Lowering the hemoglobin threshold for transfusion in coronary artery bypass procedures: effect on patient outcome.

Abstract:

BACKGROUND:There is controversy regarding the application of transfusion triggers in cardiac surgery. The goal of this study was to determine if lowering the hemoglobin threshold for red cell (RBC) transfusion to 8 g per dL after coronary artery bypass graft surgery would reduce blood use without adversely affecting patient outcome. STUDY DESIGN AND METHODS:Consecutive patients (n = 428) undergoing elective primary coronary artery bypass graft surgery were randomly assigned to two groups: study patients (n = 212) received RBC transfusions in the postoperative period if the Hb level was < 8 g per dL or if predetermined clinical conditions required RBC support, and control patients (n = 216) were treated according to individual physician's orders (hemoglobin levels < 9 g/dL as the institutional guideline). Multiple demographic, procedure-related, transfusion, laboratory, and outcome data were analyzed. Questionnaires were administered for patient self-assessment of fatigue and anemia. RESULTS:Preoperative and operative clinical characteristics, as well as the intraoperative transfusion rate, were similar for both groups. There was a significant difference between the postoperative RBC transfusion rates in study (0.9 +/- 1.5 RBC units) and control (1.4 +/- 1.8 RBC units) groups (p = 0.005). There was no difference in clinical outcome, including morbidity and mortality rates, in the two groups; group scores for self-assessment of fatigue and anemia were also similar. CONCLUSIONS:A lower Hb threshold of 8 g per dL does not adversely affect patient outcome. Moreover, RBC resources can be saved without increased risk to the patient.

journal_name

Transfusion

journal_title

Transfusion

authors

Bracey AW,Radovancevic R,Riggs SA,Houston S,Cozart H,Vaughn WK,Radovancevic B,McAllister HA Jr,Cooley DA

doi

10.1046/j.1537-2995.1999.39101070.x

subject

Has Abstract

pub_date

1999-10-01 00:00:00

pages

1070-7

issue

10

eissn

0041-1132

issn

1537-2995

journal_volume

39

pub_type

临床试验,杂志文章,随机对照试验
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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2005.00173.x

    authors: Okamura Y,Takeoka S,Teramura Y,Maruyama H,Tsuchida E,Handa M,Ikeda Y

    更新日期:2005-07-01 00:00:00

  • Center error reduction by recheck of blood type.

    abstract::Our computer system currently stores donor blood types for seven years and checks typing of all repeat donors against these files. In a recent three-month period (42,500 units), five discrepancies were found--two representing current error. Retrospective analysis of 18 errors made over the last three years showed that...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1981.21281178157.x

    authors: Grindon AJ,Liles BA

    更新日期:1981-03-01 00:00:00

  • Incest diagnosis by comparison of alleles of mother and offspring at highly heterozygous loci.

    abstract:BACKGROUND:Methods that detect a child's homozygosity by examination of allelic products are insensitive for diagnosing incest because, at a given locus, a homozygous state is expected with a frequency of only 0.25 when parents are first-degree relatives. Furthermore, these methods are not specific if the population co...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1994.34294143949.x

    authors: Wenk RE,Chiafari FA,Houtz T

    更新日期:1994-02-01 00:00:00

  • A simplified method for quality control of deglycerolized erythrocytes.

    abstract::Quality control to detect inadequately deglycerolized red blood cells can be easily and inexpensively accomplished by suspending the deglycerolized cells in either recipient serum or normal saline in the same way in which the routine crossmatch is performed. In vitro hemolysis is readily and consistently apparent when...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1982.22382224955.x

    authors: Silver H,Umlas J,Kenney P,Anderson J,Pina B,Cross D

    更新日期:1982-05-01 00:00:00

  • Comparison of the analytical and operational performance of two viral nucleic acid test blood screening systems: Procleix Tigris and cobas s 201.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2008.01965.x

    authors: Assal A,Barlet V,Deschaseaux M,Dupont I,Gallian P,Guitton C,Morel P,David B,De Micco P

    更新日期:2009-02-01 00:00:00

  • Assessing and mitigating the interference of ALX148, a novel CD47 blocking agent, in pretransfusion compatibility testing.

    abstract::ALX148, a novel CD47 blocking agent, is in clinical development for the treatment of advanced solid tumors and lymphoma. Because CD47 is highly expressed on red blood cells (RBCs), its therapeutic blockade can potentially interfere with pretransfusion compatibility testing. This study describes the interference of ALX...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.16009

    authors: Kim TY,Yoon MS,Hustinx H,Sim J,Wan HI,Kim H

    更新日期:2020-08-20 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

  • Validation and assessment of a blood-donor arm disinfectant containing chlorhexidine and alcohol.

