This study aimed to summarize our experience using a systematic approach to reduce blood transfusions in acute type A aortic dissection (ATAAD) surgery.From August 2016 to June 2020, 326 patients underwent ATAAD surgery in our center employing a systematic approach, which primarily included the following: Liu's aortic root repair technique, Liu's aortic arch inclusion technique with a frozen elephant trunk, moderate-to-mild hypothermia circulatory arrest, and application of centrifugal pump in cardiopulmonary bypass circuit. Patients were divided into two groups based on whether they had blood product transfusion during their hospital stay: transfusion group and transfusion-free group. Preoperative, intraoperative, and postoperative outcomes were compared between the 2 groups.In the transfusion group, 152 patients were included, and in the transfusion-free group, 174 patients were involved; the transfusion-free rate was 53.37%. Patients in the transfusion group were significantly older than those in the transfusion-free group, and there were more patients with preoperative anemia and malperfusion in the transfusion group. Overall in-hospital mortality was 5.21% (17/326), with 3 mortalities (1.72%) in the transfusion-free group and 14 mortalities (9.21%) in the transfusion group (P = 0.0025). At tested time points, the Hb levels of patients between the 2 groups were similar.In ATAAD patients, the transfusion group showed significantly older patient age, more incidences of preoperative anemia and malperfusion, and higher in-hospital mortality than the transfusion-free group. Through Liu's systematic approach, ATAAD surgery can be achieved and safely carried out in ATAAD patients without blood product transfusion in selected patients.
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http://dx.doi.org/10.1536/ihj.24-307 | DOI Listing |
BMJ Open
January 2025
Department of Anesthesia and Operation Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Introduction: Acute normovolaemic haemodilution (ANH) is a perioperative blood management technique involving the removal of whole blood and simultaneous infusion of colloids or crystalloids to achieve haemodilution while maintaining normovolaemia. However, its efficacy in reducing the requirement for perioperative allogeneic blood transfusion remains controversial due to inconsistent findings in the literature. An individualised red cell transfusion strategy, guided by the West China Liu's Score, has demonstrated effectiveness in reducing the need for allogeneic red cell transfusion.
View Article and Find Full Text PDFClin Chem Lab Med
January 2025
Canadian Microbiology Proficiency Testing Program (CMPT), Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
External quality assessment (EQA) enhances patient safety through the evaluation of the quality of laboratory-based and point of care testing. Regulatory agencies and accreditation organizations utilize the results and the laboratory's response to them as part of assessing the laboratory's fitness to practice. In addition, where EQA samples are commutable and the assigned value has been determined using reference measurement procedures (RMPs), EQA data contributes to the verification of metrological traceability of assays as part of the post-market surveillance of diagnostic (IVD) medical devices (IVD-MDs).
View Article and Find Full Text PDFObjective: The objective of this study was to assess the complicated relationship between frailty, perioperative complications, and patient-reported outcomes (PROs) in elderly patients (≥ 75 years old) undergoing lumbar spine fusion (LSF).
Methods: Consecutive patients who underwent LSF between March 2019 and December 2021 were recruited in this study. Frail patients (modified frailty index [mFI] score ≥ 2) were propensity score matched to nonfrail patients (mFI score 0-1) on the basis of age, sex, and the number of fused levels.
World J Urol
January 2025
Department of Urology, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Purpose: The objective of this study was to evaluate the perioperative outcomes and complications associated with the use of acetylsalicylic acid (ASA) in deceased donor kidney transplantation (KTX), with a particular focus on bleeding events.
Methods: We retrospectively analyzed 157 kidney transplant recipients (KTRs) who underwent KTX at Charité Berlin, Department for Urology, between February 2014 and December 2017. Patients were divided into two groups: patients with ASA in their preoperative medication (Group A, n = 59) and patients without ASA use (Group B, n = 98).
Alzheimers Dement
December 2024
Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand.
Background: Thalassemia is a hereditary disease with impaired red blood cell production, resulting in cumulative systemic iron burden. The life-long therapeutic blood transfusion with or without iron chelators in those patients leads to the development of early-onset neurocognitive decline. However, the effects of regularity of blood transfusion on the severity of iron burden, cognitive decline, and gut dysbiosis in thalassemia patients are still unclear.
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