Transfusion alternatives in transfusion medicine : TATM最新文献_第6页

Prevalence of preoperative anemia and hematinic deficiencies in patients scheduled for elective major orthopedic surgery 择期骨科大手术患者术前贫血和血凝缺乏症的发生率

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-12-01 DOI: 10.1111/J.1778-428X.2008.00118.X

E. Bisbe, J. Castillo, M. Sáez, X. Santiveri, A. Ruiz, M. Muñoz

{"title":"Prevalence of preoperative anemia and hematinic deficiencies in patients scheduled for elective major orthopedic surgery","authors":"E. Bisbe, J. Castillo, M. Sáez, X. Santiveri, A. Ruiz, M. Muñoz","doi":"10.1111/J.1778-428X.2008.00118.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2008.00118.X","url":null,"abstract":"SUMMARY \u0000 \u0000 \u0000Preoperative anemia is an independent risk factor for allogeneic blood transfusion in patients undergoing major orthopedic surgery (MOS) whereas hematinic deficiency can delay the recovery from postoperative anemia. Both conditions can, however, be corrected before elective procedures are undertaken. We therefore evaluated the prevalence of anemia and hematinic deficiencies in MOS patients. Demographic and laboratory data were gathered from all MOS patients from a single institution between January 2001 and December 2002. A total of 715 patients (483 women/232 men) entered the study. According to WHO criteria, the prevalence of anemia was 10.5% and increased with age, without gender-related differences. Preoperative hemoglobin was < 13 g/dL in 19.4% of patients, and the prevalence of hematinic deficiencies was 33% for iron, 12.3% for vitamin B12 and 3% for folate. In anemic patients, there were 30.8% with hematinic deficiency anemia (20% with iron-deficiency anemia), 30.8% with anemia of chronic disease and 38.4% with anemia of mixed or indeterminate cause. The prevalence of anemia, as well as of hematinic deficiencies, is high in MOS patients. Therefore, whenever possible, patients undergoing MOS should be assessed early enough to allow for proper investigation and treatment prior to the scheduled procedure.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"166-173"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2008.00118.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389699","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}

引用次数: 47

Anemia, chronic renal disease and chronic heart failure: the cardiorenal anemia syndrome 贫血、慢性肾病和慢性心力衰竭:心肾性贫血综合征

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-12-01 DOI: 10.1111/J.1778-428X.2008.00120.X

D. Silverberg, D. Wexler, A. Iaina, D. Schwartz

{"title":"Anemia, chronic renal disease and chronic heart failure: the cardiorenal anemia syndrome","authors":"D. Silverberg, D. Wexler, A. Iaina, D. Schwartz","doi":"10.1111/J.1778-428X.2008.00120.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2008.00120.X","url":null,"abstract":"SUMMARY \u0000 \u0000 \u0000The mortality and morbidity of congestive heart failure (CHF) have improved slightly over the years but are still very high. Many patients with CHF are anemic, which raises the question, ‘Could uncontrolled anemia be a cause?’ The anemia is associated with more severe CHF and higher mortality, hospitalization and morbidity rates. The only way to prove that anemia is causing this worsening of CHF is to correct it. We review here some of the published papers about correction of anemia. Many, but not all, show a positive effect of erythropoietin or its derivatives when coadministered with oral or intravenous (IV) iron, with improvements in left and right ventricular systolic and diastolic function, dilation, hypertrophy, renal function, New York Heart Association class, exercise capacity, oxygen utilization, caloric intake, quality of life, and the activity of endothelial progenitor cells. A reduction in hospitalizations, diuretic dose, pulmonary artery pressure, plasma volume, heart rate, serum brain natriuretic peptide levels, the inflammatory marker interleukin 6, and soluble Fas ligand (a mediator of apoptosis) were also observed. Iron deficiency may also play an important role in this anemia because improvement in CHF has been seen with IV iron treatment alone. We call the interaction between chronic renal failure, CHF and anemia the cardiorenal anemia syndrome. Each of these three elements causes or exacerbates the others, and their correction can prevent the progression of both renal and heart failure. However, until ongoing large placebo-controlled studies on darbepoetin alpha or IV iron are completed, we will not know whether these treatments really influence the outcome of renal failure and CHF.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"189-196"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2008.00120.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389280","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}

