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blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

World Journal of Gastroenterology 2009年第37期15卷 4686-4694页

作者： José Antonio García-Erce Fernando Gomollón Manuel Muoz transfusion Medicine and Apheresis Unit Haematology and Haemotherapy Regional Service "Miguel Servet" University Hospital Zaragoza 50009 Spain Gastroenterology Unit University Clinical Hospital and Biomedical Investigation Center at Digestive and Hepatic Disease Network c/San Juan Bosco 15 Zaragoza 50009 Spain transfusion Medicine School of Medicine University of Málaga Málaga 29071 Spain

Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion), which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a f ixed protocol [mostly two by two packed red blood cell (PRC) units] independently of the patient' s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a "one-by-one" administration schedule. Evidencebased clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD) consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within wellconstructed protocols will offer better prospe

关键词： Anaemia blood transfusion Autologous blood transfusion Inflammatory bowel diseases Risk assessment

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Distinct risk factors for early and late blood transfusion following pancreaticoduodenectomy

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 349-357页

作者： Sukhchain S.Bansal James Hodson Khalid Khalil Bobby Dasari Ravi Marudanayagam Robert P.Sutcliffe John Isaac Keith J.Roberts Department of Hepatobiliary Pancreatic Surgery Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham Institute of Translational Medicine Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham

Background: The International Study Group of Pancreatic Surgery(ISGPS) has defined two periods of postpancreatectomy hemorrhage, early(24 h). A previously published blood Usage Risk Score(BURS) aimed to predict early and late blood transfusion. The primary aim of this study was to define risk factors for early and late blood transfusion after pancreaticoduodenectomy. Secondary aims were to assess the predictive accuracy of the ***: In this retrospective observational study, multivariable analyses were used to identify independent risk factors for both early and late blood transfusion. The predictive ability of the BURS was then assessed using a receiver operating characteristic(ROC) curve ***: Among 628 patients, 99(15.8%) and 144(22.9%) received early and late blood transfusion, respectively. Risk factors for blood transfusion differed between early and late periods. Preoperative anemia and venous resection were associated with early blood transfusion whilst Whipple’s resection(as opposed to pylorus preserving pancreaticoduodenectomy), lack of biliary stent and a narrow pancreatic duct were predictors of late blood transfusion. The BURS was significantly predictive of early blood transfusion,albeit with a modest degree of accuracy(AUROC: 0.700, P blood transfusion(AUROC: 0.525, P = 0.360). Late blood transfusion was independently associated with increasing severity of postoperative pancreatic fistula(POPF)(OR: 1.85, 3.18 and 9.97 for biochemical, types B and C POPF,respectively, relative to no POPF).Conclusions: Two largely different sets of variables are related to early and late blood transfusion following pancreaticoduodenectomy. The BURS was significantly associated with early, albeit with modest predictive accuracy, but not late blood transfusion. An understanding of POPF risk allows assessment of the need for late blood transfusion.

关键词： Pancreatic cancer blood transfusion Pancreaticoduodenectomy

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Effect of perioperative blood transfusion on clinical outcomes in hepatic surgery for cancer

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World Journal of Gastroenterology 2009年第32期15卷 3976-3983页

作者： Gianlorenzo Dionigi Luigi Boni Francesca Rovera Stefano Rausei Salvatore Cuffari Giovanni Cantone Alessandro Bacuzzi Renzo Dionigi Department of Surgical Sciences Azienda Ospedaliera-Polo UniversitarioUniversity of InsubriaVia Guicciardini21100 VareseItaly Department of Anesthesiology Azienda Ospedaliera-Polo Universitario21100 VareseItaly

Allogeneic blood transfusion during liver resection for malignancies has been associated with an increased incidence of different types of complications: infectious complications, tumor recurrence, decreased survival. Even if there is clear evidence of transfusion-induced immunosuppression, it is difficult to demonstrate that transfusion is the only determinant factor that decisively affects the outcome. In any case there are several motivations to reduce the practice of blood transfusion. The advantages and drawbacks of different transfusion alternatives are reviewed here, emphasizing that surgeons and anesthetists who practice in centers with a high volume of liver resections, should be familiar with all the possible alternatives.

