Erythrocyte Suspension Transfusion Research Articles

Effect of Erythrocyte Suspension Transfusion on Thiol-Disulfide Homeostasis in Critically Ill Children

Objective: To investigate the potential relation between dynamic thiol homeostasis and blood transfusion in the pediatric intensive care unit.
 Methods: Blood samples were collected from pediatric intensive care patients before and after erythrocyte suspension transfusion and from donor blood additionally to measure thiol levels. The study involved 30 patients, including nine females, and a total of 90 blood samples from patients and donors were analyzed.
 Results: Prior to transfusion, Total Thiol (TT) and Native Thiol (NT) were 414.77 ± 156.14 (μmol/L) and 272.63 ± 115.75 (μmol/L), respectively, and post-transfusion, they were found to decrease to 398.07 ± 187.38 (μmol/L) and 258.97 ± 136.2 (μmol/L), respectively. However, no statistically significant difference was observed between pre- and post-transfusion values. In post-transfusion blood samples, there was a significant increase in Disulfide/TT and Disulfide/NT ratios, indicating an increase in oxidation (34.79 ± 92.34 and 51.89 ± 68.51, respectively), yet no statistical difference was noted.
 Conclusion: Transfusions administered in the Pediatric Intensive Care Unit were associated with a decrease in total and native thiol levels, indicative of increased oxidative stress, despite the lack of statistically significant differences. To mitigate the potential negative impact on patients with high oxidative properties after transfusions, strengthening the antioxidant defense system is recommended. Research should be planned to develop suitable strategies for enhancing the antioxidant defense system and ensuring patients' resilience to this condition.

A comparative analysis of Postpartum Hemorrhage incidence and influencing factors between nulliparous and multiparous women in Hunan Province, China: A multicenter retrospective cohort study

ObjectivesPostpartum hemorrhage (PPH) is a common cause of maternal death worldwide, but data on PPH incidence and influencing factors for nulliparous and multiparous women is scarce. So, the study aimed to assess the differences in PPH incidence and influencing factors between nulliparous and multiparous women. MethodsA multicenter retrospective cohort study was conducted among women who gave birth at ≥ 28 weeks of gestation in Hunan Province, China, from January 2017 to December 2018. Logistic regression assessed PPH-influencing factors, and the receiver operating characteristic curve (ROC curve) assessed the predictive performance of identified factors. ResultsA total of 144,845 postpartum women were included in the study. The incidence of PPH (blood loss ≥ 500 ml) was 2.1 % and 1.7 % for nulliparous and multiparous women, respectively. Among the nulliparous and multiparous women, similar influencing factors of PPH included erythrocyte suspension transfusion before childbirth, anemia, soft-birth canal avulsion, Cesarean-section, placenta abruption, and general anesthesia administration before birth. Thrombophlebitis was associated [aOR 18.46(1.67–20.31)] with PPH among only the nulliparous women, while instrument-assisted birth [aOR 1.95(1.16–3.28)] and gestational hypertension [aOR 1.57(1.13–2.19)] were associated with PPH among only the multiparous women. The areas under the ROC-curve for the overall-cohort, nulliparous, and multiparous groups were [0.829(0.821–0.838)], [0.828(0.815–0.840)] and [0.833(0.822–0.844)], respectively. ConclusionPPH incidence is higher among nulliparous women than among multiparous women, but influencing factors vary relatively by parity. The study findings provide new insights into the use of different approaches to PPH prevention for nulliparous and multiparous women in clinical practice.

