The Use of Acute Normovolemic Hemodilution in Clipping Surgery for Aneurysmal Subarachnoid Hemorrhage

Chen, Ping; Wang, Ying; Zhang, Xin-Huang; Kang, Dezhi; Lin, Xiaoxi; Lin, Qingsong

doi:10.1016/j.wneu.2020.12.110

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…Along with aneurysmal SAH cases, six studies 10,12,25,26,34,36 also included patients with non-aneurysmal non-traumatic SAH. Specific selection criteria (such as patients' age, treatment modality and severity of SAH) were applied in 12 studies 27,32,33,[37][38][39][40][41][42][43][44][45] .…”

Section: Resultsmentioning

confidence: 99%

“…com/ health/ hct-hgb). To estimate Hb values from the studies analyzing the impact of RBCT on the primary review endpoints, the corresponding institutional cutoffs for RBCT or, if reported, the mean/nadir Hb values in the RBCT/non-RBCT subgroups were applied 9,12,14,[21][22][23][24][25][26][27][28][29][30][31][32][33][34] . In the remaining studies, the severity of anemia could be assessed upon the reported absolute, nadir and mean/median Hb values.…”

Section: Study Endpoints and Data Synthesismentioning

confidence: 99%

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Systematic review and meta-analysis of outcome-relevant anemia in patients with subarachnoid hemorrhage

Said

Gümüş

Rodemerk

et al. 2022

Sci Rep

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Anemia is a common, treatable condition in patients with aneurysmal subarachnoid hemorrhage (SAH) and has been associated with poor outcome. As there are still no guidelines for anemia management after aneurysm rupture, we aimed to identify outcome-relevant severity of anemia in SAH. We systematically searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library for publications before Oct 23rd, 2022, reporting on anemia in SAH patients. The presence and severity of anemia were assessed according to the reported hemoglobin values and/or institutional thresholds for red blood cells transfusion (RBCT). Out of 1863 original records, 40 full-text articles with a total of 14,701 patients treated between 1996 and 2020 were included in the final analysis (mean 445.48 patients per study). A substantial portion of patients developed anemia during SAH (mean pooled prevalence 40.76%, range 28.3–82.6%). RBCT was administered in a third of the cases (mean 32.07%, range 7.8–88.6%), with institutional threshold varying from 7.00 to 10.00 g/dL (mean 8.5 g/dL). Anemia at the onset of SAH showed no impact on SAH outcome. In contrast, even slight anemia (nadir hemoglobin < 11.0–11.5 g/dL) occurring during SAH was associated with the risk of cerebral infarction and poor outcome at discharge and follow-up. The strongest association with SAH outcome was observed for nadir hemoglobin values ranging between 9.0 and 10.0 g/dL. The effect of anemia on SAH mortality was marginal. The development of anemia during SAH is associated with the risk of cerebral infarction and poor outcome at discharge and follow-up. Outcome-relevant severity of post-SAH anemia begins at hemoglobin levels clearly above the thresholds commonly set for RBCT. Our findings underline the need for further studies to define the optimal management of anemia in SAH patients.

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Section: Resultsmentioning

confidence: 99%

Section: Study Endpoints and Data Synthesismentioning

confidence: 99%

Systematic review and meta-analysis of outcome-relevant anemia in patients with subarachnoid hemorrhage

Said

Gümüş

Rodemerk

et al. 2022

Sci Rep

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“…Studies have shown that autologous blood predisposition before surgery is very effective in decreasing perioperative allogenic blood transfusion [ 20 , 21 ]. Moreover, acute intraoperative hemodilution and salvage have been shown to significantly increase postoperative hemoglobin levels and improve patients’ outcomes [ 22 ]. Additionally, patients with a low preoperative HB level tend to have a high nomogram score and should be encouraged to take preoperative pharmacological treatments, such as erythropoietin or antifibrinolytic management, or intraoperative self-blood collection.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for blood transfusion during intracranial aneurysm clamping surgery: a retrospective analysis

Xiao

Liu

et al. 2023

BMC Med Inform Decis Mak

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Purpose Intraoperative blood transfusion is associated with adverse events. We aimed to establish a machine learning model to predict the probability of intraoperative blood transfusion during intracranial aneurysm surgery. Methods Patients, who underwent intracranial aneurysm surgery in our hospital between January 2019 and December 2021 were enrolled. Four machine learning models were benchmarked and the best learning model was used to establish the nomogram, before conducting a discriminative assessment. Results A total of 375 patients were included for analysis in this model, among whom 108 received an intraoperative blood transfusion during the intracranial aneurysm surgery. The least absolute shrinkage selection operator identified six preoperative relative factors: hemoglobin, platelet, D-dimer, sex, white blood cell, and aneurysm rupture before surgery. Performance evaluation of the classification error demonstrated the following: K-nearest neighbor, 0.2903; logistic regression, 0.2290; ranger, 0.2518; and extremely gradient boosting model, 0.2632. A nomogram based on a logistic regression algorithm was established using the above six parameters. The AUC values of the nomogram were 0.828 (0.775, 0.881) and 0.796 (0.710, 0.882) in the development and validation groups, respectively. Conclusions Machine learning algorithms present a good performance evaluation of intraoperative blood transfusion. The nomogram established using a logistic regression algorithm showed a good discriminative ability to predict intraoperative blood transfusion during aneurysm surgery.

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Hematocrit drift and outcomes in surgical patients with aneurysmal subarachnoid hemorrhage

Wang,

Chen,

Qiu

et al. 2024

Acta Neurochir

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The Use of Acute Normovolemic Hemodilution in Clipping Surgery for Aneurysmal Subarachnoid Hemorrhage

Cited by 4 publications

References 32 publications

Systematic review and meta-analysis of outcome-relevant anemia in patients with subarachnoid hemorrhage

Systematic review and meta-analysis of outcome-relevant anemia in patients with subarachnoid hemorrhage

Development and validation of a nomogram for blood transfusion during intracranial aneurysm clamping surgery: a retrospective analysis

Hematocrit drift and outcomes in surgical patients with aneurysmal subarachnoid hemorrhage

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