关键词： blood transfusion blood products Allogeneicblood transfusion Intraoperative autotransfusion Preoperative autologous blood donation Intraoperativeisovolemic hemodilution Infectious complications Liverresection Hepatocellular carcinoma

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Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation

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World Journal of Gastroenterology 2021年第12期27卷 1161-1181页

作者： Karina Gordon Estela Regina Ramos Figueira Joel Avancini Rocha-Filho Luiz Antonio Mondadori Eduardo Henrique Giroud Joaquim Joao Seda-Neto Eduardo Antunes da Fonseca Renata Pereira Sustovitch Pugliese Agustin Moscoso Vintimilla Jose Otavio Costa Auler Jr Maria Jose Carvalho Carmona Luiz Augusto Carneiro D'Alburquerque Division of Anesthesiology Hospital das ClínicasUniversity of São Paulo School of MedicineSão Paulo 05403-000Brazil Department of Anesthesiology AC Camargo Cancer CenterSão Paulo 01509-010Brazil Department of Gastroenterology Discipline of Liver and Gastrointestinal TransplantationLaboratory of Medical Investigations LIM37 Hospital das ClinicasUniversity of São Paulo School of MedicineSão Paulo 05402-000Brazil Department of Liver Transplantation AC Camargo Cancer CenterSão Paulo 01525-901Brazil Department of Gastroenterology Division of Liver and Gastrointestinal TransplantHospital das ClinicasUniversity of São Paulo School of MedicineSão Paulo 05402-000Brazil

BACKGROUND The impact of perioperative blood transfusion on short-and long-term outcomes in pediatric living donor liver transplantation(PLDLT)must still be ascertained,mainly among young *** and surgical postoperative complications related to perioperative blood transfusion are well described up to three months after adult liver *** To determine whether transfusion is associated with early and late postoperative complications and mortality in small patients undergoing *** We evaluated the effects of perioperative transfusion on postoperative complications in recipients up to 20 kg of body weight,submitted to PLDLT.A total of 240 patients were retrospectively allocated into two groups according to postoperative complications:Minor complications(n=109)and major complications(n=131).Multiple logistic regression analysis identified the volume of perioperative packed red blood cells(RBC)transfusion as the only independent risk factor for major postoperative *** receiver operating characteristic curve was drawn to identify the optimal volume of the perioperative RBC transfusion related to the presence of major postoperative complications,defining a cutoff point of 27.5 mL/***,patients were reallocated to a low-volume transfusion group(LTr;n=103,RBC≤27.5 mL/kg)and a high-volume transfusion group(HTr;n=137,RBC>27.5 mL/kg)so that the outcome could be *** High-volume transfusion was associated with an increased number of major complications and mortality during hospitalization up to a 10-year follow-up *** a short-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and bleeding complications,with a decrease in rejection complications compared to the *** a long-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and minor neoplastic complications,with a decrease in rejection ***,Cox hazard regr

关键词： Liver transplantation Child blood transfusion Outcome Liver cirrhosis Mortality

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Machine Learning for Detecting blood transfusion Needs Using Biosignals

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Computer Systems Science & Engineering 2023年第8期46卷 2369-2381页

作者： Hoon Ko Chul Park Wu Seong Kang Yunyoung Nam Dukyong Yoon Jinseok Lee Department of Biomedical Engineering College of Electronics and InformationKyung Hee UniversityYongin17104Korea Department of Internal Medicine Wonkwang University School of MedicineIksan54538Korea Department of Trauma Surgery Jeju Regional Trauma CenterCheju Halla General HospitalJeju63127Korea Department of Computer Science and Engineering Soonchunhyang UniversityAsan31538Korea Department of Biomedical Systems Informatics Yonsei University College of MedicineYongin03722Korea

Adequate oxygen in red blood cells carrying through the body to the heart and brain is important to maintain *** those patients requiring blood,blood transfusion is a common procedure in which donated blood or blood components are given through an intravenous ***,detecting the need for blood transfusion is time-consuming and sometimes not easily diagnosed,such as internal *** study considered physiological signals such as electrocardiogram(ECG),photoplethysmogram(PPG),blood pressure,oxygen saturation(SpO2),and respiration,and proposed the machine learning model to detect the need for blood transfusion *** the model,this study extracted 14 features from the physiological signals and used an ensemble approach combining extreme gradient boosting and random *** model was evaluated by a stratified five-fold crossvalidation:the detection accuracy and area under the receiver operating characteristics were 92.7%and 0.977,respectively.

关键词： blood transfusion ECG PPG pulse transit time blood pressure machine learning

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Joint effect of pre-operative anemia and perioperative blood transfusion on outcomes of colon-cancer patients undergoing colectomy

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Gastroenterology Report 2020年第2期8卷 151-157,I0003页

作者： Zheng Liu Jia-Jun Luo Kevin Y.Pei Sajid A.Khan Xiao-Xu Wang Zhi-Xun Zhao Ming Yang Caroline H.Johnson Xi-Shan Wang Yawei Zhang Department of Colorectal Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Surgery Yale School of MedicineNew HavenCTUSA Department of Surgery School of MedicineTexas Tech University Health Sciences CenterLubbockTXUSA Department of Environmental Health Sciences Yale School of Public HealthNew HavenCTUSA

