Objectives and limitations of bloodless medical care.

Abstract:

PURPOSE OF REVIEW:To outline the rationale, limitations, and execution of bloodless medical and surgical programs, highlighting characteristics that contribute to successful outcomes. RECENT FINDINGS:Clinical experiences with patients who refuse blood transfusions for religious reasons have provided valuable lessons and raise intriguing questions about the necessity of routine blood transfusions. Healthcare centers with bloodless medicine and surgery programs feature a novel concept of patient care aimed at improving outcomes. A one-tiered approach to minimize blood usage for all patients, regardless of religious beliefs, is being successfully adopted at an increasing number of institutions. Since most single blood-conservation techniques reduce blood usage by just 1-2 units, a series of integrated preoperative, intraoperative, and postoperative conservation approaches is required. These include preoperative autologous donation, erythropoietic support, acute normovolemic hemodilution, individualized assessment of anemia tolerance, implementation of conservative transfusion thresholds, meticulous surgical techniques, and judicious use of phlebotomy and pharmacologic agents for limiting blood loss. SUMMARY:The objectives of bloodless medicine and surgery programs are straightforward but require staff with expertise in transfusion medicine, intensive teamwork, patient-specific customization, careful planning, and integrated use of multimodal strategies.

journal_name

Curr Opin Hematol

authors

Shander A,Goodnough LT

doi

10.1097/01.moh.0000245692.32085.bd

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

462-70

issue

6

eissn

1065-6251

issn

1531-7048

pii

00062752-200611000-00011

journal_volume

13

pub_type

杂志文章,评审
  • The use of hematopoietic growth factors in treating HIV infection.

    abstract::Human immunodeficiency virus infection causes multilineage hematopoietic defects. Defects in the production and function of CD4+ helper cells have been the focus of the majority of HIV research, but anemia, neutropenia, and thrombocytopenia are significant clinical problems as well. Bone marrow suppression is the dose...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199502030-00012

    authors: Miles S

    更新日期:1995-05-01 00:00:00

  • Regulation of the hematopoietic stem cell lifecycle by the endothelial niche.

    abstract:PURPOSE OF REVIEW:Hematopoietic stem cells (HSCs) predominantly reside either in direct contact or in close proximity to the vascular endothelium throughout their lifespan. From the moment of HSC embryonic specification from hemogenic endothelium, endothelial cells (ECs) act as a critical cellular-hub that regulates a ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000350

    authors: Ramalingam P,Poulos MG,Butler JM

    更新日期:2017-07-01 00:00:00

  • Ras-related GTP-binding proteins and leukocyte signal transduction.

    abstract::Many aspects of leukocyte function are regulated by both heterotrimeric and Ras-related GTP-binding proteins, but there is little definite information about their roles in the specialized processes utilized by leukocytes for cell killing. Recent progress in understanding the regulation of the phagocyte NADPH oxidase b...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章

    doi:

    authors: Bokoch GM,Knaus UG

    更新日期:1994-01-01 00:00:00

  • Iron regulation and erythropoiesis.

    abstract:PURPOSE OF REVIEW:The peptide hormone hepcidin regulates iron metabolism in response to erythropoietic demand, iron stores and inflammation. Major advances have been made in understanding the regulation of hepcidin production, and consequently the availability of iron for erythropoiesis. RECENT FINDINGS:It is becoming...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e3282f73335

    authors: Nemeth E

    更新日期:2008-05-01 00:00:00

  • Measurement of thrombopoietic levels: clinical and biological relationships.

    abstract::Platelet production is primarily regulated by the thrombopoietic cytokine thrombopoietin (TPO). In most cases thrombopoietin serum levels are determined by the rate of c-mpl receptor-mediated degradation after TPO uptake into platelets and megakaryocytes. The contribution of increased TPO protein synthesis by a transl...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200005000-00003

    authors: Verbeek W,Faulhaber M,Griesinger F,Brittinger G

    更新日期:2000-05-01 00:00:00

  • Unexpected functions of nuclear factor-κB during germinal center B-cell development: implications for lymphomagenesis.

