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Medicina Universitaria

2007, Number 37

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Med Univer 2007; 9 (37)

Bloodless surgery: avoiding transfusions

Rendón EFG, Hernández SM, Fuentes PV, Gómez DLH

Language: Spanish
References: 96
Page: 186-197
PDF size: 159.91 Kb.


ABSTRACT

Bloodless surgery is a term that was coined in the 1970’s and that has evolved from being a protocol designed only to avoid the administration of blood and to satisfy the needs of peoples, whose religious beliefs did not allow them to receive blood, to a concept that now involves technological progress and new drugs that stimulate the production of blood, help with hemostasis y decrease blood loss. These in conjunction with new institutional guidelines (change in knowledge and attitude of the medical personnel) with the goal of decreasing blood loss, increasing oxygen supply, avoiding blood transfusions as much as possible and increasing the patient’s prognosis, making modifications for each patient in particular. The objective of this review is to update concepts and trends about bloodless surgeries, helping in the daily necessary reflexions in the decisions making and the correct application of transfusions in the current medical practice.


REFERENCES

  1. Lundy JS. Clinical anesthesia: manual of clinical anesthesiology. Philadelphia: WB Saunders, 1942.

  2. NIH Consensus Conference. Perioperative red blood cell transfusion. JAMA 1988;260:2700-3.

  3. Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP. Transfusion medicine: first of two parts-blood transfusion. N Engl J Med 1999;340:438-47.

  4. Cantaloube JF, Gallian P, Biagini P, Attoui H, et al. Prevalence of GB virus type C/hepatitis G virus RNA and anti-E2 among blood donors in Southeastern France. Transfusion 1999;39: 95-102.

  5. Lefrere JJ, Roudot-Thoraval F, Morand-Joubert, Brossard Y, et al. Prevalence of GB virus type C/hepatitis G virus RNA and of anti-E2 in individuals at high or low risk for blood-borne or sexually transmitted viruses: evidence of sexual and parenteral transmission. Transfusion 1999;39:83-94.

  6. Itoh K, Hirakawa K, Okamoto H, Ukita M, et al. Infection by unenveloped DNA virus associated with non-A to G hepatitis in Japanese blood donors with or without elevated ALT levels. Transfussion 1999; 39:522-6.

  7. Ukita M, Okamoto H, Kato N, Miyakawa Y, Mayumi M. Excretion into bile of novel unenveloped DNA virus (TT virus) associated with acute and chronic non A-G hepatitis. J Infect Dis 1999;179:1245-8.

  8. Okamoto H, Nishizawa T, Kato N, Ukita M, et al. Molecular cloning and characterization of novel DNA virus (TT virus) associated with posttransfusion hepatitis of unknown etiology. Hepatol Res 1998;10:1-16.

  9. Blackbourn DJ, Ambroziak J, Lennette E, Adams M, et al. Infectious human herpesvirus 8 in a healthy North American blood donors. Lancet 1997;349:609-11.

  10. Simmonds P. Transfusion virology: progress and challenges. Blood Rev 1998;12:171-7.

  11. Moor AC, Dubbelman TM, VanSteveninck, Brand A. Transfusion- transmitted diseases: risks, prevention and perspective. Eur J Haematol 1999;62:1-18.

  12. Centers for Disease Control and Prevention (CDC). Transfusion- transmitted malaria-Missouri and Pennsylvania, 1996- 1998. MMWR Morb Mortal Wkly Rep 1999;48:253-6.

  13. Turner ML, Ironside JW. New variant Creutzfeld-Jakob disease: the risk of transmission by blood transfusions. Blood Rev 1998;12:255-68.

  14. Brunson ME, Alexander JW. Mechanisms of transfusion induced immunosupression. Transsio 1990;30:651-8.

  15. Blumberg N, Heal JM. Blood transfusion immunomodulation: the silent epidemia. Arch Pathol Lab Med 1998;122:117-9.

  16. Klein HG. Immunomodulatory aspects of transfusion. Anesthesiology 1999;91:861-5.

  17. Vamvakas EC. Transfusion-associated cancer recurrence and postoperative infection: meta-analysis of randomized, controlled clinical trials. Transfusion 1996;36:175-86.