    abstract:BACKGROUND:To minimize the bacterial contamination rate in blood collected from donors, a study was designed to evaluate the suitability of a single-use chlorhexidine-alcohol antiseptic for donor arm preparation at all blood collection venues in Australia. STUDY DESIGN AND METHODS:A prospective study of bacterial load...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2004.03362.x

    authors: Wong PY,Colville VL,White V,Walker HM,Morris RA,Microbial Contamination and Infection Control Subcommittee, Australian Red Cross Blood Service.

    更新日期:2004-08-01 00:00:00

  • Transfusion-related immune modulation: functional consequence of extracellular vesicles?

    abstract::Extracellular vesicles (EVs) are small, subcellular vesicles that are released from a variety of cells and play important roles in cell-to-cell communication. Transfused blood products, including red blood cell, platelet, and plasma products contain EVs that are capable of interacting with and altering immune cell fun...

    journal_title:Transfusion

    pub_type: 杂志文章,评审

    doi:10.1111/trf.15461

    authors: Menocha S,Muszynski JA

    更新日期:2019-12-01 00:00:00

  • Prevalence of transfusion-transmissible viral infections in first-time US blood donors by donation site.

    abstract:BACKGROUND:Understanding the donor base, infectious disease prevalence, and donation loss at various blood donation sites will help maximize blood collection efforts and blood availability. STUDY DESIGN AND METHODS:Using donation data collected at five US blood centers, the prevalence of HIV, HTLV, HBsAg, and HCV in f...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.2003.00399.x

    authors: Wang B,Schreiber GB,Glynn SA,Nass CC,Smith JW,Higgins MJ,Hutching ST,Wright DJ,McEntire RL,Murphy EL,Retrovirus Epidemiology Donor Study.

    更新日期:2003-06-01 00:00:00

  • The effect of adenine on platelet storage.

    abstract::Adenine is an approved additive to citrate-phosphate-dextrose anticoagulant for whole blood collection and extends the storage life of red blood cells. We used in vitro methods to investigate the effects of adenine on platelet function and viability during 72 hours of storage at 22 degrees C. Although the hypotonic sh...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1982.22482251208.x

    authors: Wong SC,Rock G

    更新日期:1982-07-01 00:00:00

  • Removal of citrate from PAS-III additive solution improves functional and biochemical characteristics of buffy-coat platelet concentrates stored for 7 days, with or without INTERCEPT pathogen reduction.

    abstract:BACKGROUND:Deterioration in quality of platelet concentrates (PCs) during storage results from the appearance of storage lesions affecting the hemostatic functions and posttransfusion survival of platelets. These lesions depend on the preparation and pathogen inactivation methods used, duration of storage, and platelet...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.16280

    authors: Isola H,Ravanat C,Rudwill F,Pongerard A,Haas D,Eckly A,Gachet C,Hechler B

    更新日期:2021-02-01 00:00:00

  • The development of a quantitative enzyme-linked immunosorbent assay to detect human platelet factor 4.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2005.04243.x

    authors: Schraw T,Whiteheart S

    更新日期:2005-05-01 00:00:00

  • An apparent anti-Jka reacting only in the presence of methyl esters of hydroxybenzoic acid.

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    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1982.22683068617.x

    authors: Halima D,Garratty G,Bueno R

    更新日期:1982-11-01 00:00:00

  • Preparation of white cell-depleted red cells for 42-day storage using an integral in-line filter.

    abstract::A new blood pack system for the preparation of white cell-depleted red cells was studied. The system is a modified additive-solution quadruple-unit blood pack that incorporates a cellulose-acetate fiber depth filter in-line between the AS-3 additive bag and the CP2D collection bag. Mean +/- SD white cell removal from ...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1989.29689318446.x

    authors: Davey RJ,Carmen RA,Simon TL,Nelson EJ,Leng BS,Chong C,Garcez RB,Sohmer PR

    更新日期:1989-07-01 00:00:00

  • Quality of red blood cells washed using the ACP 215 cell processor: assessment of optimal pre- and postwash storage times and conditions.

