Issues in transfusion medicine

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Sprache:English
Veröffentlicht: Philadelphia [u.a.] Saunders 2005
Schriftenreihe:Anesthesiology clinics of North America 23,2
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Datensatz im Suchindex

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adam_text IS^LI S I 1KANS1 USU »N MI.UR INI CONTENTS Foreword xi Lee A. Fleisher Preface x i Terri G. Monk and Lawrence T. Goodnough Risks of Blood Transfusion 241 Lawrence T. Goodnough This article discusses advances in blood safety during the last 20 years, particularly for prevention of transfusion transmitted viral infections. Although the most serious known risks from blood transfusion are administrative errors, transfusion related acute lung injury, and bacterial contamination in platelet products, infection from emerging pathogens such as West Nile virus emphasizes the need for implementing proactive strategies. Pathogen inactivation technologies and reactive strategies such as nucleic acid testing ensure continued advances in blood safety. Errors in Transfusion Medicine 253 Dorothy Stainsby In the past two decades, health services in the developed world have directed much resource toward improving the safety of the Wood supply. Blood is collected, tested, and processed within a carefully controlled environment, and quality is assured by rigorous donor selection procedures and increasingly sensitive and sophisticated testing for transfusion transmitted pathogens. Additional safety strategies implemented by some blood services include leukocyte reduction, bacterial screening, and pathogen inact.vat.on. Thus the transfusion chain from the donor to the point of issue from the blood center is highly regulated and secure, and transfusion transmitted infection is an increasingly rare event. VOLUME 23 • NUMBER 2 • JUNE 2005 v Autologous Blood Donation 263 Lawrence T. Goodnough Preoperative autologous blood donation has become accepted as a standard practice in elective surgery. Subsequent improvements in blood safety and evolving surgical techniques resulting in less blood loss have caused a national decline in preoperative autologous blood donation by approximately 50%. Nevertheless, the continuing emer¬ gence of new pathogens and the potential for severe blood inventory shortages continue to give preoperative autologous blood donation an important role in blood conservation strategies. Acute Normovolemic Hemodilution 271 Terri G. Monk This article examines the technique of hemodilution and the con¬ sequences, benefits, efficacy, cost effectiveness, and future of acute normovolemic hemodilution. Red Blood Cell Recovery and Reinfusion 283 Jonathan H. Waters This article describes the intraoperative washed cell salvage process and principles of cell salvage technology and addresses the param¬ eters that can maximize the effectiveness of the process. Used appropriately, this technique can be used to recover and readmin ister several blood volumes of red cells. Perioperative Assessment of the Elective Orthopedic Surgery Patient 295 Richard K. Spence and Pat Parce There are a number of safe and cost effective therapeutic options for the potential management of all patients without allogeneic blood transfusion. Orthopedic surgeons should consider blood man¬ agement using these options for all patients to provide them with safe and effective therapy, while minimizing the risks of allogeneic blood and preserving our decreasing blood resources. Preoperative Evaluation and Methods to Reduce Blood Use in Orthopedic Surgery 305 E. Michael Keating Major elective orthopedic surgery may be associated with significant blood loss and allogeneic transfusion risk. Identifying patients at risk for allogeneic transfusion is best accomplished with a thorough preoperative evaluation of the patient s hematopoietic system, vi CONTENTS which, unfortunately, is not always carried out. An evaluation of the hematopoietic system begins with an evaluation of the patient s hemoglobin level a minimum of 30 days before the scheduled sur¬ gical procedure. This allows for expedited diagnosis and treatment of underlying comorbidities. An unexplained low level of hemo¬ globin or a hemoglobin level low enough to increase the patient s allogeneic risk should cause elective surgery to be deferred until an evaluation can be performed and blood management strategies put in place. Anemia and Clinical Outcomes 315 Mercy Kuriyan and Jeffrey L. Carson This article discusses the impact of anemia in the context of the peri operative setting. Relevant data from animal and human studies, the adaptive mechanisms in anemia, and current views on transfu¬ sion triggers are evaluated. Recommendations are provided for the anesthesiologist for transfusion of red blood cells. Clinical Outcomes in Cardiac Surgery: Conventional Surgery versus Bloodless Surgery 327 Aryeh Shander and Tanuja S. Rijhwani Bleeding during and after cardiac operations and the effects of car diopulmonary bypass hemodilution commonly result in blood transfusions. Excessive microvascular bleeding can result in re exploration and prolonged hospitalization. Nearly 20% of all blood transfusions in the United States are associated with cardiac sur¬ gery. The risks associated with the use of allogeneic blood product transfusion include mistransfusion, immunologic complications, and transmission of infectious diseases. The large demand for blood products places significant pressure on the national blood supply, resulting in frequent shortages. The variability in transfusion prac¬ tice of cardiac surgery patients suggests that sound blood manage¬ ment and a conservative approach to this population can result in reduced transfusions without increasing morbidity or mortality and avoiding complications associated with allogeneic blood transfusion. Blood Conservation in Pediatric Anesthesia 347 B. Craig Weldon This article focuses on perioperative blood conservation techniques and the role of transfusion triggers and algorithms, preoperative autologous donation, acute normovolemic hemodilution, intraop erative blood salvage, deliberate hypotension, and preoperative recombinant human erythropoietin in avoiding allogeneic blood transfusion in pediatric patients. CONTENTS vii _J Blood Conservation in the Critically 111 Patient 363 Howard L. Corwin This article focuses on transfusion practice in the critically ill. Current Status of Artificial O2 Carriers 373 Caroline Thyes and Donat R. Spahn This article describes currently evaluated artificial O2 carriers, summarizes their efficacy, and discusses their side effects, based on and restricted to published data. For compounds in phase III test¬ ing, approximately 500 to 1000 patients have been dosed, and similar numbers of control patients have been investigated. For compounds in phase I or II testing, the number of patients dosed is significantly less. Unfortunately, there is a significant amount of non published data, which renders the overall assessment difficult, and the direct comparison among different types of artificial O2 carriers is significantly limited by the virtual nonexistence of studies that directly compare different products. Index 391 viii CONTENTS
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series2 Anesthesiology clinics of North America
spellingShingle Issues in transfusion medicine
Anesthesiology clinics of North America
Blood Transfusion
Bluttransfusion (DE-588)4007293-9 gnd
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title Issues in transfusion medicine
title_auth Issues in transfusion medicine
title_exact_search Issues in transfusion medicine
title_full Issues in transfusion medicine guest ed. Terri G. Monk ...
title_fullStr Issues in transfusion medicine guest ed. Terri G. Monk ...
title_full_unstemmed Issues in transfusion medicine guest ed. Terri G. Monk ...
title_short Issues in transfusion medicine
title_sort issues in transfusion medicine
topic Blood Transfusion
Bluttransfusion (DE-588)4007293-9 gnd
topic_facet Blood Transfusion
Bluttransfusion
Aufsatzsammlung
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