In Search of the Transfusion Trigger

Carson, Jeffrey L.; Chen, Arnold Y.

doi:10.1097/00003086-199812000-00005

Cited by 22 publications

(10 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(24,25) Among such studies, was a report about patients who did not receive a transfusion because of religious reasons. Even if their hemoglobin value was not within the normal range, if the intravascular volume was maintained, they could survive.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Preoperative Blood Transfusion in Stomach Cancer

Kim¹,

Lee²,

Noh³

2010

J Gastric Cancer

View full text Add to dashboard Cite

PurposeWe did a retrospective study to understand the prognostic effects of preoperative blood transfusions in stomach cancer surgery.Materials and MethodsData for 1,360 patients who underwent gastrectomy for stomach cancer between 2001 and 2009 were retrospectively reviewed. We analyzed factors that affect preoperative transfusion and clinicopathologic features. We also analyzed 5-year and overall survival rates of the transfusion and non transfusion subgroups.ResultsSixty patients (4.4%) required blood transfusion within the preoperative period. The transfused group included patients who took aspirin or clopidogrel (P<0.001), with more advanced T stages (P<0.001), with more advanced nodal metastasis (P=0.00), and with more advanced stages (P=0.00) than the non transfusion group. On multivariate analysis, preoperative transfusion was a statistically significant negative influence on 5-year survival and overall survival rates (58.2% vs 79.9% (P=0.00), 58.2% vs 76.8% (P=0.00)). Applying Cox-regression analyses, blood transfusion did appear to have an effect on prognosis and on 5-year and overall survival rates.ConclusionsWe found a direct negative relation between preoperative transfusion and long term prognosis in patients receiving gastric cancer surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Preoperative Blood Transfusion in Stomach Cancer

Kim¹,

Lee²,

Noh³

2010

J Gastric Cancer

View full text Add to dashboard Cite

show abstract

“…At present, in the absence of ischemic heart disease, a trigger of < 8 g/dL is used by many to good effect. [12][13][14][16][17][18][19][20] It is important to note that the transfusion studies look at populations undergoing procedures associated with very low mortality rates and low incidences of myocardial infarction, and therefore it is unsurprising that few are seen. The lack of overt morbidity has resulted in a degree of complacency about the certainty of declaring that low hemoglobin values carry little, if any, risk.…”

Section: P R E O P E R At I V E T R a N S F U S I O Nmentioning

confidence: 99%

The benefits of allogeneic erythrocyte transfusion: what evidence do we have?

Soni

Thomas

2008

Transfus Alt Transfus Med

View full text Add to dashboard Cite

SUMMARY Restrictive 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.

show abstract

“…One must also consider the hazards of allogeneic blood transfusion, which range from minor complications to major potential health risks including transmission of blood-borne infections, allergic reactions, immune-modulatory effects and human errors in administering the blood [11]. The drains are used mainly to prevent haematoma formation after surgery.…”

Section: Introductionmentioning

confidence: 99%