovah’s Witnesses as well as being suitable in a significant number of patients undergoing elective surgeries. Autologous transfusion improves postoperative microcirculation, tissue perfusion and reduces the risk of thromboembolism. Benchmarking transfusion activity, ensuring that it is clinically indicated and justified, will help eliminate inappropriate use of blood products and help conserve our allogeneic blood stock. Erythropoietin (EPO) has drastically and significantly altered red cell transfusion practices. There might be many patients groups who would benefit from the use of EPO analogues and thus help conserve the allogeneic blood stock for patients in whom EPO is contraindicated. There is need to formulate policies on ways to seriously and innovatively attract and retain new donors. The National Blood Service and indeed the Department for Health can do well by promoting the use of autologous blood and other alternatives therapies to complement the UK allogeneic blood transfusion program in a bid to solving the periodic and envisage future shortages in allogeneic blood particularly with an aging UK population and increasing concerns about safety arising from old and emerging transfusion-transmissible infections. This will maximize the use of the limited allogeneic blood resource particularly for patients in whom autologous blood transfusion is contraindicated. Transfusion Alternatives in Transfusion Medicine TATM","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"11 1","pages":"72-81"},"PeriodicalIF":0.0,"publicationDate":"2010-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2010.01132.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}