Bloodless medicine: current strategies and emerging treatment paradigms.

Abstract:

BACKGROUND:Advances in our understanding of the risks associated with allogeneic blood transfusions (ABTs) and the growing number of patients who wish to avoid ABTs have led to the emergence of new treatment paradigms for "bloodless" medicine and surgery. STUDY DESIGN AND METHODS:Here, we review prior studies and summarize current strategies for bloodless care used at our institution. We advocate three basic principles: 1) diagnosing and aggressively treating anemia, 2) minimizing blood loss from laboratory testing and invasive procedures, and 3) identifying and managing bleeding diatheses. Anemia is treated with erythropoiesis-stimulating agents as well as iron, folate, and B12 when indicated. Low-volume phlebotomy tubes are used for laboratory testing. Autologous blood salvage is used for childbirth and surgical patients who have the potential for substantial bleeding. RESULTS:Although there have been few retrospective studies and no prospective studies to guide management, prior studies suggest that outcomes for surgical patients managed without ABTs are comparable to those of historic controls. CONCLUSIONS:Given the emerging evidence that patients who avoid ABTs do as well if not better than patients who accept ABTs, further efforts are needed to determine whether all patients could benefit from bloodless strategies. Bloodless approaches in selected patients could reduce risks, improve outcomes, and decrease costs for all patients.

journal_name

Transfusion

journal_title

Transfusion

authors

Resar LM,Wick EC,Almasri TN,Dackiw EA,Ness PM,Frank SM

doi

10.1111/trf.13736

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

2637-2647

issue

10

eissn

0041-1132

issn

1537-2995

journal_volume

56

pub_type

杂志文章,评审
  • Transfusion-acquired hepatitis C: the Danish lookback experience. The Danish HCV [hepatitis C virus] Lookback Group.

    abstract:BACKGROUND:In 1996, the Danish National Board of Health recommended hepatitis C virus (HCV) lookback to identify recipients of blood components from donors found to be positive since the implementation of anti-HCV screening in 1991. STUDY DESIGN AND METHODS:The aim was to accumulate results of the lookback at a nation...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1999.39299154734.x

    authors: Christensen PB,Groenbaek K,Krarup HB

    更新日期:1999-02-01 00:00:00

  • A review on decision support for massive transfusion: understanding human factors to support the implementation of complex interventions in trauma.

    abstract:BACKGROUND:Critically bleeding trauma patients require coordinated and efficient decision-making processes to ensure optimal management of their massive transfusion (MT) requirements. Human factors (HFs) is a discipline that investigates factors influencing work processes from the organizational, group, and individual ...

    journal_title:Transfusion

    pub_type: 杂志文章,评审

    doi:10.1111/j.1537-2995.2012.03648.x

    authors: Enticott JC,Jeffcott S,Ibrahim JE,Wood EM,Cole-Sinclair M,Fitzgerald M,Cameron PA,Phillips LE

    更新日期:2012-12-01 00:00:00

  • Reduction in red blood cell transfusion associated with engagement of the ordering physician.

    abstract:BACKGROUND:Data on red blood cell (RBC) transfusion in the United States show variation in practice and overprescribing or overdosing is considered to be prevalent. Education or restrictive interventions could modify practice. STUDY DESIGN AND METHODS:RBC transfusion and mortality rates were recorded in a single insti...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.12552

    authors: Tavares MM,Diquattro PJ,Sweeney JD

    更新日期:2014-10-01 00:00:00

  • Impact of delayed umbilical cord clamping on public cord blood donations: can we help future patients and benefit infant donors?

    abstract:BACKGROUND:Cord blood (CB) is a widely accepted stem cell source and its clinical utilization depends, to a great extent, on its cell content. Birth-to-clamping (BTC) time of umbilical cord determines placental transfusion to the newborn, and the remaining blood that can be collected and banked. The 2017 Committee Opin...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.14574

    authors: Ciubotariu R,Scaradavou A,Ciubotariu I,Tarnawski M,Lloyd S,Albano M,Dobrila L,Rubinstein P,Grunebaum A

