Anemia ; therapy ; Erythrocyte Transfusion ; Exchange Transfusion, Whole Blood ; Female ; Hematocrit ; Hemoglobins ; analysis ; Humans ; Infant, Newborn ; Male

OBJECTIVE: To explore the blood transfusion data of emergency hemorrhage patients, so as to provide the basis for improving the quality of emergency blood transfusion and guiding clinic rational blood transfusion. METHODS: one thousand emergency blood loss patients once transfused RBC suspension were collected by Recipient Epidemiology and Donor Evaluation Study-III internationals Site range from November 2012 to November 2015. The clinical data including age, sex, clinical diagnosis etc were analyzed retrospectively. According to the quantity of blood transfusion the 1 000 patients were divided into 3 groups: low transfusion volume group(834),moderate transfusion volume group(116) and high transfusion volume group(50), difference was compared among the 3 groups，the transfusion predicting index and risk factor were analyzed by unvariate and multivoriate analyses using SPSS 23.0 software. RESULTS: High volume transfusion group was different from moderate and low volume transfusion in sex, pathogenesis, systolic pressure, hemoglobin level, with or without surgical operation, infusion volume of blood products, the retention time of ICU, total hospitalzed stay and mortality(P＜0.05), but there were no differences in age, respiration frequency, temperature before transfusion and creatinine level. The multivarate analysis showed that with or without surgical operation(OR=7.515，95% CI: 3.289-17.174, P=0.000), bleeding volume in surgery(OR=2.626, 95% CI: 1.428-4.828, P=0.043), the amount of transfused red blood cells(OR=2.574, 95% CI: 1.306-5.073, P=0.015), plasma transfusion or no(OR=2.118, 95% CI: 1.184-3.789, P=0.011), cryoprecipitate transfusion or no(OR=5.296, 95% CI: 2.164-12.960, P=0.000) were the independent risk factors for death resulted from emergency blood loss. CONCLUSION The probability of massive transfusion in the trauma patients is higher，and the massive transfusion associates with increased mortality in the emergency blood loss patients. Surgery operation, bleeding volume in operation, amount of transfused red blood cells, plasma transfusion and cryoprecipitate transfusion may predict the mortality of patients with blood transfusion.
Blood Transfusion ; Erythrocyte Transfusion ; Hemorrhage ; Humans ; Platelet Transfusion ; Retrospective Studies

OBJECTIVE: To study the clinical effects of preoperative autologous blood donation (PABD) in selective general surgery. METHODS: Paired study was performed in PABD group with 70 PABD cases screened from selective general surgery during the period from November 2017 to August 2018 in our hospital, and the control group included 70 cases without preoperative autologous blood donation, the baseline data before surgery were not significantly different. The transfusion quantities of allogeneic RBC and plasma, the levels of perioperative hemoglobin and platelets, the time and expense of hospitalization were compared between two groups. RESULTS: The levels of Hb and Plt in PABD group before and after blood collection were determined as follows: 138.26±14.73 g/L vs 127.52±13.36 g/L (P＜0.05) and (221.67±52.86)×10/L vs (198.35±52.65)×10/L (P＞0.05) respectively. The analysis of allo-RBC and allo-plasma transfusion in PABD group and control group showed that: the quantity of allogeneic RBC transfusion was 0.20±0.71 U and 0.89±0.97 U, and the quantity of allogeneic plasma transfusion was 30.43±100.81 ml and 106.52±152.61 ml (P＜0.05) respectirdy during perioperation. The comparison results of preoperative Hb and plt in PABD group and control group were 135.65±14.16 g/L vs 134.15±11.98 g/L and (270.36±58.28)×10/L vs (271.67±65.02) ×10/L respectively. The levels of postoperative Hb and plt in PABD group and control group were 120.24±14.40 g/L vs 121.20±14.30 g/L at 1 d after operation, and (241.80±63.58)×10/L vs (241.30±69.11)×10/L at 1 d after operation respectively; 123.15±13.80 g/L vs 121.65±14.33 g/L at 3 d after operation and (251.26±72.94)×10/L vs (255.54±73.85)×10/L at 3 d after operation; 122.78±13.92 g/L and 122.00±13.82 g/L (before discharge) and (262.50±80.96)×10/L and (264.56±71.08)×10/L (before discharge, platelet). These data were not statistically different (P＞0.05). The hospitalization time was 14.84±3.37 days and 14.84±2.24 days, respectively, without statistical difference (P＞0.05) in two groups. The expenses of hospitalization and the blood transfusion in two groups were 50627.27±9889.45 RMB and 50979.43±8195.00 RMB; 354.39±362.57 RMB and 684.02±425.53 RMB (P＜0.05). CONCLUSION The application of PABD reduces the use of allogeneic blood and costs for patients undergoing selective surgery with blood losts of 1000 ml.
Blood Component Transfusion ; Blood Donors ; Blood Transfusion ; Blood Transfusion, Autologous ; Humans ; Plasma