Background:Both pre-operative anemia and perioperative(intra-and/or post-operative)blood transfusion have been reported to increase post-operative complications in patients with colon cancer undergoing ***,their joint effect has not been *** purpose of this study was to evaluate the joint effect of pre-operative anemia and perioperative blood transfusion on the post-operative outcome of colon-cancer patients after ***:We identified patients from the American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database 2006–2016 who underwent colectomy for colon *** logistic regression analysis was employed to assess the independent and joint effects of anemia and blood transfusion on patient ***:A total of 35,863 patients—18,936(52.8%)with left-side colon cancer(LCC)and 16,927(47.2%)with right-side colon cancer(RCC)—were *** patients were more likely to have mild anemia(62.7%)and severe anemia(2.9%)than LCC patients(40.2%mild anemia and 1.4%severe anemia).A total of 2,661(7.4%)of all patients(1,079[5.7%]with LCC and 1,582[9.3%]with RCC)received a perioperative blood ***,the occurrence rates of complications were comparable between LCC and RCC patients(odds ratio[OR]=1.01;95%confidence interval[CI]=0.95–1.07;P=0.750).There were significant joint effects of anemia and transfusion on complications and the 30-day death rate(P for interaction:0.010).Patients without anemia who received a transfusion had a higher risk of any complications(LCC,OR=3.51;95%CI=2.55–4.85;P<0.001;RCC,OR=3.74;95%CI=2.50–5.59;P<0.001),minor complications(LCC,OR=2.54;95%CI=1.63–3.97;P<0.001;RCC,OR=2.27;95%CI=1.24–4.15;P=0.008),and major complications(LCC,OR=5.31;95%CI=3.68–7.64;P<0.001;RCC,OR=5.64;95%CI=3.61–8.79;P<0.001),and had an increased 30-day death rate(LCC,OR=6.97;95%CI=3.07–15.80;P<0.001;RCC,OR=4.91;95%CI=1.88–12.85;P=0.001)than patients without anemia who did not receive a

关键词： colon cancer colectomy anemia blood transfusion

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Perioperative blood transfusion is associated with post-operative infectious complications in patients with Crohn’s disease

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Gastroenterology Report 2018年第2期6卷 114-121,I0002页

作者： Nan Lan Luca Stocchi Yi Li Bo Shen Center for Inflammatory Bowel Disease and Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA Department of Colorectal Surgery Digestive Disease and Surgery InstituteThe Cleveland Clinic FoundationClevelandOHUSA

Background:We have previously demonstrated that blood transfusion(BT)was associated with post-operative complications in patients undergoing surgery for Crohn’s disease(CD),based on our institutional data *** aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program(ACS NSQIP)***:All CD patients undergoing surgery between 2005 and 2013 were identified from *** were defined according to the ACS NSQIP *** primary outcome was infectious complications,including superficial,deep and organ/space surgical site infection,wound dehiscence,urinary tract infection,pneumonia,systemic sepsis and septic *** analyses were performed to assess the risk factors for post-operative ***:All 10100 eligible patients were included and 611(6.0%)received perioperative *** patients were older,lighter in weight and more likely to be functionally *** patients were more likely to have post-operative infectious complications than those without BT,including superficial surgical site infection(SSI)(10.8%vs 7.4%,p¼0.002),deep SSI(3.3%vs 1.6%,p¼0.003),organ/space SSI(14.2%vs 5.4%,pblood cell(OR¼1.3,95%CI:1.2–1.5).Other independent factors were history of smoking,chronic heart disease,diabetes,hypertension and the use of ***-operative BT,however,was not found to be a risk factor to post-operative ***:Intra-and/or post-operative,not p

关键词： blood transfusion Crohn’s disease infectious complications surgical outcomes

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Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer

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World Journal of Gastrointestinal Surgery 2023年第4期15卷 643-654页

作者： Lucas Eiki Kawakami Pedro Barzan Bonomi Marina Alessandra Pereira Fabrício Oliveira Carvalho Ulysses Ribeiro Jr Bruno Zilberstein Luciana Ribeiro Sampaio Luiz Augusto Carneiro-D'Albuquerque Marcus Fernando Kodama Pertille Ramos Department of Gastroenterology Instituto do CancerHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao Paulo 01249000Brazil blood transfusion Unit Instituto do CancerHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao Paulo 01249000Brazil