    更新日期:2018-06-01 00:00:00

  • Long-term production of pre-existing alloantibodies to E and c after allogenic BMT in a patient with aplastic anemia resulting in delayed hemolytic anemia.

    abstract:BACKGROUND:Delayed hemolysis mediated by long-term production of pre-existing recipient-derived antibodies directed against donor RBC antigens after allogenic BMT is an unusual complication of hematopoietic transplantation. CASE REPORT:A 26-year-old man with aplastic anemia had pre-existing alloantibodies to E and c. ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.2003.00303.x

    authors: Izumi N,Fuse I,Furukawa T,Uesugi Y,Tsuchiyama J,Toba K,Togashi K,Yamada K,Ohtake S,Saitoh Y,Yanagisawa N,Aizawa Y

    更新日期:2003-02-01 00:00:00

  • Efficacy and safety of the drugs used to reverse direct oral anticoagulants: a systematic review and meta-analysis.

    abstract:BACKGROUND:Direct oral anticoagulants (DOACs) are effective and safe for prophylaxis and treatment of thromboembolic phenomena. However, managing DOACs during bleeding emergencies is challenging. A systematic review and meta-analysis was conducted on studies addressing efficacy and safety of the drugs used for reversal...

    journal_title:Transfusion

    pub_type: 杂志文章,meta分析,评审

    doi:10.1111/trf.14096

    authors: da Luz LT,Marchand M,Nascimento B,Tien H,Nathens A,Shah P

    更新日期:2017-07-01 00:00:00

  • Absence of acute adverse in-vitro effects on AS-1 RBCs and whole blood-derived platelets following prolonged exposure to 13.56 MHz radio energy.

    abstract:BACKGROUND:There is growing interest in radio frequency identification (RFID) technology application for tracking blood products to achieve higher productivity and safety in the transfusion medicine supply chain. We have conducted a limited study to assess the temperature and biological effects of 13.56 MHz RF radiatio...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2010.02733.x

    authors: Davis R,Gottschall J,Gutierrez A,Hohberger C,Veeramani D,Holcombe J

    更新日期:2010-07-01 00:00:00

  • Cytokine generation in stored, white cell-reduced, and bacterially contaminated units of red cells.

    abstract:BACKGROUND:Proinflammatory cytokines were measured in the supernatant portion of stored, bacterially contaminated, and/or white cell (WBC)-reduced units of red cells (RBCs). Previous studies from this laboratory and others have shown that cytokines are generated in platelet concentrates during storage. This earlier wor...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1995.35395184274.x

    authors: Stack G,Baril L,Napychank P,Snyder EL

    更新日期:1995-03-01 00:00:00

  • Studies of donors who transmit posttransfusion hepatitis.

    abstract::Sera and questionnaires were evaluated retrospectively from 128 volunteer blood donors whose blood had been implicated in cases of clinically recognized post-transfusion hepatitis in recipients of one- or two-unit blood transfusion between 1971 and 1977. Serologic markers of hepatitis B virus (HBV) infection were foun...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1979.19680104098.x

    authors: Tabor E,Hoofnagle JH,Smallwood LA,Drucker JA,Pineda-Tamondong GC,Ni LY,Greenwalt TJ,Barker LF,Gerety RJ

    更新日期:1979-11-01 00:00:00

  • Effect of storage time and donor sex of transfused red blood cells on 1-year survival in patients undergoing cardiac surgery: an observational study.

    abstract:BACKGROUND:Red blood cell (RBC) storage lesions and RBCs from females transfused into male recipients may have adverse effects on transfusion recipients' survival. We hypothesized that the effect of donor sex and the effect of age of blood on mortality would be most apparent in cardiac surgery patients. STUDY DESIGN A...

    journal_title:Transfusion

    pub_type: 杂志文章,多中心研究

    doi:10.1111/trf.13537

    authors: Desmarets M,Bardiaux L,Benzenine E,Dussaucy A,Binda D,Tiberghien P,Quantin C,Monnet E