  18. Innerhofer P, Walleczeck C, Luz G, Hobisch-Hagen P, et al. Transfusion of buffy coat-depleted blood components and risks of postoperative infection in orthopedic patients. Transfusion 1999;39:625-32.

  19. Vignali A, Braga M, Gianotti L, Radaelli G, et al. A single unit of transfused allogeneic blood increases postoperative infections. Vox Sang 1996;71:170-5.

  20. Kopko PM, Holland PV. Transfusion-related acute lung injury. Br J Haematol 1999;39:665-70.

  21. Silliman CC, Paterson AJ, Dickey WO, Stroneck DF, et al. The association of biologically active lipids with the development of transfusion-related acute injury: a retrospective study. Transfusion 1997;37:719-26.

  22. Spiess BD, Counts RB, Gould SA. Perioperative transfusion medicine. In: Winslow, RM, editor. A physiological basis for the transfusion trigger. 2nd ed. Baltimore: Williams & Wilkins 2000.

  23. Reger TB, Roditski D. Bloodless medicine and surgery for patients having cardiac surgery. Critical Care 2001;4:35-44.

  24. Goodnough LT, Monk TG, Andriole GL. Current concepts in erythropoietin therapy. N Engl J Med 1999;336:933-8.

  25. Goldberg MA, McCutchn JW, Jove M, Di Cesare P, et al. A safety and efficacy comparison study of two regimens of epoetin alfa in patients undergoing major orthopedic surgery. Am J Orth 1996;25:544-52.

  26. Goodnough LT, Price TH, Rudnick S, Soegiarso RW. Preoperative red cell production in patients undergoing aggressive autologous blood phlebotomy with and without erythropoietin therapy. Transfusion 1992;32:441-5.

  27. Eschbach JW, Abdulhadi MH, Browne JK, Delano BG, et al. Recombinant human erythropoietin in anemia patients with end-stage renal disease: results of a phase III multicenter clinical trial. Ann Intern Med 1989;111:992-1000.

  28. Eschbach JW, Abdulhadi MH, Browne JK, et al. Recombinant human erythropoietin in anemia patients with end-stage renal disease: results of a combined phase I and II multicenter clinical trial. N Engl J Med 1987;316:73-78.

  29. Sowade O, Warnke H, Scigalla P, Sowade B, et al. Avoidance of allogenic blood transfusions by treatment with epoetin beta (recombinant human erythropoietin) in patients undergoing open-heart surgery. Blood 1997;89:411-8.

  30. Goodnough LT, Despotis GJ, Parvin CA. Erithropoietin therapy in patients undergoing cardiac operations. Ann Thorac Surg 1997;64:1579-80.

  31. Grant FC. Autotransfusion. Ann Surg 1922;74:253-4.

  32. Bengtsson A, Bengston JP. Autologous blood transfusion: preoperative blood collection and blood salvage techniques. Acta Anaesthesiol Scand 1996;40:1041-56.

  33. Thomas MJ, Gillon J, Desmond MJ. Consensus conference on autologous transfusion: preoperative autologous donation. Transfusion 1996;36:633-9.

  34. Mercuriali F, Inghilleri G, Biffi E, Vinci A, et al. The potential role of oxygen-carryng products in autologous blood transfusions protocols. Artif Cells Blood Substit Immovil Biotechnol 1994;22:245-51.

  35. Gandini G, Franchini M, Bertuzzo D, Olzer D, et al. Preoperative autologous blood donation by 1073 elderly patients undergoing elective surgery: a safe and effective practice. Transfusion 1999;39:174-8.

  36. Etchason J, Petz L, Keeler E, Calhoun L, et al. The cost effectiveness of preoperative autologous blood donations. N Engl J Med 1995;332:719-24.

