Study Design: To determine whether the normovolemic hemodilution (NH) technique would limit postoperative homologous blood transfusion requirements in 68 patients having multilevel lumbar laminectomies (3-6 levels) with predominant 1- or 2-level instrumented fusions.
Objective: In this setting, to define postoperative homologous blood transfusion requirements using NH.
Summary Of Background Data: NH limits postoperative homologous blood transfusion requirements following various types of surgical procedures including those on the spine.
Methods: NH was used in an attempt to limit postoperative homologous transfusion requirements in 68 patients undergoing lumbar surgery. NH involves the removal of 1 to 2 U of blood replaced with crystalloid (2-4 mL per milliliter of blood harvested). Multiple variables contributing to homologous transfusion requirements were analyzed.
Results: Using NH, no homologous blood transfusions were required in 52 patients with a mean preoperative hematocrit of 41.3 undergoing average 3.7 level laminectomies with 1.5 level fusions. However, 16 patients with an average preoperative hematocrit of 38.5 undergoing average 4.3 level laminectomies with 1.6 level fusions required transfusion of 31 U of homologous blood after surgery.
Conclusions: Using NH, 16 (23.5%) patients required 31 postoperative homologous blood transfusions. By contrast, the remaining 52 patients with similar procedures were able to avoid the use of homologous transfusion.
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http://dx.doi.org/10.1097/01.brs.0000232703.59829.ac | DOI Listing |
Surg Endosc
January 2025
Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México.
Background: Minimally invasive pancreatoduodenectomy has gained widespread acceptance among hepatopancreatobiliary surgeons due to its demonstrated advantages in perioperative outcomes compared to the conventional open approach. This meta-analysis, along with trial sequential analysis, aimed to compare the outcomes of robotic pancreatoduodenectomy and laparoscopic pancreatoduodenectomy based on the current available evidence.
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Int Dent J
January 2025
Department of Dental Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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View Article and Find Full Text PDFBMJ Case Rep
January 2025
Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and haemophagocytic lymphohistiocytosis (HLH) are rare but severe immune-mediated diseases with overlapping clinical manifestations. We present a case of a woman in her late 40s with rheumatoid arthritis who developed DRESS/HLH overlap syndrome after starting hydroxychloroquine and leflunomide therapy. Despite corticosteroid treatment, her condition worsened, necessitating etoposide therapy.
View Article and Find Full Text PDFBMJ Open
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Department of Surgery, Alberta Health Services, Calgary, Alberta, Canada.
Introduction: To improve surgical quality and safety, health systems must prioritise equitable care for surgical patients. Racialised patients experience worse postoperative outcomes when compared with non-racialised surgical patients in settler colonial nation-states. Identifying preventable adverse outcomes for equity-deserving patient populations is an important starting point to begin to address these gaps in care.
View Article and Find Full Text PDFCardiovasc Revasc Med
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Department of Cardiovascular disease, Henry Ford, Detroit, MI, USA.
Introduction: Cardiogenic shock (CS) is marked by substantial morbidity and mortality. The two major CS etiologies include heart failure (HF) and acute myocardial infarction (AMI). The utilization trends of mechanical circulatory support (MCS) and their clinical outcomes are not well described.
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