    更新日期:2016-05-01 00:00:00

  • Effects of new brochures on blood donor recruitment and retention.

    abstract:BACKGROUND:Currently, donors may arrive at blood collection sites without prior knowledge of eligibility and deferral criteria. STUDY DESIGN AND METHODS:The effects of distributing newly developed recruitment brochures 2 weeks in advance of blood drives and the provision of brochures on temporary deferral at the takin...

    journal_title:Transfusion

    pub_type: 临床试验,杂志文章

    doi:10.1046/j.1537-2995.1994.34794330012.x

    authors: Gimble JG,Kline L,Makris N,Muenz LR,Friedman LI

    更新日期:1994-07-01 00:00:00

  • Evaluation and comparison of coagulation factor activity in fresh-frozen plasma and 24-hour plasma at thaw and after 120 hours of 1 to 6°C storage.

    abstract:BACKGROUND:Current transfusion-related acute lung injury reduction strategies include avoiding transfusion of plasma products collected from female donors or female donors that have been pregnant to reduce transfusion of plasma-containing HLA antibodies. Such a policy considerably decreases the number of donors availab...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2009.02198.x

    authors: Scott E,Puca K,Heraly J,Gottschall J,Friedman K

    更新日期:2009-08-01 00:00:00

  • Effect of screening for red cell antibodies, other than anti-D, to detect hemolytic disease of the fetus and newborn: a population study in the Netherlands.

    abstract:BACKGROUND:Hemolytic disease of the fetus and newborn (HDFN) is a severe disease, resulting from maternal red cell (RBC) alloantibodies directed against fetal RBCs. The effect of a first-trimester antibody screening program on the timely detection of HDFN caused by antibodies other than anti-D was evaluated. STUDY DES...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2007.01625.x

    authors: Koelewijn JM,Vrijkotte TG,van der Schoot CE,Bonsel GJ,de Haas M

    更新日期:2008-05-01 00:00:00

  • Differential induction of P-selectin expression on platelets by two cell separators during plateletpheresis and the effect of gender on the release of soluble P-selectin.

    abstract:BACKGROUND:Though a number of studies have elegantly characterized platelet activation during storage, less attention has been paid to the initial activation caused by different collection procedures. STUDY DESIGN AND METHODS:The effects of two blood cell separators on the initial activation of platelets were measured...

    journal_title:Transfusion

    pub_type: 临床试验,杂志文章

    doi:10.1046/j.1537-2995.1998.38198141494.x

    authors: Stohlawetz P,Hergovich N,Stiegler G,Eichler HG,Höcker P,Kapiotis S,Jilma B

    更新日期:1998-01-01 00:00:00

  • Transfusion of older stored blood worsens outcomes in canines depending on the presence and severity of pneumonia.

    abstract:BACKGROUND:In experimental pneumonia we found that transfused older blood increased mortality and lung injury that was associated with increased in vivo hemolysis and elevated plasma cell-free hemoglobin (CFH), non-transferrin-bound iron (NTBI), and plasma labile iron (PLI) levels. In this study, we additionally analyz...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.12607

    authors: Wang D,Cortés-Puch I,Sun J,Solomon SB,Kanias T,Remy KE,Feng J,Alimchandani M,Quezado M,Helms C,Perlegas A,Gladwin MT,Kim-Shapiro DB,Klein HG,Natanson C

    更新日期:2014-07-01 00:00:00

  • Reduced expression of CD47 during murine red blood cell (RBC) senescence and its role in RBC clearance from the circulation.

    abstract:BACKGROUND:Almost 2 percent of murine blood red blood cells (RBCs) are destroyed each day and are replaced by fresh RBCs generated through the process of erythropoiesis. RBCs to be destroyed are phagocytosed by macrophages in the reticuloendothelial system, especially in the spleen. CD47 molecules on RBCs may regulate ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2007.01348.x

    authors: Khandelwal S,van Rooijen N,Saxena RK

    更新日期:2007-09-01 00:00:00

  • Reducing reactions to blood donation with applied muscle tension: a randomized controlled trial.