Treatment of primary retroperitoneal tumors: Single center experience

Introduction: The aim of our study is to evaluate the results of patients who underwent surgery due to primary retroperitoneal tumors in order to contribute to the knowledge pool in the literature.
 Material Method: The data of patients who underwent surgery due to retroperitoneal tumor at Health Sciences University, Adana City Training and Research Hospital between January 2015 and January 2023 were retrospectively scanned. Approximately 54 patients with a clinical diagnosis of PRT were included in the study. Preoperative demographic characteristics of the patients, such as age at diagnosis, gender, number of surgeries for PRT, preoperative biopsy pathology and symptom status, if any, were recorded. All patients underwent computed tomography (CT) imaging with intravenous contrast. The location, size, density and presence of contrast enhancement of PRT in preoperative imaging methods were recorded. Peroperative incision type and duration, need for erythrocyte suspension transfusion, need for organ resection, complications and length of stay in the postoperative period were evaluated.
 Results: The average age of a total of 54 patients who underwent surgery due to a retroperitoneal mass was 53.8±10.0 years. While 15 (27.8%) of 54 patients with a retroperitoneal mass were diagnosed incidentally, 39 (72.2%) patients were diagnosed symptomatically. The final pathological outcome of all relapsed patients was liposarcoma. The average operation time was 178.7±85.4 minutes. In 12 (22.2%) patients, adjacent organ resection was performed in addition to the mass. The average length of stay of the patients was 6.2±3.1 days. In the postoperative period, one patient required re-operation due to ileus and one patient due to bleeding. Adjuvant therapy was given to 6 (11.1%) patients after surgery. In the final pathology results of the patients, positive surgical margins were detected in 8 (14.3%) patients. Additionally, all of these patients had organ resection. In the Kaplan-Meier survival analysis, it was found that surgical margin had a statistically significant effect on average survival (p

Impact of Erythrocyte Suspension Transfusion and Viscosity on Perfusion Index in the Emergency Department

Impact of Erythrocyte Suspension Transfusion and Viscosity on Perfusion Index in the Emergency Department

Total Diz Artroplastisinde Cerrahi Yara Kapatılması Öncesinde Kontrollü Arteriyel Hipertansiyon ile Yapılan Hemostazis Kanama Miktarını ve Transfüzyon İhtiyacını Etkiler mi?

Objective: We aimed to assess the efficacy of hemostasis while controlled augmentation of arterial blood pressure before surgical closure after total knee arthroplasty (TKA). 
 Materials and Methods: This retrospective cohort involved data collected from the medical files of 87 patients (62 women, 25 men) who underwent TKA using hypotensive epidural anesthesia (HEA). Patients were allocated into two groups. Group I (n=44) received HEA, while Group II (n=43) had controlled arterial hypertension before surgical closure. Perioperative hemoglobin and hematocrit levels, systolic and diastolic blood pressure, and the amount of erythrocyte suspension transfusion were compared between the two groups. 
 Results: The average age of our series was 66.41 ± 6.17 (range: 57-78) years. Notably, the amount of bleeding on postoperative 1st, 2nd, 4th, 12th, and 24th (p=0.031, 0.032, 0.001, 0.001, 0.001, respectively) hours was significantly less in Group II. There were no significant differences between the two groups for complications, operative duration, perioperative bleeding, duration of follow-up and hospitalisation, and compared descriptives. 
 Conclusion: Our data indicated that controlled elevation of mean arterial pressure before surgical closure might allow the achievement of meticulous hemostasis after TKA. Further prospective, randomised, controlled trials on more extensive series are warranted to verify our preliminary results.

Comparison of H-Hayman uterine compression suture with conventional vertical sutures: A cross-sectional study in a tertiary center.

To compare H-Hayman, a modified uterine compression suturing technique (UCS) that we describe for the first time in the literature, with conventional vertical UCS techniques. The H-Hayman technique was used in 14 women and the conventional UCS technique in 21 women. In order to provide standardization in the study, only patients who had developed upper-segment atony during cesarean section were recruited for the study. Bleeding control was achieved in 85.7% (12/14) of the cases using the H-Hayman technique. In the remaining two patients with persistent hemorrhage in this group, bleeding control was provided with bilateral uterine artery ligation, and a hysterectomy was avoided in all cases. With the conventional technique, bleeding control was achieved in 76.1% (16/21) of the patients, and the overall success rate was 95.2% after bilateral uterine artery ligation in those with persistent hemorrhage. In addition, the estimated blood loss and the need for erythrocyte suspension transfusion were significantly lower in the H-Hayman group (P = 0.01 and P = 0.04, respectively). We found the H-Hayman technique to be at least as successful as conventional UCS. In addition, patients who underwent suturing with the H-Hayman technique had less blood loss and a lower requirement for erythrocyte suspension transfusion.