    abstract:BACKGROUND:Washing of red blood cell concentrates (RCCs) is required for potassium-sensitive transfusion recipients, including neonates in need of large-volume transfusions. When open, nonsterile washing systems are used, postwash outdate time is limited to 24 hours, often leading to problems providing the component to...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.12170

    authors: Hansen A,Yi QL,Acker JP

    更新日期:2013-08-01 00:00:00

  • Clinical and laboratory findings on two patients with naturally occurring anti-Kell agglutinins.

    abstract::Two patients with naturally occurring anti-K agglutinins are reported. Both patients manifested clinical symptoms associated with septicemia. Transfusion of one patient with K-positive blood did not result in hemolytic complications, further stimulation of the anti-K agglutinin or any change in its immunoglobulin natu...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1981.21281178154.x

    authors: Judd WJ,Walter WJ,Steiner EA

    更新日期:1981-03-01 00:00:00

  • Preparation of pooled cryoprecipitate for treatment of hemophilia A in a home care program.

    abstract::Cryoprecipitate is used infrequently in home therapy for patients with hemophilia A since freezer storage is required and resuspension and pooling of thawed cryoprecipitate is cumbersome. We evaluated procedures for preparation of cryoprecipitate in an "open system" so that four to six bags of cryoprecipitate could be...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1984.24685066816.x

    authors: Smith KJ,Hodges PA

    更新日期:1984-11-01 00:00:00

  • Heme-related molecules induce rapid production of neutrophil extracellular traps.

    abstract:BACKGROUND:Pulmonary endothelial cell damages caused by neutrophil overactivation could result in acute lung injuries including transfusion-related acute lung injury (TRALI). We previously reported that heme-related molecules derived from hemolysis induced the production of reactive oxygen species from neutrophils. Rec...

    journal_title:Transfusion

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1111/trf.12700

    authors: Kono M,Saigo K,Takagi Y,Takahashi T,Kawauchi S,Wada A,Hashimoto M,Minami Y,Imoto S,Takenokuchi M,Morikawa T,Funakoshi K

    更新日期:2014-11-01 00:00:00

  • Easy identification of antibodies to high-prevalence Scianna antigens and detection of admixed alloantibodies using soluble recombinant Scianna protein.

    abstract:BACKGROUND:Identification of antibodies against high-prevalence Scianna (Sc; ERMAP) antigens, like Sc1 and Sc5, is difficult and may incur delays in blood procurement and costs. The detection of additional clinically significant alloantibodies is hampered in the presence of anti-Scianna. Soluble recombinant Scianna pro...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2009.02255.x

    authors: Seltsam A,Grueger D,Blasczyk R,Flegel WA

    更新日期:2009-10-01 00:00:00

  • Intravenous administration of tranexamic acid effectively reduces blood loss in primary total knee arthroplasty in a 610-patient consecutive case series.

    abstract:BACKGROUND:Tranexamic acid (TXA) has been reported to demonstrate efficacy in reducing blood loss during arthroplasty procedures. STUDY DESIGN AND METHODS:This study examines the effectiveness of TXA as a central element of a patient blood management program (PBMP) by evaluating blood loss and transfusion of red blood...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.13354

    authors: Pitta M,Zawadsky M,Verstraete R,Rubinstein A

    更新日期:2016-02-01 00:00:00

  • Clinically significant red blood cell antibodies in chronically transfused patients: a survey of Chinese thalassemia major patients and literature review.

    abstract:BACKGROUND:Red blood cell (RBC) alloimmunization is reported to occur at an incidence of 5.2% to 23.5% among patients with thalassemia requiring chronic transfusion. With very limited data on alloimmunization among the Chinese population, a territory-wide study has been performed to look at its prevalence among Chinese...

    journal_title:Transfusion

    pub_type: 杂志文章,评审

    doi:10.1111/j.1537-2995.2012.03570.x

    authors: Cheng CK,Lee CK,Lin CK

    更新日期:2012-10-01 00:00:00

  • Noninvasive determination of fetal RHD status by examination of cell-free DNA in maternal plasma.

    abstract:BACKGROUND:Cell-free fetal DNA in maternal plasma opens the way for routine risk-free diagnosis of fetal D status of D- mothers. The focus was on accuracy of RHD typing and confirmation of fetal DNA in maternal plasma while RHD was not detected. STUDY DESIGN AND METHODS:Plasma DNA was extracted (by manual and/or autom...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2005.00559.x

    authors: Brojer E,Zupanska B,Guz K,Orziñska A,Kaliñska A

    更新日期:2005-09-01 00:00:00

  • Generation of kinins during preparation and storage of whole blood-derived platelet concentrates.

