Hemodilution: Reduction of blood viscosity usually by the addition of cell free solutions. Used clinically (1) in states of impaired microcirculation, (2) for replacement of intraoperative blood loss without homologous blood transfusion, and (3) in cardiopulmonary bypass and hypothermia.Plasma Substitutes: Any liquid used to replace blood plasma, usually a saline solution, often with serum albumins, dextrans or other preparations. These substances do not enhance the oxygen- carrying capacity of blood, but merely replace the volume. They are also used to treat dehydration.Hydroxyethyl Starch Derivatives: Starches that have been chemically modified so that a percentage of OH groups are substituted with 2-hydroxyethyl ether groups.Blood Transfusion, Autologous: Reinfusion of blood or blood products derived from the patient's own circulation. (Dorland, 27th ed)Hematocrit: The volume of packed RED BLOOD CELLS in a blood specimen. The volume is measured by centrifugation in a tube with graduated markings, or with automated blood cell counters. It is an indicator of erythrocyte status in disease. For example, ANEMIA shows a low value; POLYCYTHEMIA, a high value.Blood Volume: Volume of circulating BLOOD. It is the sum of the PLASMA VOLUME and ERYTHROCYTE VOLUME.Blood Loss, Surgical: Loss of blood during a surgical procedure.Hemoglobins: The oxygen-carrying proteins of ERYTHROCYTES. They are found in all vertebrates and some invertebrates. The number of globin subunits in the hemoglobin quaternary structure differs between species. Structures range from monomeric to a variety of multimeric arrangements.Blood Transfusion: The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed)Oxygen: An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Surgical Flaps: Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature which is also transferred to the new site. They are often used in plastic surgery for filling a defect in a neighboring region.Blood Substitutes: Substances that are used in place of blood, for example, as an alternative to BLOOD TRANSFUSIONS after blood loss to restore BLOOD VOLUME and oxygen-carrying capacity to the blood circulation, or to perfuse isolated organs.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Hypovolemia: An abnormally low volume of blood circulating through the body. It may result in hypovolemic shock (see SHOCK).Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains.Oxygen Consumption: The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346)Hemoglobins, Abnormal: Hemoglobins characterized by structural alterations within the molecule. The alteration can be either absence, addition or substitution of one or more amino acids in the globin part of the molecule at selected positions in the polypeptide chains.Blood Volume Determination: Method for determining the circulating blood volume by introducing a known quantity of foreign substance into the blood and determining its concentration some minutes later when thorough mixing has occurred. From these two values the blood volume can be calculated by dividing the quantity of injected material by its concentration in the blood at the time of uniform mixing. Generally expressed as cubic centimeters or liters per kilogram of body weight.Swine: Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).Isotonic Solutions: Solutions having the same osmotic pressure as blood serum, or another solution with which they are compared. (From Grant & Hackh's Chemical Dictionary, 5th ed & Dorland, 28th ed)Blood Viscosity: The internal resistance of the BLOOD to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as SICKLE CELL ANEMIA and POLYCYTHEMIA.Fetal Hemoglobin: The major component of hemoglobin in the fetus. This HEMOGLOBIN has two alpha and two gamma polypeptide subunits in comparison to normal adult hemoglobin, which has two alpha and two beta polypeptide subunits. Fetal hemoglobin concentrations can be elevated (usually above 0.5%) in children and adults affected by LEUKEMIA and several types of ANEMIA.Catheterization, Swan-Ganz: Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, subclavian, and sometimes the femoral vein. It is used to measure pulmonary artery pressure and pulmonary artery wedge pressure which reflects left atrial pressure and left ventricular end-diastolic pressure. The catheter is threaded into the right atrium, the balloon is inflated and the catheter follows the blood flow through the tricuspid valve into the right ventricle and out into the pulmonary artery.Burns: Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like.Resuscitation: The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS.Microcirculation: The circulation of the BLOOD through the MICROVASCULAR NETWORK.Microvessels: The finer blood vessels of the vasculature that are generally less than 100 microns in internal diameter.Intestines: The section of the alimentary canal from the STOMACH to the ANAL CANAL. It includes the LARGE INTESTINE and SMALL INTESTINE.Hashimoto Disease: Chronic autoimmune thyroiditis, characterized by the presence of high serum thyroid AUTOANTIBODIES; GOITER; and HYPOTHYROIDISM.Authorship: The profession of writing. Also the identity of the writer as the creator of a literary production.Famous PersonsHistory, 19th Century: Time period from 1801 through 1900 of the common era.Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from DATABASES, FACTUAL which is used for collections of data and facts apart from bibliographic references to them.Physical Therapy Modalities: Therapeutic modalities frequently used in PHYSICAL THERAPY SPECIALTY by PHYSICAL THERAPISTS or physiotherapists to promote, maintain, or restore the physical and physiological well-being of an individual.