Management of the patient presenting with anaemia in the preoperative setting

Abeysiri, Sandaruwani; Chau, Marisa; Highton, David; Richards, Toby

doi:10.1016/j.transci.2019.06.014

Cited by 6 publications

(5 citation statements)

References 33 publications

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“…There still remains controversial regarding the optimal treatment strategy for TBF. Currently, neurological deficit is deemed as a potential surgical indication to decompress neurologic tissues for recovery [2]. However, the timing of surgical decompression and stabilization is another big controversy that still lacks of strong clinical evidence [3].…”

Section: Introductionmentioning

confidence: 99%

The influence of topical use of tranexamic acid in reducing blood loss on early operation for thoracolumbar burst fracture: a randomized double-blinded controlled study

Shen

Yang

et al. 2020

Eur Spine J

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Purpose To investigate the safety and efficacy of topical use of tranexamic acid (TXA) on early operation for thoracolumbar burst fracture (TBF). Methods Patients with acute TBF requiring early decompression were prospectively collected. The enrolled patients were randomly assigned to TXA and control group, in which wound surface was soaked with TXA or the same volume of normal saline for 5 min after wound incision, respectively. The total blood loss (TBL), intraoperative blood loss (IBL), postoperative blood loss (PBL), hemoglobin (HGB) levels on preoperatively (pre-op) and postoperatively, and amount of allogenic blood transfusion were recorded. Furthermore, the general information was also compared between groups. Results There were 39 and 37 patients enrolled in TXA and control group for final analysis. The demographics data showed no significant difference between groups (P > 0.05), but operation time and IBL were significantly decreased in TXA group (P < 0.05). Further analysis showed that HGB level was significantly higher in the TXA group at POD1, while the TBL and PBL were significantly less than those in the control group (P < 0.05), but similar to HBL (P > 0.05). The postoperative ambulation time, removal time of drainage tube, length of hospital stay, and blood transfusion rate were also significantly less in TXA group (P < 0.05). At the final follow-up, no neurological deteriorations and no TXA-related complications were observed in both groups. Conclusion This RCT first demonstrated that topical TXA usage after wound incision could effectively reduce IBL without increasing risk of complications, beneficial to enhanced recovery after early operation for TBF.

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Section: Introductionmentioning

confidence: 99%

The influence of topical use of tranexamic acid in reducing blood loss on early operation for thoracolumbar burst fracture: a randomized double-blinded controlled study

Shen

Yang

et al. 2020

Eur Spine J

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“…In case of bleeding modern algorithms of bleeding management should be used. The rising popularity achieve today patient blood management programs [ 60 ], that may change common practice patterns and reduce the necessity of allogenic perioperative blood transfusion [ 61–63 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis on the Role of Perioperative Blood Transfusion in Patients Undergoing Radical Cystectomy for Urothelial Carcinoma

Kochergin

Fahmy

Esken

et al. 2022

BLC

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BACKGROUND: Radical cystectomy (RC) is the standard of care in patients with muscle-invasive bladder cancer. The impact of perioperative red blood cell (RBC) transfusion on oncological outcomes after RC is not clearly established as the existing publications show conflicting results. OBJECTIVES: The aim of this systematic review and meta-analysis was to investigate the prognostic role of perioperative RBC transfusion on oncological outcomes after RC. METHODS: Systematic online search on PubMed was conducted, based on PRISMA criteria for publications reporting on RBC transfusion during RC. Publications with the following criteria were included: (I) reported data on perioperative blood transfusion; (II) Reported Hazard ratio (HR) and 95% -confidence interval (CI) for the impact of transfusion on survival outcomes. Primary outcome was the impact of perioperative RBC transfusion on recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Risk of bias assessment was performed using Newcastle-Ottawa Scale. Statistical analysis was performed using Revman 5.4 software. RESULTS: From 27 primarily identified publications, 19 eligible articles including 22897 patients were selected. Perioperative RBC transfusion showed no impact on RFS (Z = 1.34; p = 0,18) and significant negative impact on CSS (Z = 2.67; p = 0.008) and OS (Z = 3.22; p = 0.001). Intraoperative RBC transfusion showed no impact on RFS (Z = 0.58; p = 0.56) and CSS (Z = 1.06; p = 0.29) and OS (Z = 1.47; p = 0.14). Postoperative RBC transfusion showed non-significant trend towards improved RFS (Z = 1.89; p = 0.06) and no impact on CSS (Z = 1.56; p = 0.12) and OS (Z = 0.53 p = 0.60). CONCLUSION: In this meta-analysis, we found perioperative blood transfusion to be a significant predictor only for worse CSS and OS but not for RFS. This effect may be determined by differences in tumor stages and patient comorbidities for which this meta-analysis cannot control due to lack of respective raw data.

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“…Allogeneic transfusion has long been used to correct perioperative anemia. However, for the purpose of safety of blood transfusion itself, as well as due to limited resources and limited blood supply, modern transfusion tends to avoid this type of treatment for anemia [20]. It has been found that 30.4% (in some populations up to 75%) of patients had anemia of various grade in the preoperative period, that the risk of postoperative complications in these patients was 35% higher (most often infections), and that the 30-day risk for fatal outcome was increased by as much as 42% [21].…”

Section: Discussionmentioning

confidence: 99%

Rational red blood cells administration - have we achieved a satisfactory level?

Lukic¹,

Zivotic²,

Vasiljevic³

et al. 2020

Srp Arh Celok Lek

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Introduction The important indicators of the quality of work in blood transfusion banks and health care facilities in general is the ratio of the cross-matched red blood cell (RBC) units, and the number of transfused RBC, known as cross-match to transfusion ratio (C:T). The objective of this research was to provide an assessment of the quality of our work in a cross-sectional study, showing C:T ratios for certain areas of surgery or particular surgical indications. Methods We analyzed the data related to the activities of the Department for Pre-Transfusion Testing and Blood Distribution at the Blood Transfusion Institute of Serbia during the September and November of 2017 period. In total, 341 patients were included in the study, for whom 1,067 RBC units were requested. Results In pre-transfusion testing, 562 units were cross-matched and 249 units were transfused. The overall C:T ratio was 2.25. There are variations in C:T by departments. For the departments of abdominal surgery and reanimation, where uncrossmatched RBC units were requested, C:T was < 2. Other departments had C:T > 3 for almost all therapeutic areas. Conclusion Our results show that the C:T ratio ranged 2.02-3.6, indicating the need to reevaluate the protocols based on which the blood is requested according to individual indications, to adequately prepare patients for surgery in order to reduce the risk of possible allogeneic transfusion, and to apply Patient Blood Management protocols, which include the use of alternatives to allogeneic blood transfusion.

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Management of the patient presenting with anaemia in the preoperative setting

Cited by 6 publications

References 33 publications

The influence of topical use of tranexamic acid in reducing blood loss on early operation for thoracolumbar burst fracture: a randomized double-blinded controlled study

The influence of topical use of tranexamic acid in reducing blood loss on early operation for thoracolumbar burst fracture: a randomized double-blinded controlled study

Systematic Review and Meta-Analysis on the Role of Perioperative Blood Transfusion in Patients Undergoing Radical Cystectomy for Urothelial Carcinoma

Rational red blood cells administration - have we achieved a satisfactory level?

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