引用次数: 4

Wound drainage with or without blood salvage? An open, prospective, randomized and single-center comparison of blood loss, postoperative hemoglobin levels and allogeneic blood transfusions after major hip surgery 伤口引流是否有血液抢救?一项开放、前瞻性、随机和单中心比较髋关节大手术后失血、术后血红蛋白水平和异体输血

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-12-01 DOI: 10.1111/J.1778-428X.2009.00121.X

R. Slappendel, W. Horstmann, R. Dirksen, G. V. Hellemondt

{"title":"Wound drainage with or without blood salvage? An open, prospective, randomized and single-center comparison of blood loss, postoperative hemoglobin levels and allogeneic blood transfusions after major hip surgery","authors":"R. Slappendel, W. Horstmann, R. Dirksen, G. V. Hellemondt","doi":"10.1111/J.1778-428X.2009.00121.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2009.00121.X","url":null,"abstract":"SUMMARY \u0000 \u0000The objectives of the study were to compare an autologous blood salvage low-vacuum drainage system with a high-vacuum drainage system with regard to blood loss, postoperative hemoglobin levels and need for allogeneic transfusion. The study was an open, randomized, prospective and single-center trial. Two hundred patients scheduled for revision total hip surgery were randomized to either the Bellovac ABT (autologous blood salvage, low vacuum) or the Medinorm AG (high vacuum) drainage system. Blood loss, transfusion volumes and hemoglobin levels were measured during the whole postoperative period. No statistically significant differences were detected between the two drainage systems with regard to transfusion rate, blood loss and adverse events. The hemoglobin decrease during the first postoperative day was statistically significantly less in the Bellovac ABT group (P = 0.0111). Postoperative hemoglobin concentrations were found to be higher in the Bellovac ABT group compared with the Medinorm group at day 1. In addition, the Bellovac ABT system offers a possibility of transfusion of postoperatively salvaged blood that may decrease the need for allogeneic blood transfusion.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"174-181"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2009.00121.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389321","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}

引用次数: 10

Editorial: preoperative anemia – real but neglected 社论:术前贫血——真实但被忽视

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-12-01 DOI: 10.1111/J.1778-428X.2008.00119.X

A. Maniatis

引用次数: 0

The benefits of allogeneic erythrocyte transfusion: what evidence do we have? 异基因红细胞输血的益处:我们有什么证据?

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-09-01 DOI: 10.1111/J.1778-428X.2008.00111.X

N. Soni, B. Thomas

{"title":"The benefits of allogeneic erythrocyte transfusion: what evidence do we have?","authors":"N. Soni, B. Thomas","doi":"10.1111/J.1778-428X.2008.00111.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2008.00111.X","url":null,"abstract":"SUMMARY \u0000 \u0000 \u0000Restrictive blood transfusion practice has modified the indications for blood transfusion. There is still a need for succinct definition of transfusion thresholds in different situations, based on physiological argument balancing the mechanisms by which blood is potentially beneficial against the deleterious effects of transfusion, whether known, speculative or unknown. The latter still need identification. The key physiological benefit is through oxygen delivery and thereby the provision of a margin of safety in tissue oxygenation. This can be achieved by a range of methods that safeguard blood volume, conserve blood or increase hemoglobin as well as by transfusion, and in many situations conservation methods can or could now preclude transfusion. There are still acute and less controlled or controllable situations where conservation methods are difficult to implement or may need to be complemented by transfusion. These are the indications that still need clarification. Difficult and confusing areas of practice include the management of patients with ischemic heart disease. This is a potential driver for transfusion to prevent ischemia, but clarity of efficacy or detriment is elusive beyond acknowledging that both too high and too low hemoglobin values are detrimental. The issue in all clinical situations, whether acute or chronic, is to continue to reevaluate the safety of current thresholds. This will help limit blood usage and ensure that blood is used when necessary but not otherwise.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"147-159"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2008.00111.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389535","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}