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Periodicals as Topic: A publication issued at stated, more or less regular, intervals.Creutzfeldt-Jakob Syndrome: A rare transmissible encephalopathy most prevalent between the ages of 50 and 70 years. Affected individuals may present with sleep disturbances, personality changes, ATAXIA; APHASIA, visual loss, weakness, muscle atrophy, MYOCLONUS, progressive dementia, and death within one year of disease onset. A familial form exhibiting autosomal dominant inheritance and a new variant CJD (potentially associated with ENCEPHALOPATHY, BOVINE SPONGIFORM) have been described. Pathological features include prominent cerebellar and cerebral cortical spongiform degeneration and the presence of PRIONS. (From N Engl J Med, 1998 Dec 31;339(27))Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell.Mitochondria: Semiautonomous, self-reproducing organelles that occur in the cytoplasm of all cells of most, but not all, eukaryotes. Each mitochondrion is surrounded by a double limiting membrane. The inner membrane is highly invaginated, and its projections are called cristae. Mitochondria are the sites of the reactions of oxidative phosphorylation, which result in the formation of ATP. They contain distinctive RIBOSOMES, transfer RNAs (RNA, TRANSFER); AMINO ACYL T RNA SYNTHETASES; and elongation and termination factors. Mitochondria depend upon genes within the nucleus of the cells in which they reside for many essential messenger RNAs (RNA, MESSENGER). Mitochondria are believed to have arisen from aerobic bacteria that established a symbiotic relationship with primitive protoeukaryotes. (King & Stansfield, A Dictionary of Genetics, 4th ed)Journal Impact Factor: A quantitative measure of the frequency on average with which articles in a journal have been cited in a given period of time.Anemia: A reduction in the number of circulating ERYTHROCYTES or in the quantity of HEMOGLOBIN.Abdomen: That portion of the body that lies between the THORAX and the PELVIS.Refusal to Participate: Refusal to take part in activities or procedures that are requested or expected of an individual. This may include refusal by HEALTH PERSONNEL to participate in specific medical procedures or refusal by PATIENTS or members of the public to take part in clinical trials or health promotion programs.Erythrocyte Transfusion: The transfer of erythrocytes from a donor to a recipient or reinfusion to the donor.Treatment Refusal: Patient or client refusal of or resistance to medical, psychological, or psychiatric treatment. (APA, Thesaurus of Psychological Index Terms, 8th ed.)Pallor: A clinical manifestation consisting of an unnatural paleness of the skin.Jupiter: The fifth planet in order from the sun. It is one of the five outer planets of the solar system. Its sixteen natural satellites include Callisto, Europa, Ganymede, and Io.Reflex, Babinski: A reflex found in normal infants consisting of dorsiflexion of the HALLUX and abduction of the other TOES in response to cutaneous stimulation of the plantar surface of the FOOT. In adults, it is used as a diagnostic criterion, and if present is a NEUROLOGIC MANIFESTATION of dysfunction in the CENTRAL NERVOUS SYSTEM.Extraterrestrial Environment: The environment outside the earth or its atmosphere. The environment may refer to a closed cabin (such as a space shuttle or space station) or to space itself, the moon, or other planets.Ice: The solid substance formed by the FREEZING of water.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.BrazilPerindopril: An angiotensin-converting enzyme inhibitor. It is used in patients with hypertension and heart failure.
Shander A, Rijhwani TS (December 2004). "Acute normovolemic hemodilution". Transfusion. 44 (12 Suppl): 26S-34S. doi:10.1111/j. ... Better outcomes are achieved with the reduction or avoidance of exposure to allogeneic blood. Numerous clinical studies have ... increasingly clinicians are giving parenteral iron to ensure that the haemoglobin is increased the maximal amount before the ... "Acute Normovolemic Hemodilution Reduces Allogeneic Red Blood Cell Transfusion in Cardiac Surgery: A Systematic Review and Meta- ...
Hemodynamic Compensation during Acute Normovolemic Hemodilution | Anesthesiology | ASA Publications
Acute normovolemic hemodilution (ANH) causes a reduction in arterial oxygen content because of reduced hemoglobin concentration ... Hemodynamic Compensation during Acute Normovolemic Hemodilution You will receive an email whenever this article is corrected, ... Hemodynamic Compensation during Acute Normovolemic Hemodilution. Anesthesiology 4 2004, Vol.100, 1034. doi: ... Estafanous FG, Smith CE, Selim WM, Tarazi RC: Cardiovascular effects of acute normovolemic hemodilution in rats with ...
Cardiovascular response to hyperoxemia, hemodilution and burns : a clinical and experimental study
During preoperative acute normovolemic hemodilution a reduction of hemoglobin to 80 g/l did not compromise systolic or ... Conclusions: A reduction in hemoglobin to 80 g/l during acute normovolemic hemodilution does not normally compromise systolic ... Background: Preoperative acute normovolemic hemodilution may compromise oxygen transport. The aims of our study were to ... 1. Transesophageal echocardiographic hemodynamic monitoring during preoperative acute normovolemic hemodilution. Open this ...
DiVA - Søkeresultat
Conclusions: A reduction in hemoglobin to 80 g/l during acute normovolemic hemodilution does not normally compromise systolic ... Background: Preoperative acute normovolemic hemodilution may compromise oxygen transport. The aims of our study were to ... Transesophageal echocardiographic hemodynamic monitoring during preoperative acute normovolemic hemodilution2000Inngår i: ... Acute myocardial damage recorded by both echocardiography and leakage of troponin was common, and there was a close correlation ...
restrictive-blood-transfusion-strategies-2014 par Shelley R. Salpeter MD - Fichier PDF
using a hemoglobin transfusion trigger of ,7 g/dL results in a signiﬁcant reduction in acute coronary syndrome, pulmonary edema ... acute normovolemic hemodilution: a meta-analysis. Transfusion. 2004;44:632-644. 47. Niinikoski J, Laaksonen V, Meretoja O, ... Acute normovolemic hemodilution. Anesthesiol Clin North America. 2005;23:271-281, vi. 42. Putney LJ. Bloodless cardiac surgery ... strategy, with hemoglobin triggers of 7.5 to 9 g/dL, no signiﬁcant reduction in morbidity or mortality was seen. With the ...
Tolerance to Acute Isovolemic Hemodilution:Effect of Anesthetic Depth | Anesthesiology | ASA Publications
... hemoglobin (hemoglobin from V̇o2) and from a plot of lactate versus hemoglobin (hemoglobin from lactate). Figures 1 and 2 ... ADEQUATE tissue oxygenation during acute normovolemic anemia is maintained by both an increase in cardiac output (CO) and an ... 1,2 The increase in CO is related to the reduction in blood viscosity resulting in increased venous return and decreased ... there was a significantly different response to acute hemodilution for CI and SI. In all dogs, acute isovolemic hemodilution ...
Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients | CMAJ
... when combined with acute normovolemic hemodilution in the perioperative setting, could reduce the need for blood transfusions. ... The reduction of the allogenic transfusion requirement in aortic surgery with a hemoglobin-based solution. J Vasc Surg 2000;31: ... There are 2 classes of hemoglobin substitutes: modified hemoglobins and the perfluorocarbons.36 The artificial hemoglobin ... has been tested in combination with acute normovolemic hemodilution in a phase III trial involving patients undergoing elective ...
Search | Global Index Medicus
PURPOSE: Acute normovolemic hemodilution (ANH) is an autologous transfusion method, using blood collected during surgery, to ... Advances in surgical, anesthesiologic and pharmacologic strategies have contributed to a reduction of blood loss during HBP ... PBM in HBP surgery consists of increasing preoperative hemoglobin level, preoperative blood conservation, and preoperative ... Effects of acute normovolemic hemodilution on healing of gastric anastomosis in rats ...
BACKGROUND: The possible impact of hemodilution during acute normovolemic hemodilution (ANH) using hydroxyethyl starch (HES) on ... It is currently recommended to start transfusion when hemoglobin is under 7-8 g/dL in patients without cardiac problems, using ... However, whether significant changes that occur in propofol hypnosis in these patients could be related to the reduction on the ... Influence of acute normovolemic hemodilution on the potency and time course of action of rocuronium in rabbits ...
ARTICLES | Journal of Applied Physiology
acute normovolemic hemodilution (ANH) reduces arterial hemoglobin (Hb) concentration, and thus arterial O2 content, triggering ... Although a slight reduction of mucosal oxygenation was observed at 40 ml/kg exchange, the mucosal μHbO2 still approximated ... Wu J, Mo L, Tan J, and Peng W. The effects of moderate acute normovolemic hemodilution on intestinal oxygen supply and ... Acute normovolemic hemodilution (ANH) compromizes intestinal microcirculatory oxygenation; however, the underlying mechanisms ...
Iron: Uses, Side Effects, Interactions, Dosage, and Warning
Preoperative acute hypervolemic hemodilution with hydroxyethylstarch: an alternative to acute normovolemic hemodilution? Anesth ... Hemoglobin diseases: Taking iron might cause iron overload in people with these conditions. If you have a hemoglobin disease, ... with or without leucocyte reduction, on acute-phase response to surgery for total knee replacement. Acta Anaesthesiol.Scand ... Goodnough, L. T., Monk, T. G., Despotis, G. J., and Merkel, K. A randomized trial of acute normovolemic hemodilution compared ...
Blood management - Wikipedia
Shander A, Rijhwani TS (December 2004). "Acute normovolemic hemodilution". Transfusion. 44 (12 Suppl): 26S-34S. doi:10.1111/j. ... Better outcomes are achieved with the reduction or avoidance of exposure to allogeneic blood. Numerous clinical studies have ... increasingly clinicians are giving parenteral iron to ensure that the haemoglobin is increased the maximal amount before the ... "Acute Normovolemic Hemodilution Reduces Allogeneic Red Blood Cell Transfusion in Cardiac Surgery: A Systematic Review and Meta- ...
Reduced side-effect hemoglobin compositions - Baxter International Inc.
... particularly novel recombinant mutant hemoglobin compositions, which eliminate or substantially reduce 1) the creation of heart ... acute normovolemic hemodilution or hemoaugmentation). In addition, the reduced side effect hemoglobins of the instant invention ... A significant reduction in the tumorous condition results.  For purposes of the present invention, cancer therapy is ... The hemoglobin of claim 71 wherein the hemoglobin is lesion free hemoglobin or reduced lesion hemoglobin. 73. A hemoglobin ...
Protocols and Video Articles Authored by Pedro Cabrales (Translated to Russian)
Acute moderate isovolemic hemodilution was induced by two isovolemic hemodilution steps: in the first step, 6% 70-kDa dextran ( ... Blood Pressure Reduction Due to Hemoglobin Glycosylation in Type 2 Diabetic Patients Vascular Health and Risk Management. 2008 ... Fifteen anesthetized rats were subjected to a two-exchange normovolemic hemodilution of 40% of the circulating blood volume ... Low Oxygen-affinity Hemoglobin Solution Increases Oxygenation of Partially Ischemic Tissue During Acute Anemia Journal of the ...
Blood Flow and Oxygen Transport sub-cluster 59
Frequently, removed blood is replaced with intravenous fluids to maintain euvolemia (acute normovolemic hemodilution [ANH]). ... ANH may present problems when the circuit prime causes further hemodilution and unacceptably low hemoglobin. This investigation ... reduction of systemic venous pressure, and increased cardiac output to achieve hemodynamic stabilization. To meet these ... Neutrophil elastase has been reported to play an important role in acute lung injury, which is a major cause of postoperative ...
PubMedPro - 自体血
Pre-operative blood donation versus acute normovolemic hemodilution in cardiac surgery. Nobahar Mohammad Rezvan,Chegini Azita, ... 8 who had already showed low RET-He levels at PABD developed statistically significant reduction in hemoglobin levels after ... In this study, the development of preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH), ... Acute normovolemic hemodilution (ANH) and preoperative autologous blood donation (PABD) have questionable efficacy, viral and ...
