BACKGROUND: Autologous transfusion of intraoperative cell salvage blood may be a potential method to decrease the need for allogeneic packed red blood cell transfusions after cesarean delivery, although there are limited data on the benefits of this method. This study evaluated the implementation of targeted intraoperative cell salvage during cesarean delivery in women at increased risk for hemorrhage at the Women's and Children's Hospital in Ningbo, China. METHODS: All women who underwent cesarean delivery >28 weeks of gestation were included in the study. The period before intraoperative cell collection (October 1, 2010, to August 31, 2012, n = 11,322) was compared with the postimplementation period (September 1, 2012, to June 30, 2015, n = 17,456) using an interrupted time series analysis. In the postimplementation period, women suspected to be at increased risk of the need for a blood transfusion (1604, 9.2%) underwent intraoperative cell salvage collection. The primary outcomes were the monthly rate of allogeneic packed red blood cell use and the incidence of clinical manifestation of acute blood transfusion reactions. RESULTS: The mean (standard deviation) estimated monthly allogeneic packed blood cell transfusion rate at the end of the 57-month study was 2.2% ± 0.7% with the implementation compared with 2.7% ± 0.9% without, difference −0.5%, 95% CI, −1.4% to 0.3%; P = .22. The mean number of allogeneic units transfused per patient was 4.1 ± 0.4 units with implementation and 3.9 ± 0.9 units without, difference 0.2, 95% CI, −1.7 to 1.1 units; P = .69. Intraoperative cell salvage blood was reinfused in 757 (47%) and wasted in 847 (53%) cases. The monthly intraoperative allogeneic packed red blood cells use rate was lower after implementation (difference −0.7%, 95% CI, −0.1% to −1.4%; P = .03); however, the monthly postpartum allogeneic packed red blood cell use rate was unchanged (difference −0.2%, 95% CI, −0.4% to 0.7%; P = .56). The clinical manifestation of acute blood transfusion reactions rate was unchanged (difference −2%, 99% CI, −9% to 5%; P = .55) between the periods. CONCLUSIONS: Our findings suggest that targeted intraoperative cell salvage in women undergoing cesarean delivery was associated with less allogeneic blood exposure in the operating room, but not in the postoperative period. Intraoperative cell salvage in targeted cesarean deliveries was not associated with a lesser allogeneic red blood cell exposure over the hospital admission period. The lack of adverse events associated with intraoperative cell salvage supports the safety of intraoperative cell salvage in cesarean delivery. Accepted for publication January 8, 2018. Funding: None. R. J. McCarthy is currently affiliated with the Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois. Conflicts of Interest: See Disclosures at the end of the article. The study was presented at the 2015 Annual Meeting of the American Society of Anesthesiologists, October 24–28, San Diego, CA. Reprints will not be available from the authors. Address correspondence to Robert J. McCarthy, PharmD, Department of Anesthesiology, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612. Address e-mail to robert_j_mccarthy@rush.edu. © 2018 International Anesthesia Research Society
http://ift.tt/2FRKfpv
Αρχειοθήκη ιστολογίου
-
►
2023
(138)
- ► Φεβρουαρίου (74)
- ► Ιανουαρίου (64)
-
►
2022
(849)
- ► Δεκεμβρίου (61)
- ► Σεπτεμβρίου (74)
- ► Φεβρουαρίου (65)
-
►
2021
(2936)
- ► Δεκεμβρίου (59)
- ► Σεπτεμβρίου (180)
- ► Φεβρουαρίου (325)
-
►
2020
(1624)
- ► Δεκεμβρίου (293)
- ► Σεπτεμβρίου (234)
- ► Φεβρουαρίου (28)
-
►
2019
(13362)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (5586)
- ► Ιανουαρίου (5696)
-
▼
2018
(66471)
- ► Δεκεμβρίου (5242)
- ► Σεπτεμβρίου (5478)
-
▼
Μαρτίου
(5675)
-
▼
Μαρ 04
(128)
- Endoscopic ultrasound guided brush/fine-needle asp...
- Surface-Enhanced Raman Scattering for Rapid Detect...
- Graphene Materials in Antimicrobial Nanomedicine: ...
- Biomarkers in Cardiorenal Syndromes
- Salivary Markers and Microbial Flora in Mouth Brea...
- Metal–Organic-Framework-Assisted In Vivo Bacterial...
- The “Rust” Challenge: On the Correlations between ...
- Template Conversion of Covalent Organic Frameworks...
- Advanced Materials through Assembly of Nanocelluloses
- Nanomaterials for Cancer Precision Medicine
- Chemical and Morphological Control of Interfacial ...
- Oxidoreductase-Initiated Radical Polymerizations t...
- Lithiation/Delithiation Synthesis of Few Layer Sil...
- Electroconductive Biohybrid Collagen/Pristine Grap...
- DNA Conformation Regulates Gene Expression: The MY...
- Fatal Aβ cerebral amyloid angiopathy 4 decades aft...
- Relevance of CYP3A4*20, UGT1A1*37 and UGT1A1*28 va...
- Cancers, Vol. 10, Pages 64: The Role of Oncogenic ...
- Myeloid-derived suppressor cells suppress CD4+ T c...
- An Enlarging Lung Nodule in an Immunocompromised Host
- Cover
- News
- In the Literature
- An Enlarging Lung Nodule in an Immunocompromised Host
- Assessing Viral Transfer During Doffing of Ebola-L...