    abstract:PURPOSE OF REVIEW:B-cell tumors originating from the transformation of germinal center B cells frequently harbor genetic mutations, leading to constitutive activation of the nuclear factor-κB (NF-κB) signaling pathway. The present review highlights recent insights into the roles of separate NF-κB transcription factors ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000160

    authors: Klein U,Heise N

    更新日期:2015-07-01 00:00:00

  • Chronic myelogenous leukemia.

    abstract::Chronic myelogenous leukemia is a clonal hematopoietic malignancy characterized by a balanced translocation between chromosomes 9 and 22 that results in the generation of an abnormal bcr/abl fusion protein with increased tyrosine kinase activity. This abnormal fusion protein has transforming activity for hematopoietic...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199502040-00009

    authors: Enright H,McGlave PB

    更新日期:1995-07-01 00:00:00

  • Inhibitory antibodies in hemophilia A.

    abstract:PURPOSE OF REVIEW:The review describes recent advances in our understanding of mechanisms leading to development of neutralizing antibodies following factor VIII (FVIII) replacement therapy for hemophilia A. Novel interventions with translational potential to lessen the incidence of these deleterious immune responses a...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e328356ed37

    authors: Pratt KP

    更新日期:2012-09-01 00:00:00

  • Recent advances in the management of therapy-related myelodysplastic syndromes and acute myeloid leukemia.

    abstract:PURPOSE OF REVIEW:Therapy-related myelodysplastic syndromes and acute myelogenous leukemia (t-MDS/AML) comprise an increasingly common, poor-risk disease cohort without standard treatment options. This review describes available treatments and recent advances that may influence the clinical management of t-MDS/AML. RE...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32835d82e6

    authors: Klimek VM

    更新日期:2013-03-01 00:00:00

  • Role of FLT3 in leukemia.

    abstract::FLT3 is the most frequently mutated gene in cases of acute myelogenous leukemia (AML). About 30 to 35% of patients have either internal tandem duplications (ITDs) in the juxtamembrane domain or mutations in the activating loop of FLT3. FLT3 mutations occur in a broad spectrum of FAB subtypes in adult and pediatric AML...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200207000-00003

    authors: Gilliland DG,Griffin JD

    更新日期:2002-07-01 00:00:00

  • Hypereosinophilia.

    abstract::Recent advances in our understanding of hypereosinophilia have related particularly to the definition of criteria for distinguishing between eosinophilic leukemia and the 'idiopathic' hypereosinophilic syndromes. In this article, leukemogenic mechanisms have been identified in a number of subtypes of eosinophilic leuk...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200001000-00005

    authors: Bain BJ

    更新日期:2000-01-01 00:00:00

  • Molecular insights into stress erythropoiesis.

    abstract:PURPOSE OF REVIEW:In addition to its essential role in baseline erythropoiesis, the hormone erythropoietin drives the erythropoietic response to hypoxic stress. A mechanistic understanding of stress erythropoiesis would benefit multiple clinical settings, and may aid in understanding leukemogenesis. RECENT FINDINGS:Th...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e3280de2bf1

    authors: Socolovsky M

    更新日期:2007-05-01 00:00:00

  • Early T-cell precursor acute lymphoblastic leukaemia.

    abstract:PURPOSE OF REVIEW:Early T-cell precursor (ETP) leukaemias have been recently recognized as a form of T-cell acute lymphoblastic leukaemia (T-ALL) with a poor prognosis. The purpose of this review is to outline the most recent advances in the biology, genetics and prognostic significance of this aggressive disease. REC...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e3283623c61

    authors: Haydu JE,Ferrando AA

    更新日期:2013-07-01 00:00:00

  • Angiogenesis: vascular remodeling of the extracellular matrix involves metalloproteinases.