Test yourself: Preoperative evaluation | ACP Hospitalist
Correct answer: C. Intraoperative acute normovolemic hemodilution.. Intraoperative acute normovolemic hemodilution involves the ... Preoperative hemoglobin is 11 g/dL (110 g/L). He is anticipated to lose at least 3 units of blood during surgery, and perhaps ... β-Blockers may be administered for heart rate control after α-blockers have effected meaningful blood pressure reduction. ... With intraoperative acute normovolemic hemodilution, multiple units of blood may be withdrawn from the patient and stored in ...
The efficacy of intravenous aminocaproic acid in primary total hip and knee arthroplasty: a meta-analysis | SpringerLink
Hemoglobin reduction. Hemoglobin reduction was reported in two included studies [6, 10]. No significant heterogeneity was found ... normovolemic hemodilution, electrocautery, hypotensive anesthesia, and hemostatic agents . However, many patients still ... It is known that significant blood loss may lead to acute anemia following a THA, and blood transfusions are often required for ... postoperative hemoglobin level (MD = 0.90, 95% CI 0.78 to 1.02, P , 0.00001), hemoglobin reduction (MD = − 0.75, 95% CI − 0.93 ...
Protocols and Video Articles Authored by Stephan M. Jakob
Acute Normovolemic Hemodilution Improves Oxygenation in Ischemic Flap Tissue Anesthesiology. Jun, 2002 , Pubmed ID: 12170063 ... We explored the effects of acute cardiac preload reduction and dobutamine on hepatic arterial (Qha) and portal venous (Qpv) ... pCO(2) gradients may not parallel blood flow changes because of concomitant changes in metabolism, hemoglobin, temperature, and ... During normovolemic hemodilution, the oxygenation may further deteriorate because of the lack of erythrocytes or improve ...
Internet Scientific Publications
Anesthesia techniques for blood conservation include cell salvage, acute normovolemic hemodilution, hypervolemic hemodilution, ... Theoretically, the affects of VitagelTM should be evident in reduction of postoperative blood loss and need for additional ... however it is better to do it after the physiologic nadir of hemoglobin which is around 6 months of age.(6) The average age for ... isovolumic hemodilution, increased control of hemorrhage during surgery, and harvesting autologous blood. (4) Commonly, it is ...
Signa Vitae » Indications for blood transfusions in critical illness » Print
17) Studies on animal models with acute, normovolemic haemodilution, demonstrated that a Hgb concentration of 4 g/dL represents ... A subgroup analysis of the patients with pre-transfusion ERO2 higher than 0.30 yielded a mean reduction in ERO2 of 0.055. The ... Haemoglobin/haematocrit thresholds for blood transfusions in critical illness. Although the main goal of RBCs transfusions is ... compared the effects of fresh and stored RBCs on microvascular perfusion and DO2 after acute isovolemic hemodilution. In ...
Improvements in blood transfusion management: cross-sectional data analysis from nine hospitals in Zhejiang, China | BMC Health...
The volume of allogeneic red blood cells or autologous blood transfusions (cell salvage and acute normovolemic hemodilution [ ... Effectiveness of acute normovolemic hemodilution to minimize allogeneic blood transfusion in major liver resections. ... has been reported in the other studies that can contribute to the reduction in allogeneic blood transfusion [26, 27]. In our ... were performed without testing hemoglobin (Hb) or other necessary laboratory parameters prior to administration of the blood. ...
Prolonged Severe Anemia and Transfusion Refusal Following Abdominal Surgery. A Case Report and Short Literature Review | OMICS...
... acute normovolemic hemodilution [8,9], minimization of intra operative blood losses and optimization of tolerance of anemia [10 ... the severe reduction in hemoglobin. It is only possible to act on cardiac output by administering fluids, crystalloids and ... 2011) Evaluation of acute normovolemichemodilution and autotransfusion in neurosurgical patients undergoing excision of ... Minimal hemoglobin level that definitely compromises the process of wound healing is not clear. In animals, the effect of acute ...
Antepartum and Postpartum Hemorrhage - Prediction and Management - The Clinical Advisor
Normovolemic hemodilution is possible in cases when the potential for blood loss has been determined preoperatively. A few case ... Recent work describing obstetric management by leaving the placenta in situ shows a reduction in acute operative blood loss and ... The hemoglobin level should be optimized in the outpatient setting and a written plan for management of hemorrhage created, to ... Acute increases in pulmonary vascular resistance leading to acute pulmonary hypertension have also been reported. ...
To test the hypothesis that Acute reduction of haemoglobin acute severe haemodilution concentration to 7 g/dl does not produce ... on hemodynamic variables 40 patients scheduled for radical Overall, acute normovolemic hemodilution during acute normovolemic ... hetastarch of acute normovolemic hemodilution.. All patients underwent moderate During hemodilution, anesthetized patients ... Recommend normovolemic severe haemodilution as a safe method of managing acute massive anticipated blood To evaluate the ...
Strategies for Blood Conservation in Joint Replacement Surgery | International Congress for Joint Reconstruction
The effectiveness of acute normovolemic hemodilution in reducing transfusion need is debatable, however . Its use may be ... The authors demonstrated a significant difference in hemoglobin reduction and blood loss using 3.0 g of TXA in 100 mL of normal ... The technique of acute normovolemic hemodilution attempts to achieve a similar effect to preoperative autologous blood donation ... advantages over the previously described methods of preoperative autologous donation and acute normovolemic hemodilution. ...
Predictors of packed red cell transfusion after isolated primary coronary artery bypass grafting - The experience of a single...