  37. Savoia HF, Metz J, Maxwell EL, Hauesler MN, et al. Utilization of preoperative autologous blood donation in elective surgery. ANZ J Surg 2002;72:557-60.

  38. Yoda M, Nonoyama M, Shimakura T, Morishita A, Takasaki T. Preoperative autologous blood donation with cardiac surgery. Kyobu Geka 2003;56:479-82.

  39. Gould SA, Forbes JM. Controversies in transfusion medicine: indications for autologous and allogenic transfusion should be the same: pro. Transfusion 1995;35:446-9.

  40. Domen RE. Adverse reactions associated with autologous blood transfusion: evaluation and incidence at large academic hospital. Transfusion 1998;38:296-300.

  41. Linden JV, Kruskall MS. Autologous blood: always safer? Transfusion 1997;37:455-6.

  42. Trouwborst A, Van Bommet J, Ince C, Henny PC. Monitoring normovolaemic haemodilution. Br J Anaesth 1998;81:73-81.

  43. Tawes Rl. Alternatives to homologous blood transfusion. Semin Vasc Surg 1994;7:72-75.

  44. Intaglietta M. Hemodilution and blood substitutes. Artif Cells Blood Substit Immobil Biotechnol 1994;22:137-44.

  45. Stheling L, Zauder HL. Controversies in transfusion medicine. Perioperative hemodilution: pro. Transfusion 1994; 34:1000-21.

  46. Sphan DR, Leone BJ, Reves JG, Pasch T. Cardiovascular and coronary physiology of acute isovolemic hemodilution:A review of nomoxygen-carrying and oxygen-carrying solutions. Anesth Analg 1994:78:1000-21.

  47. Goodnugh LT, Monk TG, Brecher ME. Acute normovolemic hemodilution should replace the preoperative donation of autologous blood as a method of autologous-blood prourement. Transfusion 1998;38:473-6.

  48. Sphan DR, Schmid ER, Seifert B, Pasch T. Hemodilution tolerance in patients with coronary artery disease who are receiving chronic beta-adrenergic blocker therapy. Anesth Analg 1996;82:687-94.

  49. Sphan DR, Pasch T, Schmid ER Seifert B. Haemodilution tolerance in patients with mitral regurgitation. Anaesthesia 1998;53:20-24.

  50. Sphan DR, Zollinger A, Schlump RB, Stor S, et al. Hemodilution tolerance in elderly patients without known cardiac disease. Anesth Analg 1996;82:681-86.

  51. Malkosvski RS, Currie IC, Newman JH. Postoperative collection and reinfusion of autologous blood in total knee arthoroplasty. Ann R Coll Surg Engl 1991;73:381-5.

  52. McGill N, O´Shanghness D, Pickering R, Herberton M, Gill R. Mechanical methods of reducing blood transfusion in cardiac surgery: randomised controlled trial. BMJ 2002;324:1299-302.

  53. The Royal College of Physicians of Edimburg. Update Statement from the Conference “Autologous Transfusion”,3 years o What is new?, What has Happened? held a the Royal College of Physicians of Edimburg. Br J Haematol 1999;104:340.

  54. Halpern NA, Alicea M, Seabrook B, Spungen AM, et al. Cell saver autologous transfusion: metabolic consequences of washing blood with normal saline. J Trauma 1996;41:407-15.

  55. Schaff HV, Hauer J, Gardner TJ, Donahoo JS, et al. Routine use of autotransfusion following cardiac surgery: experience 700 patients. Ann Torca Surg 1979;27:493-9.

  56. Griffith LD, Billman GF, Daily PO. Apparent coagulopathy caused by infusion of shed mediastinal blood and its prevention by washing of the infusate. Ann Torca Surg 1989;47:400-9.

  57. Levi M, Cromheecke ME, de Jonge E, Prins MH, et al. Pharmacological strategies to decrase excesive blood loss in cardiac surgery: A metanalysis of clinically, relevant endpoints. Lancet 1999;354:1940-8.

