Anesthesiology clinics of North America
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This review focuses on perioperative blood conservation techniques and the role of transfusion triggers and algorithms, preoperative autologous donation, acute normovolemic hemodilution, intraoperative blood salvage, deliberate hypotension, and preoperative recombinant human erythropoietin in avoiding allogeneic blood transfusion in pediatric patients.
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This article describes the intraoperative washed cell salvage process and principles of cell salvage technology and addresses the parameters that can maximize the effectiveness of the process. Used appropriately, this technique can be used to recover and readminister several blood volumes of red cells.
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Anesthesiol Clin North America · Jun 2005
ReviewPreoperative evaluation and methods to reduce blood use in orthopedic surgery.
Major elective orthopedic surgery may be associated with significant blood loss and allogeneic transfusion risk. Identifying patients at risk for allogeneic transfusion is best accomplished with a thorough preoperative evaluation of the patient's hematopoietic system, which, unfortunately, is not always carried out. ⋯ This allows for expedited diagnosis and treatment of underlying comorbidities. An unexplained low level of hemoglobin or a hemoglobin level low enough to increase the patient's allogeneic risk should cause elective surgery to be deferred until an evaluation can be preformed and blood management strategies put in place.
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Anesthesiol Clin North America · Jun 2005
Comparative StudyClinical outcomes in cardiac surgery: conventional surgery versus bloodless surgery.
Bleeding during and after cardiac operations and the effects of cardiopulmonary bypass hemodilution commonly result in blood transfusions. Excessive microvascular bleeding can result in re-exploration and prolonged hospitalization. ⋯ The large demand for blood products places significant pressure on the national blood supply, resulting in frequent shortages. The variability in transfusion practice of cardiac surgery patients suggests that sound blood management and a conservative approach to this population can result in reduced transfusions without increasing morbidity or mortality and avoiding complications associated with allogeneic blood transfusion.