Lomber Enstrümantasyon Cerrahisinde Yara Yeri Enfeksiyonu ile İlişkili Faktörlerin Değerlendirilmesi

Aim: Many factors are related to wound healing after lumbar instrumentation surgery. These include cerebrospinal fluid fistula, duration of surgery, amount of bleeding, diabetes, obesity, being a smoker, low haemoglobin levels, steroid administration, and accompanying malignancy. This study aims to investigate the effect of surgery duration and the need for erythrocyte suspension transfusion on wound healing, regardless of the patient's risk factors. Methods: 490 patients who underwent lumbar instrumentation surgery at four levels or below by a single surgeon between 2020 and 2022 were included in the study. 362 of 492 patients were female, and 128 were male. The relationship between the average surgical duration, erythrocyte suspension requirement parameters, and surgical wound infection rates was investigated. Results: Surgical wound infection was observed in 14 patients (2.8%). Of these 14 patients, 12 had a history of erythrocyte suspension transfusion. The average surgical duration for the 14 patients with surgical wound infection was 120 minutes, while 90 minutes for the group without surgical wound infection. There is a correlation between erythrocyte suspension transfusion and surgical wound infection, with a higher infection rate observed in patients with an erythrocyte transfusion history (p

Factors Affecting ICU Stay and Length of Stay in the ICU in Patients with HELLP Syndrome in a Tertiary Referral Hospital

Objective The study aimed to compare patients with HELLP syndrome who require intensive care and who do not require intensive care and evaluate the factors affecting the length of stay in the intensive care unit. Methods Patients were divided into two groups as follows: requiring intensive care (group 1) and not requiring intensive care (group 2). The data of both groups were compared in terms of demographic characteristics, transfusion amounts, length of stay in the intensive care unit, maternal complications, and mortality. Results 14032 births in a tertiary center between 2011 and 2018 were evaluated in this study. During the study period, 342 patients were diagnosed with HELLP, and 32 (9.4%) of these were followed up in the intensive care unit. The length of stay in the intensive care unit was determined as 8.1 (7.2) days on average. Fresh frozen plasma, erythrocyte suspension, apheresis, and random thrombocyte transfusion were observed to be significantly more in group 1 patients. In the regression analysis, the most effective factor was found to be erythrocyte suspension and the length of stay in the intensive care unit was significantly longer in patients who had erythrocyte suspension transfusion. The receiver operating characteristic curve showed that the area under the curve value for erythrocyte transfusion was 70.6%. When the cutoff value of erythrocyte suspension was 450 (95% CI: 365–681) ml, the sensitivity was 43.8% and the specificity was 91.6%. Conclusion We think that physicians should be careful that maternal morbidity and mortality may increase as the need for erythrocyte suspension transfusion increases in patients with HELLP syndrome. Minimum transfusion to hemodynamically stable patients can be more suitable in terms of morbidity and mortality in managing patients with HELLP syndrome requiring erythrocyte suspension transfusion. Precautions and measures should be taken in this regard.

Impact of Preoperative Embolization on Carotid Body Tumor Surgery

The aim of this study is to investigate the effect of preoperative carotid body tumor embolization (CBTE) on the amount of bleeding, and vascular and neurological complications in carotid body tumors. Fifty patients treated for 51 carotid body tumors in 2 clinics, between 2005 and 2020, were evaluated. Polyvinyl alcohol embolization of the carotid body tumor was performed in 23 patients before the surgical excision. The results were compared with the remaining 28 patients, in whom CBTE was not performed, in terms of neurological complications, requirement of additional vascular interventions, bleeding amount, and length of hospital stay. Mean bleeding amount was significantly lower in the CBTE group (406-217mL, P<0.05). Median erythrocyte suspension transfusion was significantly lower in the CBTE group (0.3 units vs. 1.1 units, P<0.05). Neurological deficits developed in a total of 13 patients: 6 in the CBTE group and 7 in the non-CBTE group, in the early postoperative period (P=0.90). No significant difference was observed between the groups in terms of additional vascular interventions and length of hospital stay (P=0.79 and P=0.61). Carotid body tumors are rarely encountered tumors. However, their surgical excision is challenging for surgeons regarding intraoperative and postoperative bleeding. This study demonstrates that preoperative CBTE significantly reduces the amount of bleeding, especially in Shamblin type II/III tumors.

TOTAL KNEE ARTHROPLASTY: UNILATERAL, SIMULTANEOUS BILATERAL OR STAGED BILATERAL IN ADVANCED AGE?