BACKGROUND Gastric cancer(GC)is still a prevalent neoplasm around the world and its main treatment modality is surgical *** need for perioperative blood transfusions is frequent,and there is a long-lasting debate regarding its impact on *** To evaluate the factors related to the risk of receiving red blood cell(RBC)transfusion and its influence on surgical and survival outcomes of patients with *** Patients who underwent curative resection for primary gastric adenocarcinoma at our Institute between 2009 and 2021 were retrospectively *** and surgical characteristics data were *** patients were divided into transfusion and non-transfusion groups for *** A total of 718 patients were included,and 189(26.3%)patients received perioperative RBC transfusion(23 intraoperatively,133 postoperatively,and 33 in both periods).Patients in the RBC transfusions group were older(Ptransfusion *** rates of postoperative complications(POC)and 30-d and 90-d mortalitywere significantly higher in the RBC transfusion group than in the non-transfusion *** and albumin levels,total gastrectomy,open surgery,and the occurrence of POC werefactors associated with the RBC *** analysis demonstrated that the RBCtransfusions group had worse disease-free survival(DFS)and overall survival(OS)compared withpatients who did not receive transfusion(Ptransfusion,major POC,pT3/T4 category,pN+,D1 lymphadenectomy,and total gastrectomywere independent risk factors related to worse DFS and *** RBC transfusion is associated with worse clinical condition

关键词： Stomach neoplasms blood transfusion Red blood cells Postoperative complications Survival Prognosis

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Nurses and nursing students’knowledge regarding blood transfusion:A comparative cross-sectional study

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Journal of Integrative Nursing 2022年第3期4卷 137-144页

作者： Rakhi GAUR Shiv Kumar MUDGAL Neha SUYAL Suresh Kumar SHARMA Rajat AGARWAL Ritu RAJ Chaturvedi JITENDER College of Nursing AIIMSDeogharJharkhandIndia Government Nursing College HaldwaniUttarakhandIndia College of Nursing AIIMSJodhpurRajasthanIndia Department of CTVS AIIMSDeogharJharkhandIndia Department of Medicine AIIMSDeogharJharkhandIndia Department of Neurosurgery AIIMSRishikeshUttarakhandIndia

Objective:The objective of this study is to measure and compare the knowledge of nursing students and nurses on blood transfusion in an Indian *** and Methods:The present comparative,cross-sectional study enrolled 296 nurses and 177 nursing students through a purposive sampling from a medical university hospital and different nursing *** data were collected in the month of June and July of year 2021,using a self-structured *** questionnaire had two sections:Section-I contained demographic data(8 items for nurses and 5 for students)and section-II included 26 items that assessed nurses’and nursing students’knowledge on blood ***:Findings indicated that nurses and nursing students had insufficient knowledge about blood ***,however,had significantly greater total blood transfusion knowledge scores than nursing students(16.51±3.85 vs.12.10±3.28;Pblood transfusion(AOR=0.225,95%CI:0.062,0.818;P=0.041)was a significant predictor of the level of knowledge among nursing ***:Nurses and nursing students have unsatisfactory knowledge on blood transfusion;emphasizing the critical need for immediate and successful teaching activities in this area.

关键词： blood transfusion comparative knowledge nurses nursing students

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Influence of Perioperative blood transfusion on Prognosis in Patients with Colon Cancer

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The Chinese-German Journal of Clinical Oncology 2006年第4期5卷 261-267页

作者： LIANG Han WANG Xiaona WANG Baogui PAN Yuan LIU Ning WANG Dianchang HAO Xishan Department of Gastrointestinal Oncological Surgery Tianjin Cancer Hospital Tianjin Medical University Tianjin 300060 China

Objective： To explore the influence of perioperative blood transfusion on the postoperative survival of patients with colon cancer. Methods： Univariate and multivariate retrospective analyses were performed on the survival in a total of 723 colon cancer patients which were treated surgically during a period of 10 years. Results： Kaplan-Meier estimates showed that more than 800 mL perioperative blood transfusion was the survival predictor. blood transfusion influenced significantly the prognosis of patients 40 years old and younger, those undergoing helicoloectomy left side, those with papillary adenocarcinoma, those with big tumors （diameter ≥ 8 cm）, those with stage Ⅰ tumors, those with lymphatic node metastases and those without liver metastases. In multivariate analysis only the tumor location, radicality of operation, lymphatic invasion, liver metastasis, depth of tumor invasion and TNM stage retained their significance. Conclusion： Perioperative blood transfusion is some extent. The indication of blood transfusion the prognostic factor for patients with colon cancer to must be restricted strictly, specially in patients younger than 40 years old, with right side lesion, papillary adenocarcinoma, big tumors （diameter ≥8 cm）, stage Ⅰ tumors and lymphatic node metastases or without liver metastases. But perioperative blood transfusion may not be deleterious for patients with staging Ⅳ disease and with distant metastases.

关键词： cancer colon surgery blood transfusion prognosis

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