Objectives: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters.
Methods: Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) ( n = 75), (2) conventional cell salvage (CCS) ( n = 73) and (3) without cell salvage (WCS) ( n = 74). Salvaged blood was transfused at the end of the operation. The primary outcome of the study was the amount of homologous blood transfused. Secondary outcomes were changes in haemtochemical parameters, postoperative bleeding, need for non-invasive ventilation (NIV), postoperative complications, renal dysfunction, clotting derangement, duration of intensive care unit (ICU) and hospital stay and mortality rates.
Results: There were no deaths. In patients with >1000 ml blood loss, there was a significant reduction in HBT in the DBCS group (300 ± 161 ml) compared with the WCS group (550 ± 85 ml) ( P < 0.0001). Postoperative changes in haemtochemical parameters were significantly fewer in the DBCS group compared with the other 2 groups. The incidence of NIV ( P = 0.002), renal dysfunction ( P = 0.009) and postoperative complications ( P = 0.003) was least in the DBCS group and highest in the WCS group. Mean ICU stays were comparable ( P = 0.208); however, the mean hospital stay was significantly shorter in the DBCS group (6.08 ± 3.12 days) compared with the WCS group (7.54 ± 4.46 days) ( P = 0.022). There was no significant increase in coagulopathy in any group as suggested by comparable chest tube drainage ( P = 0.285) and comparable prothrombin time.
Conclusions: The use of the DBCS system in OPCABG resulted in a significant reduction in HBT, improvement in postoperative levels of haemoglobin, platelets and albumin and reduction in complications without increased risk of coagulopathy.
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http://dx.doi.org/10.1093/icvts/ivw371 | DOI Listing |
Acta Orthop
January 2025
Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
Background And Purpose: Vascularized fibular grafting following tumor resection is an essential treatment option in limb salvage surgery. We aimed to evaluate: (I) bone healing, (II) complications and reoperations, (III) limb salvage, and (IV) survival.
Methods: We present a retrospective evaluation of a national cohort comprising 27 patients.
Exp Hematol Oncol
January 2025
Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.
Background: Radiotherapy is the primary treatment modality for most head and neck cancers (HNCs). Despite the addition of chemotherapy to radiotherapy to enhance its tumoricidal effects, almost a third of HNC patients suffer from locoregional relapses. Salvage therapy options for such recurrences are limited and often suboptimal, partly owing to divergent tumor and microenvironmental factors underpinning radioresistance.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Medical Oncology, University of Health Sciences, Gulhane School of Medicine, Ankara 06018, Turkey.
: Salvage treatment options have not been validated in relapsed or refractory germ cell tumors. Moreover, the study populations including these patients have different heterogeneities. This study aimed to evaluate the efficacy and safety of three cycles of TIP sequential high-dose chemotherapy in patients with testicular non-seminomatous germ cell tumors who relapsed or had a refractory course after first-line platinum-based chemotherapy.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Britton Chance Laboratory of Redox Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
: Cancer cells rely on metabolic reprogramming that is supported by altered mitochondrial redox status and an increased demand for NAD. Over expression of Nampt, the rate-limiting enzyme of the NAD biosynthesis salvage pathway, is common in breast cancer cells, and more so in triple negative breast cancer (TNBC) cells. Targeting the salvage pathway has been pursued for cancer therapy.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Otolaryngology/Head & Neck Surgery, Zucker School of Medicine, Hofstra University, New York, NY 11040, USA.
Squamous cell carcinoma is the most common malignancy affecting the sinonasal tract. Local recurrence is the main pattern of treatment failure, affecting nearly half of patients treated for primary sinonasal squamous cell carcinoma (SNSCC). Due to disease rarity and heterogeneity of practices, there are limited guidelines for how to diagnose and care for these patients.
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