    abstract:BACKGROUND:Unpleasant blood donation-related symptoms may discourage otherwise healthy, altruistic individuals from becoming repeat donors. This study examined a behavioral technique called applied muscle tension (AMT) that might reduce reactions. STUDY DESIGN AND METHODS:A total of 605 donors at mobile clinics were a...

    journal_title:Transfusion

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1537-2995.2003.00488.x

    authors: Ditto B,France CR,Lavoie P,Roussos M,Adler PS

    更新日期:2003-09-01 00:00:00

  • Influence of enteral feeding and anemia on tissue oxygen extraction after red blood cell transfusion in preterm infants.

    abstract:BACKGROUND:Understanding factors that impact tissue oxygen extraction may guide red blood cell (RBC) transfusion decision making in preterm infants. Our objective was to assess the influence of enteral feeding and anemia on cerebral and mesenteric oxygen saturation (Csat and Msat) and fractional tissue oxygen extractio...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.15680

    authors: Goldstein GP,Rao A,Ling AY,Ding VY,Chang IJ,Chock VY

    更新日期:2020-03-01 00:00:00

  • Reliability of bedside ABO testing before transfusion.

    abstract:BACKGROUND:Previous studies of bedside transfusion compatibility tests have shown high rates of erroneous transfusion decision, due to defective techniques and poor user performance. An experimental study was conducted to evaluate the error rate obtained with a new ready-to-use device (Vu-Test, Medigis), in comparison ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.2002.00219.x

    authors: Migeot V,Ingrand I,Salmi LR,Ingrand P

    更新日期:2002-10-01 00:00:00

  • Laboratory diagnosis of heparin-associated thrombocytopenia and comparison of platelet aggregation test, heparin-induced platelet activation test, and platelet factor 4/heparin enzyme-linked immunosorbent assay.

    abstract:BACKGROUND:As clinical diagnosis of heparin-associated thrombocytopenia (HAT) is often difficult, confirmation by sensitive laboratory assays is desirable. STUDY DESIGN AND METHODS:The sensitivity of the heparin-induced platelet activation (HIPA) test and the platelet aggregation test (PAT) was prospectively compared ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1994.34594249047.x

    authors: Greinacher A,Amiral J,Dummel V,Vissac A,Kiefel V,Mueller-Eckhardt C

    更新日期:1994-05-01 00:00:00

  • Blood group incidence and Escherichia coli bacterial sepsis.

    abstract::Many strains of Escherichia coli possess an antigen that reacts with naturally occurring antibodies to human red cell B antigens. The authors tested the hypothesis that the presence of naturally occurring anti-B isoagglutinins afford protection against the development of E. coli septicemia. The blood groups found in 1...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1986.26687043620.x

    authors: Wittels EG,Lichtman HC

    更新日期:1986-11-01 00:00:00

  • A typology of blood donor motivations.

    abstract:BACKGROUND:Although the need for whole blood is declining, so too are the number of first-time and repeat blood donors. To develop new recruitment and retention strategies, therefore, we need to draw on as wide a variation in blood donor motivations as possible. The primary aim of this study is to draw on a large surve...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.15913

    authors: Ferguson E,Hill A,Lam M,Reynolds C,Davison K,Lawrence C,Brailsford SR

    更新日期:2020-09-01 00:00:00

  • Receptors involved in the phagocytosis of senescent and diamide-oxidized human RBCs.

    abstract:BACKGROUND:Senescent RBCs bear IgG and C3 opsonins that are three to four times less than required for similar phagocytosis of experimentally opsonized RBCs. STUDY DESIGN AND METHODS:Studies were performed to determine the phagocyte receptors involved in phagocytosis in vitro. The effect of clustering of opsonins and ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.2000.40121494.x

    authors: Tartakover-Matalon S,Shoham-Kessary H,Foltyn V,Gershon H

    更新日期:2000-12-01 00:00:00

  • Effect of fresh-frozen plasma transfusion on prothrombin time and bleeding in patients with mild coagulation abnormalities.

