Postoperative opioid misuse in patients with opioid use disorders maintained on opioid agonist treatment.

Background: Patients recovering from opioid use disorders (OUD) may be prone to relapse and opioid misuse in the postoperative period due to re-exposure to prescription opioids for pain control. This retrospective study analyzed the incidence of confirmed opioid misuse in the postoperative period in patients with OUDs enrolled in an opioid agonist treatment (OAT) program.

Methods: The study population was US veterans with a diagnosis of OUD who enrolled in the OAT program at VA Maryland Health Care System (Baltimore, Maryland, USA) between 1/1/2000 and 12/31/2016.

Impact of Multidisciplinary Spine Conferences on Surgical Planning and Perioperative Care in Elective Lumbar Spine Surgeries.

Study Design: Pre- and post-implementation analysis.

Purpose: We examined the impact of implementing multidisciplinary spine conferences-"spine board" reviews-on the general utilization of elective lumbar spine surgeries in a tertiary medical institute.

Overview Of Literature: A multidisciplinary approach to spine care reportedly improves the appropriate utilization of surgical spine procedures.

Interference in clinical chemistry assays by the hemoglobin-based oxygen carrier, Hemospan.

Objective: To evaluate interference by the hemoglobin-based oxygen carrier Hemospan on clinical laboratory assays.

Design And Methods: Interfering Hemospan concentrations were determined for general chemistry and cardiac marker analytes in pooled serum and the corresponding hemolysis index was calculated.

Results: Hemospan did not interfere with 20 of 35 analytes.

Preoperative acute normovolemic hemodilution: a meta-analysis.

Background: Acute normovolemic hemodilution (ANH) involves withdrawal of whole blood with concurrent infusion of fluids to maintain normovolemia. The aim of this study was to quantify the efficacy and safety of preoperative ANH with a systematic review and meta-analysis.

Study Design And Methods: Randomized controlled trials were identified through MEDLINE (1966-2002) and the Cochrane Controlled Trials Database and with hand searching of journals.

Use of a human polymerized hemoglobin solution as an adjunct to acute normovolemic hemodilution during complex abdominal aortic reconstruction.

Oxygen-carrying hemoglobin (Hb) solutions are under intense investigation as an alternative to allogeneic red cell transfusion during surgery, with or without acute normovolemic hemodilution. We present a case in which an investigational Hb solution was used as an adjunct to acute normovolemic hemodilution, and as a replacement for surgical blood loss in a patient undergoing complex aortic reconstruction with a large blood loss.

Polymerized human Hb use in acute chest syndrome: a case report.

Background: Acute chest syndrome (ACS) is a complication of sickle cell disease that can cause significant morbidity. Transfusion therapy has been shown to significantly increase oxygenation in patients with ACS and RBC exchange is considered the standard of care in patients at high risk of respiratory failure.

Case Report: A patient with ACS and several high-risk features, including thrombocytopenia, profound anemia, bilateral pulmonary infiltrates, staphylococcal sepsis, and pulmonary embolism is presented.

The life-sustaining capacity of human polymerized hemoglobin when red cells might be unavailable.

Background: Human polymerized hemoglobin (PolyHeme, Northfield Laboratories, Evanston, IL) is a universally compatible, immediately available, disease-free, oxygen-carrying resuscitative fluid being developed as a red cell substitute for use in urgent blood loss. PolyHeme should be particularly useful when red cells may be temporarily unavailable. This article assesses survival at life-threatening RBC hemoglobin concentration ([Hb]) in massively bleeding patients who do not receive red cells.