Abstract:IMPORTANCE
The association between red blood cell (RBC) transfusion strategies and health care–associated infection is not fully understood.
OBJECTIVE
To evaluate whether RBC transfusion thresholds are associated with the risk of infection and whether risk is independent of leukocyte reduction.
DATA SOURCES
MEDLINE, EMBASE, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, Cochrane Database of Sytematic Reviews, ClinicalTrials.gov, International Clinical Trials Registry, and t… Show more
“…In a recent meta-analysis, Rohde found no statistically significant difference in risk of infection associated with a restrictive transfusion strategy [restrictive vs. liberal, RR 1.30 (CI95% 0.85, 1.97)]. 17 Nonetheless, other strategies may exist to reduce the delivery of RBC transfusions. Clinical teams may consider discharging stable inpatients to increase their preoperative hemoglobin level.…”
Background-Pneumonia, a known complication of coronary artery bypass (CABG) surgery, significantly increases a patient's risk of morbidity and mortality. While not well characterized, red blood cell transfusions (RBC) may increase a patient's risk of pneumonia. We describe the relationship between RBC transfusion and post-operative pneumonia after CABG surgery.
“…In a recent meta-analysis, Rohde found no statistically significant difference in risk of infection associated with a restrictive transfusion strategy [restrictive vs. liberal, RR 1.30 (CI95% 0.85, 1.97)]. 17 Nonetheless, other strategies may exist to reduce the delivery of RBC transfusions. Clinical teams may consider discharging stable inpatients to increase their preoperative hemoglobin level.…”
Background-Pneumonia, a known complication of coronary artery bypass (CABG) surgery, significantly increases a patient's risk of morbidity and mortality. While not well characterized, red blood cell transfusions (RBC) may increase a patient's risk of pneumonia. We describe the relationship between RBC transfusion and post-operative pneumonia after CABG surgery.
“…However, these findings have been updated recently to include trials published after 2012 and now show that the risk of infection is significantly lower in the restrictive transfusion group (relative risk ϭ 0.82; 95% confidence interval, 0.72-0.95). 27 These findings are borderline significant and could change when the next large trial is published. However, what is important is that these studies show unequivocally that using a liberal transfusion strategy does not improve outcome in these clinical settings.…”
Substantial progress has been made in our understanding of the risks and benefits of RBC transfusion through the performance of large clinical trials. More than 7000 patients have been enrolled in trials randomly allocating patients to higher transfusion thresholds (ϳ9-10 g/dL), referred to as liberal transfusion, or lower transfusion thresholds (ϳ7-8 g/dL), referred to as restrictive transfusion. The results of most of the trials suggest that a restrictive transfusion strategy is safe and, in some cases, superior to a liberal transfusion strategy. However, in patients with myocardial infarction, brain injury, stroke, or hematological disorders, more large trials are needed because preliminary evidence suggests that liberal transfusion might be beneficial or trials have not been performed at all.
Learning Objective• To understand the clinical trial evidence that has evaluated the effect of blood transfusion on mortality and morbidity
“…Furthermore, using blood plasma, platelets, and frozen blood, a supply chain mechanism has been invented for the supply of blood products [21]. During the blood transfusion of hospitalized patients, the implementation of restrive method strategies has proved to have the capability to decrease the severe health-care infections [22]. Blood transfusion not only has improved the lifespan but also frequent transfusions will lead to a major clinical complication in the treatment [18].…”
Blood is a liquid tissue, in which abundant chemical factors and millions of different cells are dissolved. It is one of the most demanding sources in clinical and medical aspects. The issues and cost of human blood collection and storage directed this procedure toward the use of alternative blood. Thus, came an invention of artificial blood and blood substitutes. These alternative blood or blood substitute is a substance which is made to play as a substitute of erythrocytes. Thus, the main objective is to replace the normal human blood with artificial blood substitutes in the place of blood transfusion during surgeries and organ transfusion. Two major and focused blood substitutes in pharmaceutical aspects are perfluorocarbons and hemoglobin-based oxygen carriers (HBOC's). Among these HBOCs vaguely resemble normal human blood. These blood substitutes are to allow flow through the blood stream to carry the oxygen and supply it to heart and other parts of the blood. They are used to fill the lost fluid volume. They are also called as plastic blood with iron atom as the base. They are found to serve as a good oxygen carrier. The results showed by these products are discussed, and they proved that they can act as a blood substitute and also they can reach the human tissue easier than erythrocytes and can control oxygen directly. However, these artificial blood products are being processed in research laboratories for good outcome. Their important functions are oxygen carrying capacity and to replace the lost blood volume in the human body. Their special features are survivability over a wider range of temperatures, eliminating cross matching, cost efficient, pathogen free, long shelf life, minimal side effects. Thus, artificial blood products are really a good alternative source which we need for replacing normal human blood.
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