    abstract::Endothelial cell invasion is an essential event during angiogenesis (the formation of new blood vessels). This process involves the degradation of the extracellular matrix, the basement membrane, and interstitial stroma, and is governed by the activation of matrix metalloproteinases. However, the contribution of matri...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200303000-00007

    authors: Heissig B,Hattori K,Friedrich M,Rafii S,Werb Z

    更新日期:2003-03-01 00:00:00

  • Kindling the flame of integrin activation and function with kindlins.

    abstract:PURPOSE OF REVIEW:There are three kindlin family members in vertebrates, which have high-sequence homology and a common organization signature with a C-terminal 4.1, ezrin, radixin, moesin (FERM) domain bisected by a pleckstrin-homology domain. Although the cell and tissue distributions of the three kindlins differ, th...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32832ea389

    authors: Plow EF,Qin J,Byzova T

    更新日期:2009-09-01 00:00:00

  • Retrievable vena cava filters: a review.

    abstract:PURPOSE OF REVIEW:To examine the current literature regarding retrievable inferior vena cava filters and to discuss the appropriate indications for their clinical use. RECENT FINDINGS:Permanent filters have been shown to be effective, but have a number of long-term complications such as filter thrombosis or migration....

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/01.moh.0000239707.63168.ee

    authors: Imberti D,Ageno W,Carpenedo M

    更新日期:2006-09-01 00:00:00

  • Guidelines for newborn screening of primary immunodeficiency diseases.

    abstract:PURPOSE OF REVIEW:Technical possibilities to screen for inborn errors of immune function at the neonatal stage have been rapidly progressing, whereas the guidelines that apply for the evaluation of benefits and concerns on expanding screening panels have not been broadly discussed for primary immunodeficiency diseases ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32835a9130

    authors: Borte S,von Döbeln U,Hammarström L

    更新日期:2013-01-01 00:00:00

  • Neutrophilic dermatosis: disease mechanism and treatment.

    abstract:PURPOSE OF REVIEW:The purpose of this review is to describe the physiopathological and therapeutic aspects of neutrophilic dermatosis, taking into account their most frequent associated conditions. RECENT FINDINGS:In autoinflammatory syndromes featuring neutrophilic dermatosis, the role of interleukin-1 and tumor necr...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000100

    authors: Maalouf D,Battistella M,Bouaziz JD

    更新日期:2015-01-01 00:00:00

  • Bacterial responses to neutrophil phagocytosis.

    abstract:PURPOSE OF REVIEW:This review focuses on adaptive bacterial interactions with neutrophils, emphasizing information communicated within the past year about bacterial factors that respond to contact with or phagocytosis by PMN. RECENT FINDINGS:Since the discovery of type III and IV secretion, progress in the analysis of...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200401000-00002

    authors: Rosen H

    更新日期:2004-01-01 00:00:00

  • Molecular basis of erythrocyte membrane disorders.

    abstract::Disorders of the erythrocyte membrane, such as hereditary spherocytosis, hereditary elliptocytosis, and hereditary pyropoikilocytosis, are characterized by heterogeneity in their clinical and laboratory manifestations. Recent work has shown that these disorders also exhibit marked genetic heterogeneity. Multiple genet...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199704020-00009

    authors: Gallagher PG,Ferriera JD

    更新日期:1997-03-01 00:00:00

  • The role of PI3K/protein kinase B (PKB/c-akt) in migration and homing of hematopoietic stem and progenitor cells.

    abstract:PURPOSE OF REVIEW:Hematopoietic stem cell (HSC) transplantation is the most powerful treatment modality for a variety of hematological disorders. Successful hematopoietic recovery after transplantation depends on optimal homing of HSCs to the bone marrow and subsequent lodging in the HSC niche. The molecular mechanisms...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32834760e5

    authors: Buitenhuis M

    更新日期:2011-07-01 00:00:00

  • D-dimer for the diagnosis of venous thromboembolism.