... preoperative hemoglobin ≤ 13 gm/dL, preoperative hematocrit ≤ 40%, serum creatinine > 100 μmol/L, Euro SCORE (standard/logistic ... acute perioperative normovolemic hemodilution and intraoperative blood salvage [9, 24, 25]. The adoption of available blood ... McDonald and McMillan, in 2005 , utilized the product of BSA (m2) and preoperative hemoglobin (gm/L) as an index for ... However, despite current reductions in transfusion requirements for patients undergoing CABG, many patients continue to require ...
Circuitul perfuziilor minime şi managementul fluidelor (volum) | Chirurgie cardiotoracică şi vasculară
Acute normovolemic hemodilution reduces allogeneic red blood cell transfusion in cardiac surgery: a systematic review and meta- ... Significant reduction in blood loss in patients undergoing minimal extracorporeal circulation. Gerritsen WB, van Boven WJ, ... Effects of a multimodality blood conservation schema toward improvement of intraoperative hemoglobin levels and off-pump ... The effect of retrograde autologous priming volume on haemodilution and transfusion requirements during cardiac surgery. ...
BJCVS, Vol.: 29 Ed.: 4 - 606/621 - 2014, Therapeutic options to minimize allogeneic blood transfusions and their adverse...
5 - Acute Normovolemic Hemodilution (ANH). Hemodilution, besides being a low-cost strategy, can produce beneficial effects, ... of r-Hu-EPO 40,000 IU per week resulted in a significant increase in hemoglobin levels and consequently in a reduction of 19% ... Licker M, Ellenberger C, Sierra J, Kalangos A, Diaper J, Morel D. Cardioprotective effects of acute normovolemic hemodilution ... acute normovolemic hemodilution, cell salvage, anemia tolerance (supplementary oxygen and normothermia), as well as various ...
US7643858B2 - System and method for detection of brain edema using spectrophotometry - Google Patents
Schou, Henning, et al., "Uncompensated Blood Los is not Tolerated During Acute Normovolemic Hemodilution in Anesthetized Pigs, ... Apparatus for measuring hemoglobin US5735284A (en) 1992-06-24. 1998-04-07. N.I. Medical Ltd.. Method and system for non- ... after weight reduction," Journal of Applied Physiology, vol. 87, pp. 294-298 (1999). ... Apparatus for measuring hemoglobin US5860919A (en) 1995-06-07. 1999-01-19. Masimo Corporation. Active pulse blood constituent ...
Cell salvageSalvageOxygenationHemostatic agentsHematocritReducesIsovolemicMyocardial infarctionPostoperativeAllogeneic bloodOutcomesNoninvasive Hemoglobin MonitoringCoronarySplanchnicInclude acuteArterialFluidPreoperative hemoglobinPerioperativePediatric trauma patientsTransfusionsOxygenPerfusionErythropoietinLower hemoglobinComposition of claim 1 whereinCompensatoryTotal HemoglobinHemolytic transfusionAlbuminViscosityPatientsConcentrationsDecreaseHypothesisRelatesInvolvesLevelsRenal failureCardiopulmonaryMasimoBlood loss
- The volume of allogeneic red blood cells or autologous blood transfusions (cell salvage and acute normovolemic hemodilution [ANH]) for each case was recorded. (biomedcentral.com)
- Treating anemia and thrombocytopenia, suspending anticoagulants and antiplatelet agents, reducing routine phlebotomies, utilizing less traumatic surgical techniques with moderate hypothermia and hypotension, meticulous hemostasis, use of topical and systemic hemostatic agents, acute normovolemic hemodilution, cell salvage, anemia tolerance (supplementary oxygen and normothermia), as well as various other therapeutic options have proved to be effective strategies for reducing allogeneic blood transfusions. (rbccv.org.br)
- Preoperative, intraoperative and postoperative measures are required, such as optimization of red blood cell mass, adequate preoperative plan and invasive hemostatic procedures, assisting anesthetic techniques, individualization of anemia tolerance, autologous blood donation, normovolemic hemodilution, intraoperative cell salvage and pharmacologic agents for controlling blood loss. (biomedcentral.com)
- These strategies include the use of hemostatic agents, hemoglobin substitutes and blood salvage techniques, the reduction of blood loss associated with diagnostic testing, the use of erythropoietin and the use of restrictive blood transfusion triggers. (cmaj.ca)
- In the case of surgery, acute normovolemic hemodilution or intraoperative blood salvage can also be considered. (bvsalud.org)
- These include optimizing preoperative hematologic conditions by the use of Epogen, intraoperative blood salvage, isovolumic hemodilution, increased control of hemorrhage during surgery, and harvesting autologous blood. (ispub.com)
- ADEQUATE tissue oxygenation during acute normovolemic anemia is maintained by both an increase in cardiac output (CO) and an increase in tissue oxygen extraction. (asahq.org)
- acute normovolemic hemodilution (ANH) reduces arterial hemoglobin (Hb) concentration, and thus arterial O 2 content, triggering compensatory mechanisms at different levels of O 2 transport to maintain tissue oxygenation. (physiology.org)
- Hemoglobin is essential for tissue oxygenation, but the serum hemoglobin concentration is just one of several factors involved. (ccjm.org)
- Just 20 years ago, physicians were using arbitrary cutoffs such as hemoglobin 10 g/dL or hematocrit 30% as indications for blood transfusion, without reasonable evidence to support these values. (ccjm.org)
- Anemia is common in critically ill patients, and is usually diagnosed after measuring the concentration of hemoglobin (Hb) and the hematocrit (Hct), which reveals the ratio between the existing red blood cells and the plasma volume . (hellonursing.info)
- Recurring reduction of the hematocrit along with low reticulocyte count and normal other cell line indicated a pure red cell aplastic state. (ajts.org)
- The relationship between nadir hematocrit and acute renal failure was worsened by intra-operative transfusions in this study. (biomedcentral.com)
- Acute normovolemic hemodilution reduces allogeneic red blood cell transfusion in cardiac surgery: a systematic review and meta-analysis of randomized trials. (jw.org)