引用次数: 2

Editorial: allogeneic blood usage – risks and benefits 社论:异体血液的使用——风险和益处

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-09-01 DOI: 10.1111/J.1778-428X.2008.00115.X

M. Contreras

引用次数: 0

Current Information on the Infectious Risks of Allogeneic Blood Transfusion 异基因输血感染风险的最新信息

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-09-01 DOI: 10.1111/J.1778-428X.2008.00112.X

A. Kitchen, J. Barbara

{"title":"Current Information on the Infectious Risks of Allogeneic Blood Transfusion","authors":"A. Kitchen, J. Barbara","doi":"10.1111/J.1778-428X.2008.00112.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2008.00112.X","url":null,"abstract":"SUMMARY \u0000 \u0000 \u0000The safety of allogeneic blood and blood products in relation to infection risk is paramount, even though absolute safety is an ideal that clearly cannot be attained. In countries with developed healthcare systems and with effective and well-managed national transfusion services, any residual infection risk is generally much lower than the risk of non-infectious adverse events. The number of infectious agents known to be transmitted by transfusion is not insignificant, but at the same time only a proportion of these present a significant universal threat. It is therefore important to understand and attempt to quantify the residual infectious risks associated with transfusion. These risks generally fall into two categories: the risk of infection because of the failure to identify infection in a donation from a recently infected donor and the risk of infection from a ‘new’ infectious agent or from one that donations are not routinely screened for. Both of these scenarios are ‘real’ in the sense that these are the threats faced every day by transfusion services. The mitigation of such threats is by ensuring that there are effective donor screening and deferral procedures in place, that the screening performed is carried out to the highest possible standards in terms of sensitivity and reliability, and finally that the transfusion service actively monitors ‘new’ or emerging infectious threats so that action can be taken if the safety of the blood supply is likely to be compromised, as well as maintaining hemovigilance of adverse events in recipients of transfusions.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"102-111"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2008.00112.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389547","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}

引用次数: 21

Immunomodulation and Allogeneic Blood Transfusion 免疫调节和异体输血

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-09-01 DOI: 10.1111/J.1778-428X.2008.00114.X

M. Waanders, L. Watering, A. Brand

{"title":"Immunomodulation and Allogeneic Blood Transfusion","authors":"M. Waanders, L. Watering, A. Brand","doi":"10.1111/J.1778-428X.2008.00114.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2008.00114.X","url":null,"abstract":"SUMMARY \u0000 \u0000Allogeneic blood transfusions expose a patient to many soluble and cell-bound antigens, expressed on viable and decaying cells. In particular, contaminant leukocytes are presumed to play an important role interacting with the recipient's immune system. This immune response to transfusions is influenced by the condition of the patient, and a patient in steady state will respond differently to a patient in hemorrhagic shock, under anesthesia or after surgical tissue injury. Blood transfusions affect both the innate immediate defense immune system and the adaptive immune response, the latter often resulting in antibodies and (less well characterized) cellular immunity. Removal of allogeneic leukocytes by filtration of red cells and platelet products significantly reduces febrile non-hemolytic transfusion reactions and the formation of leukocyte antibodies, causing refractoriness to platelet transfusions. However, an effect of leukocyte-containing transfusions on cellular immune functions relevant to transplant tolerance, cancer surveillance, viral replication or susceptibility to nosocomial infections is less obvious. Randomized studies showed a significant effect of removal of allogeneic leukocytes in blood transfused to cardiac surgery patients, reducing postoperative mortality. As for the other reported clinical effects of (passenger) leukocytes in blood transfusions, there is not yet sufficient evidence.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"127-138"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2008.00114.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389601","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}