Increasingly, autologous blood transfusion has been arousing concern owing to awareness of adverse effects of allogenic blood transfusion, blood shortage and patients, having religious or personal issues. With the development of medicine, Cell Salvage and Acute normovolemic hemodilution (ANH) has been proposed as an alternative to allogenic blood transfusion. This review looked at the use of ANH and cell salvage and evaluated the benefits and usefulness based on the strengths and indications. Although not consistent with all cases of ANH, there were benefits in the amount of hemorrhage and transfusion, and no supplementary plasma or platelet transfusion was needed after surgery when employing ANH. But, it showed a cutoff value only for massive bleeding surgery (at least 500 mL). In the case of cell salvage, the amount of blood transfusion was reduced in most cases and platelet or plasma transfusion was not required in most cases. When the Leukoreduction filter (LDF) was utilized, it showed the effect of removing bacterial infection or tumor cells. Nonetheless, the effectiveness and benefits for patients in certain condition of cell salvage and ANH is ambiguous with discrepancies among studies or patients. Therefore, the aim of this study is to provide clinical knowledge relative to the procedure, measure the efficacy and usefulness of peri-operative blood management mentioned above and discuss the forthcoming prospects and challenges.
Bacterial Infections ; Blood Platelets ; Blood Transfusion ; Blood Transfusion, Autologous ; Hemodilution ; Hemorrhage ; Humans ; Operative Blood Salvage ; Plasma ; Platelet Transfusion

BACKGROUND: Intraoperative autotransfusion or residual blood in a cardiopulmonary bypass (CPB) circuit has been used to reduce the need for an homologous blood transfusion during cardiac surgery. However, it may contain some free hemoglobin released from damaged cells. The load of blood containing free hemoglobin may cause renal dysfunction. We measured the amount of free hemoglobin in banked blood, cell saver blood and CPB blood to evaluate what is the least hemolytic blood transfused in cardiac surgery. METHODS: This study was performed in 20 patients undergoing cardiac surgery. In each patient, the banked blood, intraoperative salvaged blood with a cell saver and CPB residual blood were sampled at the end of the operation. The concentration of free hemoglobin, hemoglobin and platelet counts were measured in these blood samples and percent of hemolysis was calculated (%hemolysis = [free hemoglobin] / [free hemoglobin hemoglobin]) RESULTS: In salvaged blood with a cell saver, CPB residual blood and banked blood, hemoglobin concentrations were 20.1+/-2.7 g/dl, 8.0+/-1.1 g/dl, and 22.2+/-2.7 g/dl, respectively. Free hemoglobin concentrations were 336.6+/-239.5 mg/dl, 49.2+/-26.8 mg/dl, and 279.5+/-167.5 mg/dl respectively. Platelet counts were 26.1+/-22.2X10(3)/mm3, 116.8+/-56.5X10(3)/mm3, and 94.9+/-43.6X10(3)/mm3 respectively. % Hemolysis were 1.6+/-1.1%, 0.6+/-0.4%, and 1.2+/-0.7% respectively. In the comparison between the salvaged blood with a cell saver and CPB residual blood, free hemoglobin concentration, % hemolysis, and platelet counts had positive correlations (r = 0.8, 0.7, and 0.6). CONCLUSIONS: In twenty cardiac surgeries, CPB residual blood had a lower free hemoglobin level than the other two blood groups. The platelet counts in CPB residual blood were higher than those in cell saver blood but did not differ from those in banked blood. Therefore, CPB residual blood was the least hemolytic blood among the three blood groups when a transfusion was performed in cardiac surgery.
Blood Group Antigens ; Blood Transfusion ; Blood Transfusion, Autologous ; Cardiopulmonary Bypass ; Hemolysis ; Humans ; Platelet Count ; Thoracic Surgery*