Introduction: Most people with arthritic knees often present with symmetrical joint involvement, a condition often requiring surgery for both knees. There are, however, some disagreements concerning whether or not total knee arthroplasty should be performed simultaneously or in stages. This study aimed to evaluate the length of hospital stay, the need for erythrocyte suspension transfusion, the need for intensive care, and the mortality rates of the patients who underwent unilateral, simultaneous bilateral, and staged bilateral total knee arthroplasty. Materials and Methods: This retrospective study included 1,129 patients, who were divided into three groups based on whether they underwent unilateral, simultaneous bilateral, or staged bilateral total knee arthroplasty, and they were evaluated in terms of hospital stay, erythrocyte suspension transfusion needs, intensive care needs, and mortality rates. Results: Of all the patients, 85.5% were women, with the mean age of 67.58±7.23 years; and 75.6% of them underwent unilateral, 19.9% underwent simultaneous bilateral, 4.5% had staged bilateral total knee arthroplasty, 8.8% required ICU care, and 5 patients died. The need for erythrocyte suspension transfusion and length of hospital stay were highest in those who underwent staged bilateral knee arthroplasty surgery, while it was lowest in those who underwent simultaneous bilateral total knee arthroplasty surgery (all p&lt;0.001). There was no statistically significant difference in terms of the need for intensive care need, length of stay in intensive care unit and mortality rates between patients who underwent unilateral, simultaneous bilateral, and staged bilateral total knee arthroplasty. Conclusion: Simultaneous bilateral total knee arthroplasty may be preferred in younger patients with bilateral knee osteoarthritis but without risky comorbidities, just as we practiced in our clinic. Keywords: Osteoarthritis, Knee; Arthroplasty, Replacement, Knee; Mortality

The efficacy, safety, and cost-effectives of combined administration of Intravenous and Local Tranexamic Acid in the management of Patients Undergoing Primary Total Hip Arthroplasty: A prospective, blinded and randomized clinical study.

The aim of this study was to compare the efficacy, safety, and cost-effectiveness of combined administration of intravenous and local tranexamic acid with those of either intravenous or local administrations in patients undergoing primary total hip arthroplasty (THA). This prospective, blinded, and randomized clinical study was performed on patients undergoing unilateral primary THA from September 2018 to December 2019. A total of 90 patients were included and prospectively allocated to one of three groups: the combined group (n= 30, 14 male, 16 female; mean age = 54.9 ± 12 years), intravenous (IV) group (n = 30, 13 male, 17 female; mean age = 54.9 ± 12.3 years), and local group (n = 30, 13 male, 17 female; 50.3 ± 12.3). Tranexamic acid was used systemically by IV application (15mg/kg) in IV group, locally in the surgical field (2g) in local group as well as combined systemic and local together in combined group. The amount of blood loss, number of erythrocyte suspension transfusion, and changes in hemoglobin and hematocrit levels were documented accordingly. The estimated mean tranexamic acid and erythrocyte suspensions cost, extra nurse care, monitoring and laboratory costs associated with blood transfusion, and total hospital costs were compared among groups. No differences existed in hemoglobin and hematocrit levels after surgery among the groups. The combined group required fewer blood transfusion compared to the local and IV groups, and the total amount of ES was statistically significantly lower (P = 0.039) in the combined group. Although the medication cost was higher in the combined group than in the other groups (P < 0.001), combined group was more cost-effective (P < 0.001) when the total costs related to blood loss were evaluated. No occurrence of deep vein thrombosis or pulmonary embolism was found in the study. Combined administration of IV and local tranexamic acid seems to be more effective in reducing the requirement and amount of blood transfusion without increasing the risk of thromboembolic complications in primary THA compared to IV or local administrations. Despite increasing the prophylaxis costs, combined administration of TXA can result in lower total hospitalization costs by decreasing blood loss and consequent treatment costs in primary THA. Level I, Randomized Controlled Trial.