    abstract::D-dimer, a breakdown product of cross-linked fibrin has been extensively evaluated as a diagnostic test for acute venous thromboembolism. Rapid, highly sensitive D-dimer assays are now available that are suitable for testing in the emergency setting. Preliminary studies suggest that when using a highly sensitive D-dim...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200009000-00007

    authors: Anderson DR,Wells PS

    更新日期:2000-09-01 00:00:00

  • Progress in the treatment of adults with acute lymphoblastic leukemia.

    abstract:PURPOSE OF REVIEW:Despite improvements in the achievement of complete remission and progress in the supportive care of adults with acute lymphoblastic leukemia during the last decade, the majority of patients have eventually relapsed with overall survival in adult acute lymphoblastic leukemia of only 30-40%. However, t...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e3283034697

    authors: Larson S,Stock W

    更新日期:2008-07-01 00:00:00

  • Microtransplantation: clinical applications and mechanisms.

    abstract:PURPOSE OF REVIEW:Microtransplantation (MST) has been successfully used to manage patients with hematological malignancies, especially older patients with acute myeloid leukemia (AML). Recent clinical applications and mechanistic studies of MST are reviewed. RECENT FINDINGS:MST improves complete remission rates which ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000470

    authors: Cai B,Guo M,Ai H

    更新日期:2018-11-01 00:00:00

  • Pathophysiology of transfusion-related acute lung injury.

    abstract:PURPOSE OF REVIEW:The purpose of this review is to summarize the recent experimental and clinical literature on the pathogenesis of transfusion-related acute lung injury (TRALI). RECENT FINDINGS:In both experimental and clinical TRALI, an immune priming step is generally necessary to produce lung injury. Experimental ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32833c07d3

    authors: Looney MR,Gilliss BM,Matthay MA

    更新日期:2010-09-01 00:00:00

  • Thrombocytopenia in liver disease.

    abstract:PURPOSE OF REVIEW:To evaluate recent findings in the multifaceted pathophysiological mechanisms underlying thrombocytopenia in patients with chronic liver disease and to assess its therapeutic management. RECENT FINDINGS:Antiplatelet antibodies, despite being observed rather frequently in patients with chronic viral l...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32830a9746

    authors: Giannini EG,Savarino V

    更新日期:2008-09-01 00:00:00

  • Reconstitution of thymic function after stem cell transplantation in humans.

    abstract::The reconstitution of T-cell populations is a critical component of immune recovery after allogeneic stem cell transplantation. Recent studies have used new techniques to focus on the interplay of thymopoiesis and peripheral expansion that defines T-cell repopulation. Peripheral expansion, driven by host cytokines and...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200211000-00004

    authors: Hakim FT,Gress RE

    更新日期:2002-11-01 00:00:00

  • Resistance to activated protein C caused by a factor V gene mutation.

    abstract::Each year, approximately one in 1000 individuals suffers from venous thromboembolism. The pathogenesis of the disease is multifactorial and a thrombotic event is the result of a combination of genetic and circumstantial risk factors. Until recently, genetic defects could only be identified in a minority of thrombosis ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199502050-00006

    authors: Zöller B,Dahlbäck B

    更新日期:1995-09-01 00:00:00

  • Clinical applications of stem cell factor.

    abstract::Stem cell factor is an early-acting hematopoietic cytokine that probably functions constitutively to support the proliferation and survival of pluripotent progenitor cells and to increase their receptivity to lineage commitment and differentiation in response to lineage-specific cytokines. Stem cell factor also can in...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199603030-00010

    authors: Glaspy J

    更新日期:1996-05-01 00:00:00

  • Hematopoietic stem cell lineage specification.

    abstract:PURPOSE OF REVIEW:Hematopoietic stem cells (HSCs) possess two fundamental characteristics, the capacity for self-renewal and the sustained production of all blood cell lineages. The fine balance between HSC expansion and lineage specification is dynamically regulated by the interplay between external and internal stimu...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000260

    authors: Pouzolles M,Oburoglu L,Taylor N,Zimmermann VS

    更新日期:2016-07-01 00:00:00