    abstract:BACKGROUND:Leukoreduction of platelet (PLT) concentrates (PCs) may be associated with hypotension in recipients, and a role for bradykinin (BK)-related peptides has been proposed for this side effect. STUDY DESIGN AND METHODS:The concentration of BK and one of its vasoactive metabolites, des-arginine(9)-BK (des-Arg(9)...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2007.01097.x

    authors: Moreau ME,Thibault L,Désormeaux A,Chagnon M,Lemieux R,Robillard P,Marceau F,Colman RW,Lepage Y,Rivard GE,Adam A

    更新日期:2007-03-01 00:00:00

  • The prevalence of human parvovirus B19 DNA and antibodies in blood donors from four Chinese blood centers.

    abstract:BACKGROUND:Human parvovirus B19 is a common human pathogen that causes a variety of diseases with outcomes ranging from asymptomatic to severe, especially in immunocompromised patients. The B19 virus can be transmitted via blood and/or blood products and its resistance to common viral inactivation and/or removal method...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2011.03067.x

    authors: Ke L,He M,Li C,Liu Y,Gao L,Yao F,Li J,Bi X,Lv Y,Wang J,Hirsch ML,Li W

    更新日期:2011-09-01 00:00:00

  • Additional red blood cell alloantibodies after blood transfusions in a nonhematologic alloimmunized patient cohort: is it time to take precautionary measures?

    abstract:BACKGROUND:Red blood cell (RBC) alloimmunization is common in transfused patients. Most studies report on the rate of alloimmunization in chronically transfused patients, which can be as high as 60 percent. Less is known on the incidence of clinically relevant antibodies in accidentally transfused patients. Because the...

    journal_title:Transfusion

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1537-2995.2006.00764.x

    authors: Schonewille H,van de Watering LM,Brand A

    更新日期:2006-04-01 00:00:00

  • Is red blood cell rheology preserved during routine blood bank storage?

    abstract:BACKGROUND:Red blood cell (RBC) units stored for more than 2 weeks at 4 degrees C are currently considered of impaired quality. This opinion has primarily been based on altered RBC rheologic properties (i.e., enhanced aggregability, reduced deformability, and elevated endothelial cell interaction), during prolonged sto...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/j.1537-2995.2009.02521.x

    authors: Henkelman S,Dijkstra-Tiekstra MJ,de Wildt-Eggen J,Graaff R,Rakhorst G,van Oeveren W

    更新日期:2010-04-01 00:00:00

  • Improvement in appropriate autologous donations with local education: 1987 to 1989.

    abstract::Preoperative autologous blood donation for elective surgery patients at university hospitals was underused in the past. More recently, national educational efforts have been made. To test the impact of local surgeon interviews and education, in 1988 the same local educational program was instituted at three university...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1046/j.1537-2995.1992.32692367202.x

    authors: Toy PT,McVay PA,Strauss RG,Stehling LC,Ahn DK

    更新日期:1992-07-01 00:00:00

  • Transfusion of banked red blood cells and the effects on hemorrheology and microvascular hemodynamics in anemic hematology outpatients.

    abstract:BACKGROUND:The aim of this study was to investigate the effects of red blood cell (RBC) transfusion on the hemorrheologic properties and microcirculatory hemodynamics in anemic hematology outpatients receiving 2 to 4 RBC units of either "fresh" (leukoreduced storage for less than 1 week) or "aged" (leukoreduced storage...

    journal_title:Transfusion

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1537-2995.2012.03905.x

    authors: Yürük K,Milstein DM,Bezemer R,Bartels SA,Biemond BJ,Ince C

    更新日期:2013-06-01 00:00:00

  • Thrombotic thrombocytopenic purpura during pregnancy versus imitator of preeclampsia.

    abstract:BACKGROUND:Thrombotic thrombocytopenic purpura (TTP) is a severe disorder affecting the microcirculation of multiple organs due to a systemic endothelial cell injury secondary to a deficiency in ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 motif, member 13) activity. TTP is a rare complication...

    journal_title:Transfusion

    pub_type: 杂志文章

    doi:10.1111/trf.13207

    authors: Gasparri ML,Bellati F,Brunelli R,Perrone G,Pecorini F,Papadia A,Meloni G,Trisolini SM,Gozzer M,Domenici L,Lecce F,Benedetti Panici P

    更新日期:2015-10-01 00:00:00