- As intraoperative parenteral fluids contribute to hemodilution, we evaluated the hypothesis that intraoperative fluid restriction reduces packed red-cell (PRC) use, especially in transfusion-prone adults undergoing elective cardiac surgery. (biomedcentral.com)
- Continuous and noninvasive hemoglobin monitoring reduces red blood cell transfusion during neurosurgery: a prospective cohort study. (masimo.co.jp)
- Crystal GJ, Rooney MW, Salem MR: Regional hemodynamics and oxygen supply during isovolemic hemodilution alone and in combination with adenosine-induced controlled hypotension. (asahq.org)
- Recent acceptance of a lower transfusion trigger in the perioperative period has raised the question of the effects of anesthetic depth on the tolerance to acute isovolemic anemia. (asahq.org)
- Indeed, anesthetic agents could alter the compensatory mechanisms implicated during isovolemic hemodilution, especially the CO response. (asahq.org)
- We hypothesized that the negative cardiovascular effects of anesthetic agents may exceed their effects on tissue metabolism, so that increasing the level of anesthesia may reduce tolerance to acute isovolemic anemia and increase the critical hemoglobin. (asahq.org)
- We tested this hypothesis in a dog model of stepwise isovolemic hemodilution. (asahq.org)
- thus, isovolemic hemodilution was planned to be performed immediately following anesthesia induction. (springeropen.com)
- Weiskopf and colleagues studied patients who underwent isovolemic reduction of Hb to 7, 6, and 5 g/dL. (tomhsiung.com)
- Background: Elevated blood viscosity has been shown to be independently correlated with cardiovascular risk factors and associated with increased risk of major cardiovascular events, including death and acute myocardial infarction. (biomedsearch.com)
- 10, 11) The results of the TRICC study demonstrated that 30 day mortality, frequency of myocardial infarction, acute respiratory distress syndrome (ARDS) and pulmonary oedema were reduced when RBCs were administered at lower Hgb levels or when they were not administered at all. (signavitae.com)
- A postoperative hemoglobin level of between 80 and 100 g/dL may not be low enough to warrant transfusion, but these patients often feel lethargic and have a higher risk of syncopal episodes, impairing their ability to mobilize and participate in rehabilitation. (icjr.net)
- Based on a pilot study in patients undergoing total hip arthroplasty for osteoarthritis, it is anticipated that patients treated with continuous-flow cryocompression therapy will have less pain, less morphine consumption and lower decrease of postoperative hemoglobin levels. (biomedcentral.com)
- The primary objective of this study is to compare acute pain the first 72 h postoperative, measured with numeric rating scale for pain. (biomedcentral.com)
- PURPOSE: Acute normovolemic hemodilution (ANH) is an autologous transfusion method, using blood collected during surgery, to reduce the need for allogeneic blood transfusion. (bvsalud.org)
- Better outcomes are achieved with the reduction or avoidance of exposure to allogeneic blood. (wikipedia.org)
- One study observed a significant reduction in both the incidence and volume of allogeneic blood transfusion. (blood.gov.au)
- 204 The other study found a significant reduction in volume of allogeneic blood transfused compared with the control, but no effect on incidence. (blood.gov.au)
- Manufacturers have also contributed to this reduction in allogeneic blood use. (perfusion.biz)
- Thereby the risks of transfusion are removed and hemoglobin status is maximized, leading a positive effect on the patient's recovery and early- and long-term outcomes. (icjr.net)
- As the risk of transfusion-associated adverse outcomes may depend on the amount of transfusion [ 4 ], reduction of blood transfusions is considered a relevant, important goal in cardiac surgery. (biomedcentral.com)
- Not until acute normovolemic hemodilution studies were performed were we able to progressively appraise how well patients could tolerate lower levels of hemoglobin without significant adverse outcomes. (ccjm.org)
Noninvasive Hemoglobin Monitoring7
- Does a digital regional nerve block improve the accuracy of noninvasive hemoglobin monitoring? (masimo.co.jp)
- Continuous Noninvasive Hemoglobin Monitoring During Complex Spine Surgery. (masimo.co.jp)
- Continuous noninvasive hemoglobin monitoring estimates timing for detecting anemia better than clinicians: a randomized controlled trial. (masimo.cn)
- Continuous and noninvasive hemoglobin monitoring may reduce excessive intraoperative RBC transfusion. (masimo.cn)
- Continuous Noninvasive Hemoglobin Monitoring: A Measured Response to a Critical Review. (masimo.cn)
- Noninvasive Hemoglobin Monitoring: A Rapid, Reliable, and Cost-Effective Method Following Total Joint Replacement. (masimo.cn)
- Noninvasive hemoglobin monitoring in critically ill pediatric patients at risk of bleeding. (masimo.cn)
- Effects of a multimodality blood conservation schema toward improvement of intraoperative hemoglobin levels and off-pump transfusions in coronary artery bypass graft surgery. (jw.org)
- For decades, physicians believed in the benefit of prompt transfusion of blood to keep the hemoglobin level at arbitrary, optimum levels, ie, close to normal values, especially in the critically ill, the elderly, and those with coronary syndromes, stroke, or renal failure. (ccjm.org)
- Additional clinical practice guidelines exist that specify Hb targets for critical care patients with conditions including sepsis, ischemic stroke, and acute coronary syndrome. (tomhsiung.com)
- The causes are multifactorial and include acute blood loss, blood loss from diagnostic testing and blunted red blood cell production. (cmaj.ca)
- 1 The reasons for anemia in critically ill patients are multifactorial and include acute blood loss (e.g., from trauma, surgery or gastrointestinal bleeding), iatrogenic blood loss from diagnostic testing and blunted red blood cell production. (cmaj.ca)