Risk factors of cerebral complications after Stanford type A aortic dissection undergoing arch surgery

To explore the risk factors of cerebral neurological complications after surgery for Stanford type A aortic arch surgery. One hundred sixteen patients who received Stanford type A aortic dissection from January 2012 to December 2019 were recruited. All patients received surgery under deep hypothermic circulatory arrest (DHCA) and general anesthesia. They were grouped by degree of postoperative cerebral neurological complication. The related factors of cerebral neurological complications were analyzed by single-factor analysis and multi-factor logistic regression. Postoperative neurological complications were observed in 31 cases (26.72%). Two groups were identified: permanent neurological dysfunction (PND) was observed in seven cases, and temporary neurological dysfunction (TND) was observed in 24 cases. In-hospital mortality was 9.48% (11/116), with six in the cerebral complication groups and five in the non-complication group. Single-factor analysis showed the associated factors were age, stroke history, carotid plaque or stenosis, emergency surgery, renal dysfunction, hypotension, aortic clamping time, deep hypothermic circulatory arrest time, postoperative hypoxemia, postoperative low cardiac output and plasma transfusion >800ml, and erythrocyte suspension transfusion >6 U. Multi-factor logistic analysis showed the independent predictive factors were DHCA time >40min, plasma transfusion >800ml, erythrocyte suspension transfusion >6 U, history of stroke, and carotid plaque or stenosis. The factors independently associated with neurological complications are DHCA time >40min, plasma transfusion >800ml, erythrocyte suspension transfusion >6 U, history of stroke, and carotid plaque or stenosis. Our findings suggest that patients with these risk factors should receive intervention during treatment to reduce cerebral neurological complications.

Does heated erythrocyte suspension transfusion with medical devices containing phthalates increase DEHP and MEHP levels?

It is commonly known that stored blood and blood products are heated before transfusion to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate (DEHP) content leaching into the blood and blood products and thereby causes greater conversion of DEHP to mono (2-ethylhexyl) phthalate (MEHP). However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension (ES) transfused via warming. In this study, we aimed to investigate the DEHP and MEHP content in blood following the heated ES transfusions administered by DEHP-containing and DEHP-free infusion sets. The study included 30 patients that were randomly divided into two groups with 15 patients each: group I underwent ES transfusion via DEHP-containing infusion sets warmed with blood-fluid warmers, and group II underwent ES transfusion via DEHP-free infusion sets warmed with blood-fluid warmers. DEHP and MEHP levels were measured both before and after transfusion. DEHP-free infusion sets led to no increase in the phthalate content, whereas DEHP-containing infusion sets significantly increased the DEHP and MEHP, where the DEHP level increased almost four times (P=.001). DEHP-containing products lead to toxicity. Therefore, using DEHP-free medical devices may prevent toxicity in patients undergoing ES transfusion.

Comparison of postoperative outcomes between robotic mitral valve replacement and conventional mitral valve replacement.

Robotic mitral valve surgery continues to become widespread all over the world in direct proportion to the developing technology. In this study, we aimed to compare the postoperative results of robotic mitral valve replacement and conventional mitral valve replacement. A total of consecutive 130 patients who underwent robotic mitral valve replacement and conventional mitral valve replacement with full sternotomy between 2014 and 2020 were included in our study. All patients were divided into two groups:Group I, with 64 patients who underwent robotic mitral valve replacementand Group II, with 66 patients with conventional full sternotomy. General demographic data (age, gender, body weights, etc.),comorbidities (hypertension, diabetes mellitus, chronic obstructive pulmonary disease, peripheral artery disease, hyperlipidemia, etc.), intraoperative variables (cardiopulmonary bypass times, and cross-clamp times), postoperative ventilation times, drainage amounts, transfusion amount, inotropic need, revision, arrhythmia, intensive care and hospital stay times, and mortality were analyzed retrospectively. There was no significant difference between demographic data, such as age, gender, body kit index, and preoperative comorbid factors of both patient groups (p > .05). Cardiopulmonary bypass time (204.12 ± 45.8 min) in Group I was significantly higher than Group II (98.23 ± 17.8 min) (p < .001). Cross-clamp time in Group I (143 ± 27.4 min)was significantly higher than Group II (69 ± 15.2 min) (p < .001). Drainage amount in Group I (290 ± 129 cc) was significantly lower than Group II (561 ± 136 cc) (p < .001). The erythrocyte suspension transfusion requirement was 0.4 ± 0.3 units in Group I; it was 0.9 ± 1.2 units in Group II, and this requirement was found to be significantly lower in Group I (p = .014). While the mean mechanical ventilation time was 5.3 ± 3.9 h in Group I, it was 9.6 ± 4.2 h in Group II. It was significantly lower in Group I (p = .001). Accordingly, intensive care stay (p = .006) and hospital stay (p = .003) were significantly lower in Group I. In the early postoperative period, three patients in Group I and four patients in Group II were revised due to bleeding. In the postoperative hospitalization period, neurological complications were observed in one patient in Group I and two patients in Group II. Two patients in Group I returned to the sternotomy due to surgical difficulties. Two patients died in both groups postoperatively, and there was no significant difference in mortality (p = .97). According to conventional methods, robotic mitral valve replacement is an effective and reliable methodsince total perfusion and cross-clamp times are longer, drainage amount and blood transfusion need are less, and ventilation time, intensive care, and hospital stay time are shorter.

