The effect of postoperative peritoneal lavage on survival, peritoneal wound healing and adhesion formation has been studied in rats both with and without fecal peritonitis. Peritoneal lavage with both Hartmann's solution and noxytiolin through an indwelling peritoneal cannula resulted in a delay in peritoneal wound healing in the absence of fecal peritonitis. There was also an increase in the incidence of adhesions. Induction of a fecal peritonitis followed by operation 2½–3 hours later resulted in 100 per cent mortality within 24 hours. This mortality was reduced by 66 per cent following peritoneal lavage with Hartmann's solution alone, although this resulted in a delay in peritoneal wound healing. Peritoneal lavage with noxytiolin did not reduce the mortality rate.

Background and Objectives Transfusion-associated circulatory overload is a leading cause of transfusion-related adverse events. The frequency and risks for transfusion-associated circulatory overload in ambulatory haematology patients are not known. Materials and MethodsA retrospective cohort analysis of ambulatory patients transfused in a tertiary haematology centre, using medical records and an electronic transfusion database, was undertaken between January and December 2014. Variables studied included age, gender, diagnosis, heart failure, kidney disease and details of transfusions. Transfusion-associated circulatory overload was defined according to proposed International Society of Blood Transfusion criteria. Patients with clinical evidence of hypervolaemia, not meeting the TACO definition and/or who were prescribed otherwise unscheduled diuretic agent, were collectively deemed to be at 'risk of clinically significant hypervolaemia' (ROCSH). ResultsIn the study period, 93 ambulatory patients (male = 49, female = 44, mean age = 75Á89 -11Á37 years) attended 715 transfusion encounters, totalling 1536 packed red cell units. No cases of TACO occurred whilst 'ROCSH' events occurred in 57/715 (8%) of transfusion encounters. In a univariate model, age was significantly associated with 'ROCSH', odds ratio = 1Á05 (P = 0Á017 95%, CI 1Á01-1Á09) and no factors were significant on multivariate analysis.Conclusions Transfusion-associated circulatory overload occurs infrequently haematology patients receiving ambulatory blood transfusions. To our knowledge, this is the first study to report on occurrence and risk factors for circulatory overload in ambulatory transfusions. This study provides vital baseline data for future prospective studies on this important aspect of haemovigilance.