- In prospective clinical studies we investigated previously cardiovascular healthy adults during hyperoxemia, and during preoperative acute normovolemic hemodilution or early fluid resuscitation of severe burn victims. (diva-portal.org)
- BACKGROUND: We investigated the effect of irrigation fluid on coagulation according to the hemodilution level using rotational thromboelastometry (ROTEM). (bvsalud.org)
- Another technique, acute normovolemic hemodilution" involves the collection of a selected calculated volume of autologous blood in collection bags prior to the start of surgery with the simultaneous replacement of an equal volume of asanguinous fluid. (wikipedia.org)
- Some of the causes (Table 34.1) can be modified, which may facilitate prevention strategies, such as making the collection of blood samples more efficient in order to reduce losses, guiding fluid replacement therapy to avoid extreme hemodilution, and the supply of iron. (hellonursing.info)
- Preoperative hemoglobin is 11 g/dL (110 g/L). He is anticipated to lose at least 3 units of blood during surgery, and perhaps more if the tumor bed is highly vascular. (acphospitalist.org)
- Such a strategy should be individualized and based on patient-specific risk factors, including preoperative hemoglobin level, anticipated difficulty of the procedure and blood loss, and associated medical co-morbidities. (icjr.net)
- Several studies have highlighted the significant influence of preoperative hemoglobin on the requirement for transfusion in total joint arthroplasty [10, (icjr.net)
- Salido et al demonstrated that few patients with a preoperative hemoglobin level greater than 150 g/L need allogenic blood, while patients with preoperative hemoglobin level less than 110 g/L had a 100% transfusion rate . (icjr.net)
- Similarly, Pierson et al showed that an algorithm-based strategy aimed at improving the preoperative hemoglobin level was effective in reducing transfusion rate . (icjr.net)
- Therefore, in patients with multiple risk factors, it is vitally important to correct anemia and maximize the preoperative hemoglobin. (icjr.net)
- Of the 19,102 perioperative transfusions reviewed, 44.1% were performed without testing hemoglobin (Hb) or other necessary laboratory parameters prior to administration of the blood. (biomedcentral.com)
- The acute recovery phase after hip fracture surgery in elder patients is often complicated by severe pain, high morphine consumption, perioperative blood loss with subsequent transfusion and delirium. (biomedcentral.com)
Pediatric trauma patients2
- Blood transfusions are frequently given to patients in intensive care units to treat low hemoglobin levels due to either acute blood loss or subacute anemia associated with critical illness. (cmaj.ca)
- Lowering the hemoglobin threshold at which blood is transfused will reduce the need for transfusions and is not associated with increased morbidity or mortality among most critically ill patients without active cardiac disease. (cmaj.ca)
- Many critically ill patients receive blood transfusions for the treatment of low hemoglobin levels due to either acute blood loss or subacute anemia associated with critical illness. (cmaj.ca)
- Economic Analysis of the Reduction of Blood Transfusions during Surgical Procedures While Continuous Hemoglobin Monitoring Is Used. (masimo.cn)
- 1. A pharmaceutical composition for transporting and releasing oxygen comprising a suspension of from about 5 to about 20 grams of reduced lesion hemoglobin per deciliter of a pharmaceutically acceptable carrier. (freepatentsonline.com)
- The latter may be due to the impaired ability of erythrocytes to off-load oxygen within the microcirculation, thus yielding low tissue/plasma P o 2 but elevated microcirculatory hemoglobin oxygen (HbO 2 ) saturations. (physiology.org)
- The problem with such indications is that the clinical evaluation may be misleading in severely ill patients and haemoglobin levels that impair oxygen delivery cannot be determined easily. (signavitae.com)
- 2. The composition of claim 1 wherein the partially deoxygenated hemoglobin solution contains less than 1000 parts per million of oxygen. (google.com.au)
- 15. The composition of claim 12 wherein the reducing agent is ascorbate and the partially deoxygenated hemoglobin solution contains less than about 150 ppm oxygen. (google.com.au)
- First, the reduction in red blood cell mass is presumed to compromise oxygen delivery to tissues and thus obligate the organism to compensate for reduced oxygen-carrying capacity. (cmaj.ca)
- 4 Increased extraction of oxygen from the tissues, combined with a rightward shift in the oxygen-hemoglobin dissociation curve, is sufficient to maintain normal oxygen delivery in the presence of mild to moderate anemia. (cmaj.ca)
- In people who are exercising, reductions in hemoglobin levels have been shown to reduce maximal oxygen consumption and endurance performance, but this is of uncertain relevance to chronically ill patients. (cmaj.ca)
- This shift allows for the unloading of oxygen to the tissues at higher partial pressures of oxygen, ensuring adequate oxygen delivery despite the reduction in RBC mass. (tomhsiung.com)
- This reduction in viscosity leads to an increase in regional blood flow at the tissue and organ level , driving up local perfusion area and pressures leading to increased oxygen extraction. (tomhsiung.com)
- Hemodilution leads to a decrease in the formed elements of the blood, especially in erythrocytes, and the blood's oxygen transport capacity is reduced due to hemodilutional anemia. (clinicsinsurgery.com)
- Influence of Fraction of Inspired Oxygen on Noninvasive Hemoglobin Measurement: Parallel Assessment of 2 Monitors. (masimo.cn)
- The aetiology of anaemia in critical illness relates to haemodilution, bleeding, blood sampling, increased haemolysis, nutritional deficiencies, blunted erythropoietin production, abnormalities in iron metabolism, etc. (1, 2) The ability to develop compensatory mechanisms that would assure metabolic needs, will determine the tolerance of anaemia in each patient. (signavitae.com)