A Retrospective Study of Coronary Artery Bypass Grafting with Low-Thermal Plasma Dissection Device Compared to Conventional Monopolar Electrosurgery.

Introduction:The objective of this study is to compare the effects of conventional monopolar electrosurgery (CMES) and low-thermal plasma kinetic cautery (PKC) on complications such as bleeding, abnormal wound healing, pain, and drainage in patients who underwent on-pump coronary artery bypass grafting (CABG).Methods:This retrospective clinical study included 258 patients undergoing CABG; the patients were randomized to PKC (PEAK PlasmaBlade, n=153) and CMES (n=105) groups. The patients’ clinical data were examined retrospectively for biochemical variables, postoperative drainage, post-surgery erythrocyte suspension transfusion count, surgical site pain examined with visual analogue scale (VAS), and wound healing. Two-sided P-value > 0.05 was considered as statistically significant.Results:The median post-surgery erythrocyte suspension transfusion number was significantly lower with PKC compared to CMES (0 [0-1] vs. 1 [1-4], respectively, P<0.001). Mean postoperative drain output and time until removal of drain tubes were significantly lower with PKC compared to CMES (300±113 vs. 547±192 and 1.95±1.5 vs. 2.44±1.8; P<0.001 and P=0.025, respectively). Mean VAS score for spontaneous and cough-induced pain were significantly lower with PKC compared to CMES (1.98±1.51 vs. 3.94± 2.09 and 3.76±1.46 vs. 5.6±1.92; P<0.001 for both comparisons). Reoperation due to bleeding was significantly higher with CMES compared to PKC (0 vs. 11 [7.2%], P=0.001).Conclusion:Use of PKC during CABG considerably reduces postoperative drainage, need for blood transfusion, reoperation due to bleeding, and postoperative pain. PCK appears to be a good alternative to CMES for CABG.

Erythrocyte Suspension Transfusion Assessment in a University Intensive Care Unit: A Retrospective Study

Erythrocyte Suspension Transfusion Assessment in a University Intensive Care Unit: A Retrospective Study

Is tranexamic acid effective on hidden blood loss in patients during total knee arthroplasty?

Objectives This study aims to investigate if tranexamic acid (TXA) reduces both visible and hidden blood loss in patients undergoing total knee arthroplasty (TKA).Patients and methods A total of 128 female patients (mean age 68.9±5.8 years; range, 55 to 80 years) who underwent TKA and were admitted between January 2010 and January 2020 were included in this retrospective study. Only patients who had primary unilateral knee arthroplasty with a cemented posterior cruciate ligament substituting implant were included. Patients were divided into two groups according to TXA administration in the perioperative period. Group 1 consisted of patients who did not receive TXA (n=69), while Group 2 consisted of patients who received TXA (n=59). The effect of TXA on visible and hidden blood loss, amount of erythrocyte suspension transfusions, postoperative early wound complications, and the relationship between the volume of hidden blood loss and drainage volume were detected.Results There was no statistically significant difference between the groups in terms of age, body mass index, operation side, preoperative hematocrit (HCT) values, and total blood volume. Postoperative HCT values were statistically higher in Group 2. Fifty-four units of erythrocyte suspension transfusion were required in Group 1, while six units were required in Group 2 (p<0.001). Early wound complication was determined in 10 patients in Group 1 and only in one patient in Group 2 (p=0.011). Intraoperative blood loss, postoperative drainage volume, hidden blood loss, and total blood loss values were significantly lower in Group 2 (p=0.001). In all patients, there was a significant positive correlation between the postoperative drainage volume and the hidden blood loss volume (r=0.532, p=0.001).ConclusionThe use of TXA in patients undergoing TKA reduces postoperative bleeding (visible and hidden blood loss), blood transfusion needs, and early wound complications. In addition, drainage volume in postoperative 24 hours can be used to estimate the amount of hidden blood loss in early postoperative period.