  58. Levy JH. Hemostatic agents and their saftey. J Cardiothorac Vasc Anesth 1999;13:6-11.

  59. Kovesi T, Royston D. Pharmacological approaches to reducing allogeneic blood exposure. Vox Sang 2003;84:2-10.

  60. Rich JB. The efficacy and saftey of aprotinin use in cardiac surgery. Ann Thorca Surg 1998;66:S6-11.

  61. Peters DC, Noble S. Aprotinin: an update of its pharmacology and therapeutic use in open heart surgery and coronary bypass surgery. Drugs 2000;57:233-60.

  62. Landis RC, Asimakopoulos G, Poullis M, HAskard DO, Taylor KM. The antithrombotic and antinflammatory mechanism of action of aprotinin. Ann Torca Surg 2001;72:2169-75.

  63. Mangano DT, Tudor IC, Dietzel C. The risk associated with aprotinin in cardiac surgery. N Engl J Med 2006;354:353-65.

  64. Frumento RJ, O’Malley CMN, Bennett-Guerreo E. Stroke alter cardiac surgery: a retrospective analysis of the effects of aprotinin dosing regimens. Ann Torca Surg 2003;75:479-83.

  65. Porte RJ, Molenaar IQ, Begliomini B, Groenland TH. Aprotinin and transfusion requirements in orthotopic liver transplantation: a multicentre randomised double-blind study EMSALT Study Group. Lancet 2000;355:1303-9.

  66. Muñoz JJ, Birkmeyer NJ, Birkmeyer J, O’Connor GT, Daccy LJ. Is epsilon-aminocaproic acid as effective as aprotinin in reducing bleeding whithin cardiac surgery. Meta-analysis. Circulation 1999;99:81-89.

  67. Wong BI, Malean RF, Fremes SE, Deemar KA, et al. Aprotinin and tranexamic acid for high transfusion risk cardiac surgery. Ann Torca Surg 2000;69:808-16.

  68. Casati V, Della Valle P, Benussi S, Franco A, et al. Effects of tranexamic acid and postoperative bleeding and related histochemical variables in coronary surgery: comparison between on-pump and off-pump thecniques. J Thorac Cardiovasc Surg 2004;128:83-91.

  69. Jansen AS, Andreicas S, Claeys M, D’Haese J, Camu F, Jachmans K. Use of tranexamic acid for an effective blood conservation, strategy after total knee arthroplasty. Br J Anesth 1999;83:596.

  70. De la Fuente B, Kasper CK, Rickles FR, Hoyer LW. Response of patients with mild and moderate hemophilia A and Von Willebrand disease to treatment with desmopressin. Ann Intern Med. 1985;103:6-14.

  71. Ozkisacik E, Islamoglu F, Posacioglu H, Yagdi T, et al. Desmopressin usage in elective cardiac surgery. J Cardiovasc Surg 2001; 42:741-7.

  72. Despotis GJ, Levine V, Saleem R, Spitznagel E, Joist JH. Use of point-of-care test in identification of patients who can benefit from desmopressin during cardiac surgery: a randomised controlled trial. Lancet 1999;354:106-10.

  73. Hedner U. NovoSeven as a universal haemostatic agent. Blood Coagul Fibrinolysis 2000;11:S107-S111.

  74. Hedner U. Recombinant factor VIIa (Novoseven) as a haemostatic agent. Semin Hematol 2001;38:43-47.

  75. Hedner V, Erhardtsen E. Potential role for rFVIIa in transfusion medicine. Transfusion 2002;42:114-24.

  76. White B, McHale J, Ravi N, Reynolds J, et al. Successful use of recombinant FVIIa (Novoseven) in the management of intractable post-surgical intra-abdominal haemorrhage. Br J Haematol 1999;107:677-8.

  77. Pickard JD, Kirkpatrick PJ, Melsen T, Andreasen RB, et al. Potential role of NovoSeven in the prevention of rebleeding following aneurysmal subarachnoid haemorrhage. Blood Coagul Fibrinolysis 2000;11:S117-S120.

