Preoperative blood transfusions for sickle cell disease

Giant oral tumor in a child with malnutrition and sickle cell trait: Anesthetic challenges

“…[5] These can be avoided if sickle cell hemoglobin is lower than 30% of total hemoglobin. [6] In our patient, this was less than 20% and would have decreased upon transfusion of normal PRBC (Packed Red Blood Cells); thus, no further specific measures were needed. We were liberal with maintenance fluids and vigilant throughout the procedure avoiding any desaturation, which could precipitate sickling associated problems.…”

Giant oral tumor in a child with malnutrition and sickle cell trait: Anesthetic challenges

“…[5] These can be avoided if sickle cell hemoglobin is lower than 30% of total hemoglobin. [6] In our patient, this was less than 20% and would have decreased upon transfusion of normal PRBC (Packed Red Blood Cells); thus, no further specific measures were needed. We were liberal with maintenance fluids and vigilant throughout the procedure avoiding any desaturation, which could precipitate sickling associated problems.…”

Anemia in the Preoperative Patient

“…A Cochrane Database review concluded that although a conservative transfusion strategy appears as effective in preoperative patients as an aggressive regimen, further studies are needed to determine the best possible course of therapy and whether preoperative transfusion is required in all surgical settings. 24 In our opinion a transfusion threshold of 7 g/dL can be used safely in most perioperative patients, provided that they have no underlying ischemic heart disease and are asymptomatic. The optimal threshold is unknown in patients with cardiovascular disease for there is no randomized evidence available.…”

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

“…In fact, we found only five RCTs to provide the highest grade of evidence to support recommendations. Additional bias analysis of these high‐quality studies following PRISMA guidelines was not different than in the previously published Cochrane studies . To palliate for the restricted amount of gradable trial evidence, we chose upfront to include all types of studies, and extended our capture of potentially valuable empirical data to expert‐opinion/institutional guidelines and patient advocacy group content.…”

Giant oral tumor in a child with malnutrition and sickle cell trait: Anesthetic challenges

“…[5] These can be avoided if sickle cell hemoglobin is lower than 30% of total hemoglobin. [6] In our patient, this was less than 20% and would have decreased upon transfusion of normal PRBC (Packed Red Blood Cells); thus, no further specific measures were needed. We were liberal with maintenance fluids and vigilant throughout the procedure avoiding any desaturation, which could precipitate sickling associated problems.…”

Anemia in the Preoperative Patient

“…A Cochrane Database review concluded that although a conservative transfusion strategy appears as effective in preoperative patients as an aggressive regimen, further studies are needed to determine the best possible course of therapy and whether preoperative transfusion is required in all surgical settings. 24 In our opinion a transfusion threshold of 7 g/dL can be used safely in most perioperative patients, provided that they have no underlying ischemic heart disease and are asymptomatic. The optimal threshold is unknown in patients with cardiovascular disease for there is no randomized evidence available.…”

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

“…In fact, we found only five RCTs to provide the highest grade of evidence to support recommendations. Additional bias analysis of these high‐quality studies following PRISMA guidelines was not different than in the previously published Cochrane studies . To palliate for the restricted amount of gradable trial evidence, we chose upfront to include all types of studies, and extended our capture of potentially valuable empirical data to expert‐opinion/institutional guidelines and patient advocacy group content.…”

Giant oral tumor in a child with malnutrition and sickle cell trait: Anesthetic challenges

“…[5] These can be avoided if sickle cell hemoglobin is lower than 30% of total hemoglobin. [6] In our patient, this was less than 20% and would have decreased upon transfusion of normal PRBC (Packed Red Blood Cells); thus, no further specific measures were needed. We were liberal with maintenance fluids and vigilant throughout the procedure avoiding any desaturation, which could precipitate sickling associated problems.…”

Anemia in the Preoperative Patient

“…A Cochrane Database review concluded that although a conservative transfusion strategy appears as effective in preoperative patients as an aggressive regimen, further studies are needed to determine the best possible course of therapy and whether preoperative transfusion is required in all surgical settings. 24 In our opinion a transfusion threshold of 7 g/dL can be used safely in most perioperative patients, provided that they have no underlying ischemic heart disease and are asymptomatic. The optimal threshold is unknown in patients with cardiovascular disease for there is no randomized evidence available.…”

Perioperative care of children with sickle cell disease: A systematic review and clinical recommendations

“…In fact, we found only five RCTs to provide the highest grade of evidence to support recommendations. Additional bias analysis of these high‐quality studies following PRISMA guidelines was not different than in the previously published Cochrane studies . To palliate for the restricted amount of gradable trial evidence, we chose upfront to include all types of studies, and extended our capture of potentially valuable empirical data to expert‐opinion/institutional guidelines and patient advocacy group content.…”