Since the introduction of Rh-immune globulin in 1968, the incidence of Rh D hemolytic disease of the newborn(HDN) had become markedly reduced but in the contrary the HDN by minor blood group antibodies has become increased relatively. As anti-E is the most common minor blood group antibody identified in antenatal serology and because of the frequency of E-negative people in Korea is ranged from 38.8% to 50.3%, the probability of HDN caused by anti-E is expected relatively high. We had experienced antenatal therapy for a E-isoimmunized pregnant woman, who has the history of one previous stillbirth and one neonatal death. In addition to above obstetric history, she had a history of blood transfusion, in which she was given 7 units of whole blood during the operation of brain cyst 7 years ago, before her marriage. Therapeutic plasma exchanges were repeated from the 22nd to 25th weaks of gestation. During the period a mean volume of 350mL plasma volume was exchanged on average twice a week. After the period, therapeutic plasma exchange procedure was failed because of unsuccessful vascular access. So that we gave her intravenous immunoglobulin(IVIG), 0.4gm/kg for 5 days, and two intrauterine transfusion were given at 25th and 27th weeks of gestation to relief from grave HDN. The maximal antiglobulin titer of anti-E during the gestation period was 1:32. In spite of intensive therapy as above mentioned, she was delivered a severely hydropic fetus weighing 1,900g at 29th weeks of gestation under Cesarean section. The neonate died 2 days after the birth with severe erythroblastosis fetalis and disseminated intravascular coagulation (DIC). Even though we could not save the baby, we report this experience as a reviewable case of antenatal treatment modalities for Rh immunization and the serious consequence of blood transfusion before marriage.
Antibodies ; Blood Transfusion ; Blood Transfusion, Intrauterine* ; Brain ; Cesarean Section ; Disseminated Intravascular Coagulation ; Erythroblastosis, Fetal ; Female ; Fetus ; Humans ; Immunization ; Immunoglobulins, Intravenous* ; Incidence ; Infant, Newborn ; Korea ; Marriage ; Parturition ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Pregnancy ; Pregnant Women ; Stillbirth

The purpose of this study is to compare the quality of intraoperative salvaged blood with that of Citrate Phosphate Dextrose(CPD) stored blood in 32 patients having cardiac surgery involving cardiopulmonary bypass. 20 patients in the control group received one week cild CPD stored blood and 12 patients received autologous intraoperative salvaged blood which prepared and processed with the Hemonetics Cell Saver Plus autotransfusion device. 1) Salvaged blood had a higher hemoglobin concentration(l7.6 vs 13.1 g/dl, P<0.005), a higher 2.3-diphosphoglycerate concentration(3.1 vs 0.6 mmol/L, P<0.005), higher pH(7.6 vs 6.8, P<0.005) than CPD stored blood group. Salvaged blood had a lower ATP concentration was(47.7 vs 67.7 pmol/dl, P<0.005) than stored blood group. 2) Platelet count was l3.4 X 10(9)/L and WBC count was 5.09 X 10(9)/L in salvaged blood. 3) Salvaged blood volume was 1411+/-487.9 ml(range 580 to 2325 ml). Intraoperative salvaged blood had a superior oxygen carrying and delivery capacity, but modification of washing is required to lessen the platelet and white blood cell count in the salvaged blood.
2,3-Diphosphoglycerate* ; Adenosine Triphosphate* ; Blood Platelets ; Blood Transfusion, Autologous ; Blood Volume ; Cardiopulmonary Bypass ; Citric Acid ; Erythrocytes* ; Humans ; Leukocyte Count ; Oxygen ; Platelet Count ; Thoracic Surgery

No abstract available.
Blood Transfusion, Autologous*

No abstract available.
Blood Transfusion, Autologous*

No abstract available.
Blood Transfusion, Autologous*