Ultrafiltration reduces blood transfusions following cardiac surgery: a meta-analysis

Boodhwani, Munir; Williams, Kathryn; Babaev, A.; Gill, G. W.; Saleem, Nusrat; Rubens, Fraser D.

doi:10.1016/j.ejcts.2006.09.014

Cited by 96 publications

(80 citation statements)

References 21 publications

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“…61,62 Evidence from a recent meta-analysis also supports the idea that the need for blood transfusions is significantly reduced by ultrafiltration during cardiac surgery. 63 In addition, evidence from the latter study 62 also demonstrated that the platelet count after bypass was not significantly different from that in the non-haemofiltration group, an observation that is also in agreement with our findings.…”

Section: Adverse Events and Overall Safety Of Intraoperative Zero-balsupporting

confidence: 82%

The impact of continuous haemofiltration with high-volume fluid exchange during cardiopulmonary bypass surgery on the recovery of patients with impaired renal function: a pilot randomised trial

Matata

Mediratta²,

Morgan³

et al. 2013

Health Technology Assessment

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Health Technology Assessment is indexed in MEDLINE, CINAHL, EMBASE, The Cochrane Library and the ISI Science Citation Index and is assessed for inclusion in the Database of Abstracts of Reviews of Effects.This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/53/33. The contractual start date was in April 2010. The draft report began editorial review in May 2012 and was accepted for publication in January 2013. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are thos...

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Section: Adverse Events and Overall Safety Of Intraoperative Zero-balsupporting

confidence: 82%

The impact of continuous haemofiltration with high-volume fluid exchange during cardiopulmonary bypass surgery on the recovery of patients with impaired renal function: a pilot randomised trial

Matata

Mediratta²,

Morgan³

et al. 2013

Health Technology Assessment

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“…Šios aplinkybės skatina siaurinti ir griežtinti indikacijas donorinio kraujo perpylimui, įdiegti naujus metodus, padedančius išvengti ar bent minimalizuoti alogeninio kraujo transfuzijų poreikį (10)(11)(12)(13)(14)(15)(16)(17).…”

Section: įVadasunclassified

Transfusion of autologous blood

Veikutienė¹,

Širvinskas²,

Adukauskienė

2008

Medicina

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ĮvadasPastaraisiais metais, nuolat daugėjant sudėtingų traumų (jų metu nukentėjęs žmogus dažnai labai nukraujuoja), didėjant įvairių ligų chirurginio gydymo galimybėms, plečiantis ortopedinių operacijų apimčiai, didėja alogeninio kraujo perpylimo poreikis (1). Deja, alogeninio kraujo perpylimas susijęs su daugeliu problemų: kraujo, kaip biologinio audinio, išteklių ribotumu, augančiais kraujo paruošimo kaštais, krauju perduodamų infekcinių ligų pavojumi, neigiamu imunomoduliaciniu poveikiu recipientui, pneumonija bei kitomis pooperacinėmis infekcijomis, piktybinių navikų išplitimo bei jų atsinaujinimo rizika (2-9). Yra duomenų, kad alogeninio kraujo perpylimas didina sergamumą, mirtingumą, ilgina lovadienių trukmę intensyviosios terapijos skyriuose gydomiems ligoniams (8).Šios aplinkybės skatina siaurinti ir griežtinti indikacijas donorinio kraujo perpylimui, įdiegti naujus metodus, padedančius išvengti ar bent minimalizuoti alogeninio kraujo transfuzijų poreikį (10-17).Autologinio kraujo perpylimas -tai yra, kai donoras ir recipientas yra tas pats asmuo (paties ligonio kraujo perpylimas). Pastaraisiais metais akivaizdžiai padidėjo susidomėjimas autologinio kraujo panaudojimo galimybėmis, kaip viena tinkamiausių alternatyvų donorinio kraujo perpylimui. Šiuolaikiniai autologinio kraujo moksliniai tyrimai bei klinikinė praktika pateikia naują sampratą apie autologinio kraujo perpylimo praktinę vertę. Autologinio kraujo perpylimas yra pats saugiausias, nes galima išvengti ar bent gerokai sumažinti daugelį potencialių komplikacijų, sukeliamų donorinio kraujo perpylimo. Svarbus autologinio kraujo perpylimo vaidmuo ir kraujo taupymo programoje. Šis kraujo perpylimas geriausias, o dažnai ir vienintelis pasirinkimo būdas tiems ligoniams, kuriems tapataus donorinio kraujo nepavyksta parinkti, kai yra itin reto fenotipo kraujo grupė arba dėl imunizacijos susidarę aloantikūnai (18).Ne visos planinės chirurginės intervencijos susijusios su didesniu nukraujavimu, todėl ne visi ligoniai turėtų būti ruošiami autologinio kraujo perpylimui. Yra keletas autologinio kraujo perpylimo metodų, kurie skirtingiems ligoniams gali būti naudojami atskirai ar įvairiuose deriniuose.Autologinio kraujo perpylimo metodai:

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“…However, it is unclear whether this benefit is due to the volume of fluid removed from the circulating bypass blood vs the modified ultrafiltration [60][61][62][63] . There are conflicting results about the different ultrafiltration techniques, because in neonatal surgery, removal of fluid from a miniaturized circuit during cardiopulmonary bypass, corresponding to conventional ultrafiltration, is difficult and inconsistent when fluid replacement is needed to maintain adequate reservoir level [64] .…”

Section: Ultrafiltrationmentioning

confidence: 99%

Perfusionist strategies for blood conservation in pediatric cardiac surgery

Durandy¹

2010

WJC

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There is increasing concern about the safety of homologous blood transfusion during cardiac surgery, and a restrictive transfusion practice is associated with improved outcome. Transfusion-free pediatric cardiac surgery is unrealistic for the vast majority of procedures in neonates or small infants; however, considerable progress has been made by using techniques that decrease the need for homologous blood products or even allow bloodless surgery in older infants and children. These techniques involve a decrease in prime volume by downsizing the bypass circuit with the help of vacuumassisted venous drainage, microplegia, autologous blood predonation with or without infusion of recombinant (erythropoietin), cell salvaging, ultrafiltration and retrograde autologous priming. The three major techniques which are simple, safe, efficient, and cost-effective are: a prime volume as small as possible, cardioplegia with negligible hydric balance and circuit residual blood salvaged without any alteration. Furthermore, these three techniques can be used for all the patients, including emergencies and small babies. In every pediatric surgical unit, a strategy to decrease or avoid blood bank transfusion must be implemented. A strategy to minimize transfusion requirement requires a combined effort involving the entire surgical team with pre-, peri-, and postoperative planning and management.

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Ultrafiltration reduces blood transfusions following cardiac surgery: a meta-analysis

Cited by 96 publications

References 21 publications

The impact of continuous haemofiltration with high-volume fluid exchange during cardiopulmonary bypass surgery on the recovery of patients with impaired renal function: a pilot randomised trial

The impact of continuous haemofiltration with high-volume fluid exchange during cardiopulmonary bypass surgery on the recovery of patients with impaired renal function: a pilot randomised trial

Transfusion of autologous blood

Perfusionist strategies for blood conservation in pediatric cardiac surgery

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