Perioperative blood transfusion associated with infectious complications after colorectal cancer operations

Tartter, Paul Ian; Quintero, Sandra; Barron, Deborah M.

doi:10.1016/0002-9610(86)90207-2

Cited by 157 publications

(70 citation statements)

References 19 publications

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“…Research has shown that smoking directly leads to alterations in platelet membranes and causes impairment of their natural function [13,35,38], therefore it seemed plausible to us that there would be an association between smoking and blood loss after spinal surgery. Should that be the case, it would be a modifiable risk factor that potentially could help patients avoid the neurologic compli cations of bleeding after spine surgery (such as development of a compressive hematoma), and the known deleterious effects of transfusions [15,16,20,32,40,42,43,45,52]. Our results suggest that smoking is strongly associated with increased surgical blood loss and perioperative transfusions in patients undergoing lumbar spine surgery.…”

Section: Discussionmentioning

confidence: 76%

Smoking is Associated with Increased Blood Loss and Transfusion Use After Lumbar Spinal Surgery

McCunniff

Young

Ahmadinia

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Little is known about the association between smoking and intraoperative blood loss and perioperative transfusion use in patients undergoing spinal surgery. However, we found that although many of the common complications and deleterious effects of smoking on surgical patients had been well documented, the aspect of blood loss seemingly had been overlooked despite data reported in nonorthopaedic sources to suggest a possible connection. Questions/Purposes We asked: (1) Is smoking associated with increased estimated blood loss during surgery in patients undergoing lumbar spine surgery? (2) Is smoking associated with increased perioperative transfusion usage?Methods Between 2005 and 2009, 581 lumbar decompression procedures (with or without fusion) were performed at one academic spine center. Of those, 559 (96%) had sufficient chart documentation to categorize patients by smoking status, necessary intra-and postoperative data to allow analysis with respect to bleeding and transfusion-related endpoints, and who did not meet exclusion criteria. Exclusion criteria included: patients whose smoking status did not fit in our two categories, patients with underlying coagulopathy, patients receiving anticoagulants (including aspirin and platelet inhibitors), history of hepatic disease, history of platelet disorder or other blood dyscrasias, and patient or family history of any other known bleeding disorder. Smoking history in packs per day was obtained for all subjects. We defined someone as a smoker if the patient reported smoking up until the day of their surgical procedure; nonsmokers were patients who quit smoking at least 6 weeks before surgery or had no history of smoking. We used a binomial grouping for whether patients did or did not receive a transfusion perioperatively. Age, sex, number of levels of discectomies, number of levels decompressed, number of levels fused, and use of instrumentation were recorded. The same approaches were used for transfusions in all patients regardless of smoking history; decisions were made in consultation between the surgeon and the anesthesia team. Absolute indications for transfusion postoperatively were: a hemoglobin less than 7 g/dL, continued symptoms of dizziness, tachycardia, decreased exertional tolerance, or hypotension that failed to respond to fluid resuscitation. Multiple linear regression analyses correcting for the above variables were performed to determine associations with intraoperative blood loss, while logistic regression was used to analyze perioperative transfusion use.

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Section: Discussionmentioning

confidence: 76%

Smoking is Associated with Increased Blood Loss and Transfusion Use After Lumbar Spinal Surgery

McCunniff

Young

Ahmadinia

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…The following year, Blumberg et al [32] stated that transfusion may be associated with recurrence for various human neoplasms. In the same year, Tartter and colleagues highlighted that blood transfusion may be a more significant factor affecting postoperative immune function and susceptibility to infectious complications than previously recognized [33]. In 1987, Isbister highlighted the need for a paradigm shift in blood transfusion [34].…”

Section: Adverse Transfusion Outcomementioning

confidence: 99%

Five Drivers Shifting the Paradigm from Product-Focused Transfusion Practice to Patient Blood Management

2011

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The objective of this paper is to introduce clinicians and health care professionals to the concept of patient blood management (PBM) and to explain the difference between PBM and the concept of "appropriate use" of blood products. The five reasons why modern health systems need to shift from product-focused transfusion practice to PBM are also presented. These are: the aging population with a leveraged demand for blood products opposed to a shrinking donor base; the growing awareness that transfusion is a complex service involving many different cost centers within a hospital and representing a multiple of the blood product cost; the continuous effort to protect blood pools from known, new, or re-emerging pathogens while facing uncertainty over their potentially long silent carrier states; the emerging evidence that transfusion is an independent risk factor for adverse outcomes; and finally, a lack of evidence for benefit of transfusion for the vast majority of recipients. The Oncologist 2011;16(suppl 3):3-11

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“…Tartter ve ark. (8) yaptık-ları bir çalışmada, elektif kolorektal kanser ameliyatlarından sonra oluşan enfeksiyöz komplikasyonların kan transfüzyonunun immünsüpresif etkisine bağlı olarak oluşabileceğini belirtmişlerdir.…”

Section: Discussionunclassified

“…Dolaşımdaki kan hacminin düzeltilmesi, eritrositlerin oksijen taşıma kapasitelerinin arttırılması veya düşük olan pıhtılaşma faktörlerini yerine koymak amacıya kan transfüzyonuna sıklıkla başvurulur. Yapılan çalış-malarda kan transfüzyonlarının, transplantasyon yapılan hastalarda doku rejeksiyon oranını azalttığı (3,4) tümörlü hastalardan tümör nüks oranını arttırdığı ve genel sağ kalımı azalttığı (4)(5)(6) ve postoperatif infeksiyöz komplikasyonlara eğilimi arttırdığı gösterilmiş-tir (3,(6)(7)(8) . Kolorektal cerrahide yapılan intestinal anastomozların iyileşmesinin, kan trasfüzyonlarının immünsupresif etkisine bağlı olarak bozulduğu gös-terilmiştir (7) .…”

Section: Introductionunclassified

Effects of Immune-Modulating Enteral Nutrition and Blood Transfusion in Experimental Colonic Anastomosis in Rats

Cezik¹,

Kara²,

Sarıcı³

et al. 2016

IKSST

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Perioperative blood transfusion associated with infectious complications after colorectal cancer operations

Cited by 157 publications

References 19 publications

Smoking is Associated with Increased Blood Loss and Transfusion Use After Lumbar Spinal Surgery

Smoking is Associated with Increased Blood Loss and Transfusion Use After Lumbar Spinal Surgery

Five Drivers Shifting the Paradigm from Product-Focused Transfusion Practice to Patient Blood Management

Effects of Immune-Modulating Enteral Nutrition and Blood Transfusion in Experimental Colonic Anastomosis in Rats

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