Before and After Erythrocyte Suspension Transfusion

Before and After Erythrocyte Suspension Transfusion

Acil Serviste Kan Transfüzyonu Yapılan Hastaların Özellikleri

Bu çalışmanın amacı acil serviste kan ve kan ürünleri transfüzyonu yapılan hastaların transfüzyon sonrası değişim verilerin incelenmesi amacıyla prospektif olarak incelemektir. Bu çalışma Sağlık Bilimleri Üniversitesi Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi acil servisine başvuran hastaların yaş ve cinsiyetleri, şikayetleri, muayene bulguları, kan grupları, verilen kan ürünleri ve ünitelerinin dağılımı, transfüzyon öncesi ve sonrası hemoglobin(Hb), hematokrit(Hct) değerleri incelenerek yapıldı. Çalışmaya 92 hasta alınmış olup hastaların %56,5’u 65 yaş ve üzerindeydi. %59,8’i kadındı. %44,6 ile en fazla “halsizlik”şikayeti vardı. Muayenede hastaların %17,4’inde melena %14,1’inde hematokezya vardı. Hastaların %40,2’si anemi ve %35,9’u Gastrointestinal Sistem(GİS) kanaması tanısı almıştı. Hastalar en fazla %45,7 ile A RH+ ve %29,3 ile 0 RH + kan gruplarına sahipti. Hastaların %94,6’sına eritrosit süspansiyonu (ES) ve %5,4’üne ES+ taze donmuş plazma(TDP) transfüzyonu yapıldı. Hastaların %46,7’sine iki ünite ES ve %40,2’sine bir ünite ES verildi. Yaş gruplarının transfüzyon öncesi Hb değerleri arasında istatistiksel olarak önemli bir fark yokken ( p=0,879), transfüzyon sonrası istatistiksel olarak önemli fark olduğu bulundu (p=0,003). ES transfüzyonu sonrası hastaların %58,2’si beklenen Hb değerine ve %50,0’si beklenen Hct değerlerine ulaşmıştı. Yaş, cinsiyet ve tanıya göre beklenen Hb ve Hct düzeylerine ulaşma durumları arasında istatistiksel olarak önemli fark yoktu (p&amp;gt;0,05). Transfüzyon öncesi ve sonrası hastaların nabız, tansiyon ve ateş gibi vital bulgularında istatistiksel olarak fark yoktu (p&amp;gt;0,05), ancak Hb, Hct, MCV ve MCH’de önemli artış vardı (p&amp;lt;0,05). Çalışma sonunda acil serviste yapılan kan ve kan ürünü transfüzyonları incelendiğinde düşünülenin aksine travmaya bağlı acil transfüzyon değil de en fazla GİS kanama ve anemiye bağlı transfüzyon yapıldığı tespit edilmiştir.

The results of interventional catheterization in infants weighing under 2,000 g.

The aim of this study was to evaluate the early and mid-term results of interventional cardiac catheterization and procedure-related complications in infants weighing <2,000 g. Between May 1998 and April 2017, 22 patients (14 males, 8 females; mean age 14±8.4 days; range, 1 to 30 days) weighing <2,000 g who underwent a total of 23 interventional cardiac catheterization were retrospectively analyzed. Procedures were balloon coarctation angioplasty in 14, balloon atrial septostomy in five, balloon aortic valvuloplasty in one, balloon pulmonary valvuloplasty in one, patent ductus arteriosus closure in one, and stent placement in the ductus in one patient. Another patient underwent balloon coarctation angioplasty and balloon aortic valvuloplasty in the same session. The overall success rate of the interventional procedures was 95.6%. The mean follow-up was 3.2±1.6 years (range, 1 to 5.5) for 18 patients with available records. The rate of serious complications was 18%. The most frequent complications in the early period were low hemoglobin levels requiring erythrocyte suspension transfusion (54.5%) and vascular injury (54.5%). Two patients required reintervention, one patient required surgery after the second intervention, and three patients required only surgery. Six patients underwent palliative interventional procedures, and interventional procedures led to definitive treatment in five patients. The mortality and morbidity rate of surgery is high in premature under 2,000 g infants and interventional heart catheterization can be life-saving in this patient group, although it is associated with significant complications in low birth weight newborns.