- Human Factors Risk Analyses of a Doffing Protocol ...
- Global Trends in CD4 Cell Count at the Start of An...
- Erratum
- Erratum
- Combating Global Antibiotic Resistance: Emerging O...
- Infectious Diseases, Weather, and Climate
- The Human Immunodeficiency Virus Care Continuum in...
- Reply to Raoult
- Endocarditis Prophylaxis
- Management of an Outbreak of Exophiala dermatitidi...
- Frequent Undetected Ward-Based Methicillin-Resista...
- Prosthetic Valve Candida spp. Endocarditis: New In...
- High Human Immunodeficiency Virus Incidence and Pr...
- Vancomycin Is Ineffective in Eliminating Methicill...
- Marshaling the Translational Potential of MC1R for...
- Effects of Black Raspberry on Dibenzo[a,l]Pyrene D...
- Targeting Epigenetics to Prevent Obesity Promoted ...
- Chemoprevention of Preclinical Breast and Lung Can...
- A BET Bromodomain Inhibitor Suppresses Adiposity-A...
- Clinical Outcomes after Conservative Management of...
- Tough job market pushes more surgical specialists ...
- Deans of medicine urge provincial action on reside...
- Narrowing the treatment gap in managing opioid use...
- Opioids for chronic pain [Letters]
- The status quo bias and decisions to withdraw life...
- Outcomes, experiences and palliative care in major...
- Management of opioid use disorders: a national cli...
- Professional writers can help to improve clarity o...
- Diffuse skin thickening, myalgias and joint stiffn...
- Canada and US going opposite directions on conscie...
- Who needs palliative care? [Commentary]
- Jamestown Canyon virus meningoencephalitis mimicki...
- Effect of Vitrification on Functional Morphology a...
- Intracellular Reorganization of Cardiomyocytes in ...
- Induction of Alternative Splicing and Inhibition o...
- Studying the Phenotypic and Genotypic Expression o...
- Preparation of Human Olfactory Ensheathing Cells f...
- Survival of Mesenchymal Stem Cells in Different Me...
- Analysis of Dynamic Geometric Configuration of the...
- Monocytes with Oncogenic Mutation JAK2 V617F as a ...
- Analysis of IL-1α, bFGF, TGF-β1, IFNγ, MMP-1, and ...
- L-Lysine-α-Oxidase: Acidovorax citrulli Bacterium ...
- Expression of Adhesion Molecules in Activated Endo...
- Experimental Evaluation of the Effects of Low-Dose...
- Changes in Canonical β-Catenin/Wnt Signaling Activ...
- Role of Matrix Metalloproteinase-2 in the Developm...
- Analysis of the Basic Characteristics of Osteogeni...
- Infrared Fluorescent Angiography during Experiment...
- Matrix Metalloproteinases MMP-1 and MMP-9 and Thei...
- Role of Endogenous Melatonin in the Regulation of ...
- Machine learning aided exploration of relationship...
- Issue Information
- Outcomes of laparoscopic sleeve gastrectomy in Cro...
- Corrigendum
- Exploring the Pharmacological Mechanism of Danzhi ...
- Specificity of Good Manufacturing Practice (GMP) f...
- Some Peculiarities of Local Distribution of Multip...
- Measuring of Adhesion Force in the Cell—Cell Syste...
- Isolation and Characterization of Human Myoblast C...
- Peculiarities of Cyto- and Chemoarchitectonics of ...
- Co-Culturing of Multipotent Mesenchymal Stromal Ce...
- In Vitro Modeling of Co-Transplantation of Multipo...
- KrioBlast TM as a New Technology of Hyper-fast Cry...
- Low-level clonal FGFR2 amplification defines a uni...
- Phosphaturic Mesenchymal Tumor Without Osteomalaci...
- A case report of atypical Spitz tumor harboring a ...
- Propranolol prevents liver cirrhosis by inhibiting...
- Clinical-oriented Three-dimensional Gait Analysis ...
- Cryopreservation of Zebrafish Spermatogonia by Who...
- Usage and Usability of a Web-based Program for Fam...
- Antidiabetic Effects of a Chinese Herbal Medicinal...
- Association between Growth Hormone-Insulin-Like Gr...
- The Vocal Extent Measure: Development of a Novel P...
- Past, present and future of in vitro 3D reconstruc...
- Machine Learning in Ultrasound Computer-Aided Diag...
-
▼
Μαρ 04
(128)
- ► Φεβρουαρίου (4835)
- ► Ιανουαρίου (5592)
-
►
2017
(44259)
- ► Δεκεμβρίου (5110)
- ► Σεπτεμβρίου (5105)
-
►
2016
(7467)
- ► Δεκεμβρίου (514)
- ► Σεπτεμβρίου (1038)
- ► Φεβρουαρίου (793)
Αναζήτηση αυτού του ιστολογίου
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
-
Αλέξανδρος Γ. Σφακιανάκης Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,0030693260717...
-
heory of COVID-19 pathogenesis Publication date: November 2020Source: Medical Hypotheses, Volume 144Author(s): Yuichiro J. Suzuki ScienceD...
-
https://ift.tt/2MQ8Ai8
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου
Σημείωση: Μόνο ένα μέλος αυτού του ιστολογίου μπορεί να αναρτήσει σχόλιο.