  78. Friederich PW, Geerdink MG, Spataro M, Messelink EJ, et al. The effect of the administration of recombinant activated factor VII (NovoSeven) on perioperative blood loss in patients undergoing transabdominal retropubic prostatectomy: the PROSE study. Blood Coagul Fibrinolysis 2000;11:S129-S132.

  79. Al Douri M, Shafi T, Al Khudairi D, Al Bokhari E, et al. Effect of the administration of recombinant activated factor VII (rFVIIa; NovoSeven) in the management of severe uncontrolled bleeding in patients undergoing heart valve replacement. Blood Coagul Fibrinolysis 2000;11:S121-S127.

  80. Powner DJ, Hartwell EA, Keith Hoots W. Counteracting the effects of anticoagulants and antiplatets agents during neurosurgical emergencies. Neurosurgery 2005;57:823-31.

  81. Henry DA, Moxey AJ, Carless PA, O’Connell D, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 2001;1:CD001886.

  82. Kurz A, Sessler DI, Lenhardt R. For the Study of Wound Infection and Temperature Group: perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med 1996;334:1209-15.

  83. Bock M, Muller J, Bach A, Bohrer H, et al. Effects of preinduction and intraoperative warming during major laparotomy. Br J Anaesth 1998;80:159-63.

  84. Schmied H, Kurz A, Sessler DI, Kosek S, Reiter A. Mild hypothermia increase blood loss and transfusion requirements during total hip arthroplasty. Lancet 1996;347:289-92.

  85. Schmied H, Schiferer A, Sessler DI, Meznik C. The effects of red cell scavenging, hemodilution, and active warming on allogenic blood requirements in patients undergoing hip or knee arthroplasty. Anesth Analg 1998;86:387-91.

  86. Michelson AD, MacGregor H, Barnard MR, Kestin AS, et al. Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro. Thromb Haemost 1994;71:633-40.

  87. Ruttmann TG, James MFM, Aronson I. In vivo investigation into effects of haemodilution with hydroxyethil starch (200/0.5) and normal saline on coagulation. Br J Anesth 1998;80:612-6.

  88. Karoutsos S, Nathan N, Lahrimi A, Grouille D, et al. Thromboelastogram reveals hypercoagulability after administration of gelatin solution. Br J Anaesth 1999;82:175-7.

  89. Habler OP, Kleen MS, Hutter JW, Podtschaske AH, et al. Effects of hyperoxic ventilation on hemodilution induced changes in anesthetized dogs. Transfusion 1998;38:135-44.

  90. Zollinger A, Hager P, Singer T, Freidl HP, et al. Extreme hemodilution due to massive blood loss in tumor surgery. Anesthesiology 1997;87:985-7.

  91. Boldt J, Weber A, Mailer K, Papsdorf M, Schuster P. Acute normovolaemic haemodilution vs controlled hypotension for reducing the use of allogenic blood in patients undergoing radical prostatectomy. Br J Anaesth 1999;82:170-4.

  92. Williams-Russo P, Sharrock NE, Mattis S, Liguori GA, et al. Randomized trial of hypotensive epidural anesthesia in older adults. Anesthesiology 1999;91:926-35.

  93. Gould SA, Moore EE, Hoyt DB, Burch JM, et al. The first trial of human polymerized hemoglobin as a blood substitute in acute trauma and emergent surgery. J Am Coll Surg 1998;187:113- 20.

  94. Spahn DR, van Brempt R, Theilmeir G, Reibold JP, et al. Perflubron emulsion delays blood transfusion in orthopedic surgery. Anethesiology 1999;91:1195-208.

  95. Faithfull N, Weers G. Perfluorocarbon compounds. Vox Sang 1998;74:243-8.

  96. Weiskopf RB, Viele MK, Feiner J, Kelley S, et al. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA 1998;279:217-21.




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