Transfusion medicine
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Transfusion medicine · Oct 2009
Biography Historical ArticleProfessor Alan Harold Waters MBBS(Hons), PhD, FRCPA, FRACP, FRCPath, FRCP (1934-2009).
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Transfusion medicine · Aug 2009
Randomized Controlled TrialEfficacy and cost-effectiveness of cell saving blood autotransfusion in adult lumbar fusion.
The objective of this study was to explore the use of cell saver blood autotransfusion in spinal surgery and to evaluate the efficacy and cost-effectiveness of cell saver blood autotransfusion during lumbar spine fusion in adults. Specific indications for the use of cell saver in adult lumbar fusion surgery have not yet been clearly determined. A total of 50 consecutive candidates for posterolateral fusion with internal fixation were prospectively randomized into either receiving perioperatively cell saving autotransfusion (Group A: 25 patients) or not (Group B: 25 patients). ⋯ The cost of blood transfusion in Group A was 995 +/-euro447 per patient and 1220 +/- 269 in Group B (P < 0.05). In elective lumbar fusion blood requirements can be satisfied with the use of autotransfusion. The use of cell saver appears to be useful and cost-effective during most elective lumbar fusions.
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Transfusion medicine · Aug 2009
A survey of physicians' reasons to transfuse plasma and platelets in the critically ill: a prospective single-centre cohort study.
Data on the rationality of transfusion practice of fresh frozen plasma (FFP) and platelets in the critically ill are sparse and may contribute to efforts to reduce transfusion rates. To provide insight into determinants of the decision of intensive care unit (ICU)-physicians to transfuse, a survey study was performed. The reasons of ICU-physicians to transfuse FFP and platelets were determined during a 10-week period. ⋯ FFP transfusion failed to normalize prolonged coagulation test results in the majority of the patients. Transfusion of platelets was restrictive in non-bleeding patients and liberal in bleeding patients. Education on indications of FFP transfusion and improved identification of bleeding may reduce transfusion rates.
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Transfusion medicine · Jun 2009
Changes in transfusion practice in multiple injury between 1993 and 2006: a retrospective analysis on 5389 patients from the German Trauma Registry.
To evaluate transfusion practices in multiple injured patients and to demonstrate changes in the pattern of packed red blood cell (pRBC) transfusions over the last one-and-half decade (1993-2006). A retrospective analysis using the German Trauma Registry database (DGU-Traumaregister) including 29 353 multiple injured patients was conducted. The study population included primary admissions presenting to the emergency room (ER) with clinical and laboratory signs of active haemorrhage [haemoglobin < 9 g x dL(-1), platelets < 90000 xmicroL(-1) and prothrombin time (Quick-value) < 60%]. ⋯ The percentage of patients who received pRBC transfusions between ER and ICU dropped from 72% in 1993-1998 to 54% in 2003-2006 (P < 0.005). Similarly, the percentage of patients receiving mass transfusions (> 10 pRBC units) dropped from 51.3 to 17.1%. This decline was accompanied by lower incidence rates for septic complications, ventilator days, ICU length-of-stay and mortality. pRBC transfusion practices in acute trauma care have changed substantially over the last one-and-half decade and were associated with better outcome.
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Transfusion medicine · Apr 2009
Improving the evidence base for transfusion medicine: the work of the UK systematic review initiative.
Clarifying the existing evidence base is crucial to improve the effectiveness of transfusion practice. The UK Systematic Review Initiative has been pursuing this objective primarily through writing systematic reviews on important topics in transfusion medicine. ⋯ The article considers future challenges including the need for wider involvement from the transfusion medicine community in the process of maintaining and updating systematic reviews and the identification and prioritization of topics for further clinical research including clinical trials. Collaboration between international and local research groups is important if these challenges are to be met.