Adverse Blood Transfusion Outcomes: Establishing Causation

Isbister, James P.; Shander, Aryeh; Spahn, Donat R.; Erhard, J; Farmer, Shannon; Hofmann, Axel

doi:10.1016/j.tmrv.2010.11.001

Cited by 165 publications

(109 citation statements)

References 78 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…In clinical practice, anaemia is the main predictor of red cell transfusion [27], and this is independently associated with increased morbidity and mortality as mentioned before [10][11][12]28].…”

mentioning

confidence: 84%

“…Observational studies suggest that patients who receive allogeneic red cell transfusion are at increased risk of mortality, ischaemic complications, delayed wound healing, and increased length of stay [10][11][12]. However, it is not clear whether this link is causal or associative, as the findings of most observational studies are confounded by the fact that sicker patients, with associated worse clinical outcomes receive more blood.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Evidence and triggers for the transfusion of blood and blood products

2014

View full text Add to dashboard Cite

SummaryAllogeneic red cell transfusion is a commonly used treatment to improve the oxygen carrying capacity of blood during the peri-operative period. Increasing arterial oxygen content by increasing haemoglobin does not necessarily increase tissue oxygen delivery or uptake. Although the evidence-base for red cell transfusion practice is incomplete, randomised studies across a range of clinical settings, including surgery, consistently support the restrictive use of red cells, with no evidence of benefit for maintaining patients at higher haemoglobin thresholds (liberal strategy). A recent meta-analysis of 7593 patients concluded that a restrictive transfusion strategy was associated with a reduced risk of healthcare-associated infections (pneumonia, mediastinitis, wound infection, sepsis) when compared with a liberal transfusion strategy. The degree to which the optimal haemoglobin concentration or transfusion trigger should be modified for patients with additional specific risk factors (e.g. ischaemic heart disease), remains less clear and requires further research. Although most clinical practice guidelines recommend restrictive use of red cells, and many blood transfusion services have seen marked falls in overall usage of red cells, the use of other blood components such as fresh frozen plasma, platelets, and cryoprecipitate has risen. In clinical practice, administration of fresh frozen plasma is usually guided by laboratory tests of coagulation, mainly prothrombin time, international normalised ratio and activated partial thromboplastin time, but the predictive value of these tests to predict bleeding is poor.

show abstract

mentioning

confidence: 84%

mentioning

confidence: 99%

Evidence and triggers for the transfusion of blood and blood products

2014

View full text Add to dashboard Cite

show abstract

“…Unlike most modern medical treatments, the safety and efficacy of allogeneic blood transfusions have never been established through randomized controlled trials; and hence, formulation of evidence-based indications for blood transfusion has remained a challenge. 19 Transfusion guidelines for various patient populations are available, and they all emphasize that blood products should be transfused when clear physiologic need exists, rather than blindly based on arbitrary hemoglobin or hematocrit triggers. The goal should be treating the patient, rather than attaining a certain hemoglobin level.…”

Section: Indication Of Transfusionmentioning

confidence: 99%

From Bloodless Surgery to Patient Blood Management

Shander

Javidroozi

Perelman

et al. 2012

Mount Sinai J Medicine

Self Cite

View full text Add to dashboard Cite

Safety and efficacy concerns of allogeneic blood transfusions and their impact on patient outcomes and associated staggering costs and restricted supply have fueled the quest for other modalities and strategies to reduce use of blood components. Patient blood management focuses on multidisciplinary and multimodal preventive measures to reduce or obviate the need for transfusions and ultimately to improve the clinical outcomes of patients. Patient blood management strategies can be applied at every stage of care to surgical and nonsurgical patients, and they Address

show abstract

“…This is considered as an independent risk factor that increases peri-operative adverse outcomes [5,7]. Many studies demonstrated that there was an increased risk of postoperative mortality and morbidity including pulmonary and infectious complications after receiving intraoperative blood transfusions [8][9][10]. Thus, there has been an increased emphasis on the correction of preoperative anaemia to improve the patient's outcome and decrease the need for allogeneic blood transfusion.…”

Section: Design Overviewmentioning

confidence: 99%

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

Khalafallah¹,

Al-Barzan²,

Chan³

et al. 2012

J Blood Disord Transfus

View full text Add to dashboard Cite

Background: Improving preoperative anaemia is associated with a better surgical outcome. There is lack of data regarding treatment of preoperative anaemia with intravenous versus oral iron.Objective: Assessment of efficacy of oral iron sulphate versus a single intravenous iron polymaltose and subsequent effect on perceived quality of life in both treatment groups. Patients and methods:We conducted a prospective randomised controlled trial with iron therapy for the treatment of Iron Deficiency Anaemia (IDA) patients who were undergoing elective joint arthroplasty. At a single institution, we recruited 44 patients who were randomized to a single intravenous iron polymaltose infusion (16/22) versus oral daily iron sulphate (17/22). Median age was 68 years (range, 45-91) with a male to female ratio of 14:19.

show abstract

Adverse Blood Transfusion Outcomes: Establishing Causation

Cited by 165 publications

References 78 publications

Evidence and triggers for the transfusion of blood and blood products

Evidence and triggers for the transfusion of blood and blood products

From Bloodless Surgery to Patient Blood Management

A Prospective Randomized Controlled Trial to Assess the Effect of Intravenous versus Oral Iron Therapy in the Treatment of Preoperative Anaemia

Contact Info

Product

Resources

About