引用次数: 5

Immunological complications of blood transfusion 输血的免疫并发症

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-09-01 DOI: 10.1111/J.1778-428X.2008.00116.X

C. Taylor, C. Navarrete, M. Contreras

{"title":"Immunological complications of blood transfusion","authors":"C. Taylor, C. Navarrete, M. Contreras","doi":"10.1111/J.1778-428X.2008.00116.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2008.00116.X","url":null,"abstract":"SUMMARY In the developed world, most of the reported complications of transfusion have an immunological basis. Although the media and the public are worried about the infectious risks of transfusion, hemovigilance reports show that antigen–antibody reactions are responsible for the vast majority of acute and delayed transfusion reactions. Among the immediate complications of transfusion, the most common and serious are intravascular hemolytic transfusion reactions because of ABO incompatibility caused by giving the wrong blood to a patient (e.g. group A blood to a group O recipient). Fortunately, the vast majority of ABO-incompatible transfusions do not lead to major morbidity or mortality. Another important cause of severe immediate transfusion reactions is transfusion-related acute lung injury (TRALI), caused by white cell antibodies in donor plasma. The most common, although not severe, acute tansfusion reactions are urticaria and febrile, nonhemolytic, mostly preventable by leukodepletion and leukoreduction. Delayed transfusion reactions are: (i) hemolytic, caused by anamestic responses to red cell antigens, causing hemolysis days after the transfusion; (ii) post-transfusion purpura, caused by an anmnestic response to platelet antigens; (iii) graft-versus-host disease, caused by engrafted donor lymphocyte reacting against the recipient; and (iv) immunological refractoriness to platelet transfusions, caused mostly by human leukocyte antigen antibodies destroying transfused platelets. The diagnosis of most of these complications can now be made by immunohematologists, with the aid of specialist reference laboratories, thus enabling prompt therapy as required.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"112-126"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2008.00116.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389643","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}

引用次数: 19

Pathogen inactivation of blood components 血液成分致病菌灭活

Transfusion alternatives in transfusion medicine : TATM Pub Date : 2008-09-01 DOI: 10.1111/J.1778-428X.2008.00113.X

C. Prowse

{"title":"Pathogen inactivation of blood components","authors":"C. Prowse","doi":"10.1111/J.1778-428X.2008.00113.X","DOIUrl":"https://doi.org/10.1111/J.1778-428X.2008.00113.X","url":null,"abstract":"SUMMARY \u0000 \u0000 \u0000Blood donations are screened for infectious agents of concern, but this approach is always challenged when a new infection is identified. Ideally, each donation or blood component would be treated to inactivate pathogens, as is now done for fractionated plasma products. Technology that allows this is now being developed for red cell and platelet products, and has been available for some time for whole plasma. For plasma and platelets, clinical trials have been completed and show some loss of potency as a result of treatment to reduce pathogens. Most of the methods developed arte effective against lipid-enveloped viruses and bacteria but less so for non-enveloped viruses. \u0000 \u0000 \u0000 \u0000Some European countries have already implemented provision of pathogen-reduced plasma and are in the process of large-scale field evaluations of platelet technologies, now that these are licensed (CE marked) in Europe. As yet there is no licensed technology for pathogen reduction of red cells, and no licenses for component pathogen reduction are in place in the USA. \u0000 \u0000 \u0000 \u0000Cost-effectiveness of pathogen reduction is very poor if one bases assessment only on those pathogens for which mandatory screening is already in place, as the residual risks of infection are already very low. However, if other factors such as emerging infections, bacterial contamination or the risk of transfusion-related acute lung injury are also included in the evaluation, the economic case becomes more attractive.","PeriodicalId":90375,"journal":{"name":"Transfusion alternatives in transfusion medicine : TATM","volume":"10 1","pages":"139-146"},"PeriodicalIF":0.0,"publicationDate":"2008-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/J.1778-428X.2008.00113.X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"63389591","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}

引用次数: 5