Issues in transfusion medicine:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2005
|
| Schriftenreihe: | Anesthesiology clinics of North America
23,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 241 - 395 Ill., graph. Darst. |
| ISBN: | 1416028064 |
Internformat
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Datensatz im Suchindex
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| adam_text | IS^LI S I 1KANS1 USU »N MI.UR INI
CONTENTS
Foreword xi
Lee A. Fleisher
Preface x i
Terri G. Monk and Lawrence T. Goodnough
Risks of Blood Transfusion 241
Lawrence T. Goodnough
This article discusses advances in blood safety during the last 20
years, particularly for prevention of transfusion transmitted viral
infections. Although the most serious known risks from blood
transfusion are administrative errors, transfusion related acute lung
injury, and bacterial contamination in platelet products, infection
from emerging pathogens such as West Nile virus emphasizes the
need for implementing proactive strategies. Pathogen inactivation
technologies and reactive strategies such as nucleic acid testing
ensure continued advances in blood safety.
Errors in Transfusion Medicine 253
Dorothy Stainsby
In the past two decades, health services in the developed world have
directed much resource toward improving the safety of the Wood
supply. Blood is collected, tested, and processed within a carefully
controlled environment, and quality is assured by rigorous donor
selection procedures and increasingly sensitive and sophisticated
testing for transfusion transmitted pathogens. Additional safety
strategies implemented by some blood services include leukocyte
reduction, bacterial screening, and pathogen inact.vat.on. Thus
the transfusion chain from the donor to the point of issue from the
blood center is highly regulated and secure, and transfusion
transmitted infection is an increasingly rare event.
VOLUME 23 • NUMBER 2 • JUNE 2005 v
Autologous Blood Donation 263
Lawrence T. Goodnough
Preoperative autologous blood donation has become accepted as a
standard practice in elective surgery. Subsequent improvements in
blood safety and evolving surgical techniques resulting in less blood
loss have caused a national decline in preoperative autologous blood
donation by approximately 50%. Nevertheless, the continuing emer¬
gence of new pathogens and the potential for severe blood inventory
shortages continue to give preoperative autologous blood donation
an important role in blood conservation strategies.
Acute Normovolemic Hemodilution 271
Terri G. Monk
This article examines the technique of hemodilution and the con¬
sequences, benefits, efficacy, cost effectiveness, and future of acute
normovolemic hemodilution.
Red Blood Cell Recovery and Reinfusion 283
Jonathan H. Waters
This article describes the intraoperative washed cell salvage process
and principles of cell salvage technology and addresses the param¬
eters that can maximize the effectiveness of the process. Used
appropriately, this technique can be used to recover and readmin
ister several blood volumes of red cells.
Perioperative Assessment of the Elective Orthopedic
Surgery Patient 295
Richard K. Spence and Pat Parce
There are a number of safe and cost effective therapeutic options
for the potential management of all patients without allogeneic
blood transfusion. Orthopedic surgeons should consider blood man¬
agement using these options for all patients to provide them with
safe and effective therapy, while minimizing the risks of allogeneic
blood and preserving our decreasing blood resources.
Preoperative Evaluation and Methods to Reduce Blood
Use in Orthopedic Surgery 305
E. Michael Keating
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,
vi CONTENTS
which, unfortunately, is not always carried out. An evaluation of
the hematopoietic system begins with an evaluation of the patient s
hemoglobin level a minimum of 30 days before the scheduled sur¬
gical procedure. This allows for expedited diagnosis and treatment
of underlying comorbidities. An unexplained low level of hemo¬
globin 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 performed and blood management strategies put
in place.
Anemia and Clinical Outcomes 315
Mercy Kuriyan and Jeffrey L. Carson
This article discusses the impact of anemia in the context of the peri
operative setting. Relevant data from animal and human studies,
the adaptive mechanisms in anemia, and current views on transfu¬
sion triggers are evaluated. Recommendations are provided for the
anesthesiologist for transfusion of red blood cells.
Clinical Outcomes in Cardiac Surgery: Conventional Surgery
versus Bloodless Surgery 327
Aryeh Shander and Tanuja S. Rijhwani
Bleeding during and after cardiac operations and the effects of car
diopulmonary bypass hemodilution commonly result in blood
transfusions. Excessive microvascular bleeding can result in re
exploration and prolonged hospitalization. Nearly 20% of all blood
transfusions in the United States are associated with cardiac sur¬
gery. The risks associated with the use of allogeneic blood product
transfusion include mistransfusion, immunologic complications,
and transmission of infectious diseases. The large demand for blood
products places significant pressure on the national blood supply,
resulting in frequent shortages. The variability in transfusion prac¬
tice of cardiac surgery patients suggests that sound blood manage¬
ment 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.
Blood Conservation in Pediatric Anesthesia 347
B. Craig Weldon
This article focuses on perioperative blood conservation techniques
and the role of transfusion triggers and algorithms, preoperative
autologous donation, acute normovolemic hemodilution, intraop
erative blood salvage, deliberate hypotension, and preoperative
recombinant human erythropoietin in avoiding allogeneic blood
transfusion in pediatric patients.
CONTENTS vii
_J
Blood Conservation in the Critically 111 Patient 363
Howard L. Corwin
This article focuses on transfusion practice in the critically ill.
Current Status of Artificial O2 Carriers 373
Caroline Thyes and Donat R. Spahn
This article describes currently evaluated artificial O2 carriers,
summarizes their efficacy, and discusses their side effects, based on
and restricted to published data. For compounds in phase III test¬
ing, approximately 500 to 1000 patients have been dosed, and
similar numbers of control patients have been investigated. For
compounds in phase I or II testing, the number of patients dosed is
significantly less. Unfortunately, there is a significant amount of non
published data, which renders the overall assessment difficult, and
the direct comparison among different types of artificial O2 carriers
is significantly limited by the virtual nonexistence of studies that
directly compare different products.
Index 391
viii CONTENTS
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| title | Issues in transfusion medicine |
| title_auth | Issues in transfusion medicine |
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| title_fullStr | Issues in transfusion medicine guest ed. Terri G. Monk ... |
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| title_short | Issues in transfusion medicine |
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| topic_facet | Blood Transfusion Bluttransfusion Aufsatzsammlung |
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