Journal of clinical apheresis
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Randomized Controlled Trial Clinical Trial
Augmented autologous transfusions in major reconstructive spine surgery.
Intraoperative autologous transfusion during major reconstructive spine surgery decreased allogeneic red blood cell transfusions, but patients were exposed to significant numbers of allogeneic blood products. This study reports a prospective study of 160 randomized patients undergoing major reconstructive spine surgery. Without delaying start of surgery, 80 patients underwent hemapheresis with coincidental normovolemic hemodilution in the operating room to sequester autologous blood components. ⋯ The per patient cost for IAT, with or without sequestration, was competitive with supplying one unit of cross-matched allogeneic red cells. IAT only patients had greater allogeneic blood donor exposures than Sequestration patients, in whom the numbers of allogeneic red cells, plasma and platelet transfusions were decreased. Compared with IAT alone, the hospital post-operative stay of Sequestration patients was 23% less than IAT only patients.
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Clinical Trial Controlled Clinical Trial
Rapid red cell transfusion by apheresis.
Packed red cells (RBC) are customarily infused slowly to allow time for re-equilibration of intravascular volume, but they may be given rapidly for convenience during hemodialysis or partial RBC exchange when blood volume can be adjusted extracorporeally. We describe an apheresis procedure for rapid transfusion of RBC to patients with chronic anemia in which an equivalent volume of recipient plasma is withdrawn as donor RBC are infused. Fifteen such procedures, transfusing 3 to 5 RBC units each, have been performed on nine patients (4 of them outpatients) with either COBE Spectra or COBE 2997. ⋯ Immediate post-procedure systolic blood pressures did not differ significantly from baseline, although one hypertensive patient had headache followed by increased blood pressure 4 hours after a procedure. We conclude that rapid transfusion of RBC is a technically feasible and more time efficient means for RBC transfusion. It is particularly attractive in the outpatient setting, and could also prevent fluid overload associated with RBC transfusion in some volume-sensitive patients.
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Randomized Controlled Trial Clinical Trial
Method for the safe and rapid pretransfusion warming of stored blood: an in vitro and in vivo evaluation of a radiofrequency (RF) instrument.
Inadvertent hypothermia due to massive infusion of stored blood can be prevented by pretransfusion warming. One approach is the heating of individual packs by means of electromagnetic conduction, which is a method safely used over the last 25 years. The prototype instrument, which has now been re-engineered, can effectively raise the temperature of a unit of blood to approximately 33 degrees C in less than 3 minutes. ⋯ Each donor acted as his own control. In paired studies, pretransfusion radiofrequency heating was shown to have no deleterious effect when compared to measurements using the unwarmed blood pack. It is concluded that this method can be recommended as safe.