    abstract:BACKGROUND:Fresh-frozen plasma (FFP) is frequently transfused to patients with mild prolongation of coagulation values under the assumption that FFP will correct the coagulopathy. There is little evidence to support this practice, however. To determine the effect of FFP on coagulation variables and correlation with ble...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2006.00891.x

    authors: Abdel-Wahab OI,Healy B,Dzik WH

    更新日期:2006-08-01 00:00:00

  • Adequacy of physician documentation and correlation with assessment of transfusion appropriateness: a follow-up study in the setting of prospective audits and patient blood management.

    abstract:BACKGROUND:A previous study in our hospitals correlated suboptimal documentation and failure to justify transfusions. In light of implemented blood-conservation strategies, including patient blood management (PBM) and prospective audits (PAs), we performed a follow-up study. STUDY DESIGN AND METHODS:We reviewed prospe...

    journal_title:Transfusion

    pub_type: 杂志文章,多中心研究

    doi:10.1111/trf.13917

    authors: Madrigal E,Prajapati S,Avadhani V,Annen K,Friedman MT

    更新日期:2017-02-01 00:00:00

  • An acute hemolytic transfusion reaction caused by an anti-P1 that reacted at 37 degrees C.

    abstract:BACKGROUND:Hemolytic transfusion reactions (HTRs) due to anti-P1 have rarely been reported. There is only one report (from 1945) of an acute HTR due to anti-P1. CASE REPORT:A 74-year-old woman with anti-P1 was given blood that had been found to be compatible by the use of prewarmed serum and saline-suspended red cells...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1998.38498257376.x

    authors: Arndt PA,Garratty G,Marfoe RA,Zeger GD

    更新日期:1998-04-01 00:00:00

  • In vivo red cell destruction by anti-Lu6.

    abstract::An example is presented of an IgG1, anti-Lu6, that reacted by indirect antiglobulin test and was capable of destroying antigen-positive red cells in vivo. Two methods for the measurement of red cell survival, 51Cr labeling and flow cytometry, gave the same result: 20 percent of the test dose of Lu:6 red cells was dest...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1990.30390194349.x

    authors: Issitt PD,Valinsky JE,Marsh WL,DiNapoli J,Gutgsell NS

    更新日期:1990-03-01 00:00:00

  • The extension of 4 degrees C storage time of frozen-thawed red cells.

    abstract::Blood was drawn from volunteer donors and frozen using the high glycerin, mechanical freezing procedure accepted by the United States Navy. Subsequently, the units of blood were thawed and washed. Various anticoagulants were added, and the red cells were stored in a refrigerator at 4 degrees C for periods of up to 28 ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1992.32492263449.x

    authors: Myhre BA,Marcus CS

    更新日期:1992-05-01 00:00:00

  • Low incidence of D alloimmunization among patients with a serologic weak D phenotype after D+ transfusion.

    abstract:BACKGROUND:By consensus definition, the red blood cells (RBCs) of patients that react weak to 2+ in the serologic D test are classified as having the serologic weak D phenotype (weak D). The risk of D alloimmunization in patients with weak D is not well studied. This study retrospectively determined the incidence of D ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.13725

    authors: Yazer MH,Brunker PA,Bakdash S,Tobian AA,Triulzi DJ,Earnest V,Harris S,Delaney M

    更新日期:2016-10-01 00:00:00

  • Complement activation and adult respiratory distress syndrome during intermittent flow apheresis procedures.

    abstract::We observed complement (C) activation during intermittent flow apheresis procedures (Haemonetics model 30) in four subjects, two of whom developed adult respiratory distress syndrome (ARDS). Actual C3 conversion during apheresis was illustrated by the finding of significantly elevated C3d levels (p less than 0.05) and...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1986.26186124040.x

    authors: Boogaerts MA,Roelant C,Goossens W,Verwilghen RL

    更新日期:1986-01-01 00:00:00