- Preoperative levels of hemoglobin and erythropoietin were 21.9 g/dl (normal 11.5-15 g/dl) and 23.2 IU/ml (normal 4.2-23.7 IU/ml), respectively. (springeropen.com)
- Although she did not report any symptoms other than abdominal pain and her activity level was not impeded, blood tests showed a relatively high level of erythropoietin and a remarkably high level of hemoglobin. (springeropen.com)
- Changes in hemoglobin and erythropoietin levels. (springeropen.com)
- The targets in these studies were modest at first, but researchers aimed progressively for more aggressive hemodilution with lower hemoglobin targets and demonstrated that the body can tolerate and adapt to more severe anemia. (ccjm.org)
- Recent publications have proposed targeting lower hemoglobin levels (7 g/dL) to reduce complications related to transfusion of blood products, such as transfusion related infections, immunosuppression, transfusion-related acute lung injury (TRALI), hemolytic reactions and fever reactions, in addition to its effects on mortality. (hellonursing.info)
Composition of claim 1 wherein5
- 2. The pharmaceutical composition of claim 1 wherein the hemoglobin is reduced gastrointestinal effect hemoglobin, low gastrointestinal effect hemoglobin, low pressor effect hemoglobin, or hemoglobin which exhibits decreased aggregate formation when stored in solution in deoxygenated form for prolonged periods. (freepatentsonline.com)
- 7. The composition of claim 1 wherein the reducing agent is less than 3 moles of reducing agent per mole of hemoglobin. (google.com.au)
- 9. The composition of claim 1 wherein the storage stable hemoglobin is storage stable for at least one year. (google.com.au)
- 10. The composition of claim 1 wherein the storage stable hemoglobin is storage stable for at least six months. (google.com.au)
- 12. The composition of claim 1 wherein the storage stable hemoglobin is storage stable up to 40 C. (google.com.au)
- Noninfectious risks, which include febrile, allergic/ anaphylactic and hemolytic transfusion reactions, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO), are more common than infectious risks and lead to greater morbidity and mortality. (cmaj.ca)
- An acute hemolytic transfusion reaction due to ABO incompatibility is specifically identified as a reviewable sentinel event for which a comprehensive analysis of cause, corrective action, preventive action and reporting are required. (scribd.com)
- Laboratory tests are normal except for a hemoglobin of 10.0 g/dL (100 g/L) and a serum albumin level of 2.9 g/dL (29 g/L). The chest radiograph shows only changes consistent with COPD, and the electrocardiogram is normal. (acphospitalist.org)
- Weiskopf et al 9 assessed the effect of severe anemia in 32 conscious healthy patients (11 presurgical patients and 21 volunteers not undergoing surgery) by performing acute normovolemic hemodilution with 5% human albumin, autologous plasma, or both, with a target hemoglobin level of 5 g/dL. (ccjm.org)
- Isooncotic preparations of colloids (for example, human albumin or hydroxyethyl starch) remain nearly completely intravascular when infused to compensate for acute blood losses. (biomedcentral.com)
- 4 In this review, we explore the rationale and summarize the evidence for blood conservation strategies to reduce acute blood loss and prevent subacute anemia in critically ill patients ( Table 1 and Table 2 ). (cmaj.ca)
- Based on the results of this study, PABD should be recommended in well selected patients undergoing TKA: older female patients with a low basal haemoglobin level. (pubmed.pro)
- Cabibbo Sergio,Garozzo Giovanni,Antolino Agostino,Bennardello Francesco,Calabrese Salvatore,Manenti Oriella,Assenza Giorgio,Sallemi Giorgio,Bonomo Pietro Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis BACKGROUND:We analysed the relationship between baseline haemoglobin levels and the need for post-operative blood transfusion in our patients. (pubmed.pro)
- Significant reduction in blood loss in patients undergoing minimal extracorporeal circulation. (jw.org)
- In a minority of patients, severe reductions can occur. (cmaj.ca)
- Subsequently, studies proved that healthy, elderly, and stable cardiac patients can tolerate acute anemia with normal cardiovascular response. (ccjm.org)
- Although there is significant fall in activity of factor VIII, but it is an acute phase reactant and raised in most of the diseases so it is suggested that frozen plasma would be an acceptable product for most patients requiring fresh frozen plasma. (ajts.org)
- stated that "It is a clever idea to provide blood before surgery," referring to patients whose hemoglobin levels were between 8 and 10 g/dL. (hellonursing.info)
- With the more restrictive use of blood transfusion since the 1980s, there have been attempts to define specific indications for transfusion, minimal hemoglobin levels for critically ill patients, and the benefits and potential risks of transfusion . (hellonursing.info)
- Anemia in critically ill patients is multifactorial and is hematologically similar to chronic anemia, but often patients experience acute onset anemia . (hellonursing.info)
- Additionally, antifibrinolytic agents have been used in various studies to control acute hemorrhage and decrease transfusion requirements in patients undergoing surgical treatment [ 5 , 7 , 9 ]. (asianspinejournal.org)
- We recommend to substitute the five-fold amount of crystalloids or to use an isooncotic preparation in the face of acute bleeding in patients where edema prevention might be advantageous. (biomedcentral.com)
- This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH) in a hospital from central India. (ajts.org)
- Accuracy of a Continuous Noninvasive Hemoglobin Monitor in Intensive Care Unit Patients. (masimo.co.jp)
- A comparison of three methods of hemoglobin monitoring in patients undergoing spine surgery. (masimo.co.jp)
- Evaluation of Non-Invasive Hemoglobin Monitoring in Trauma Patients with Low Hemoglobin Levels. (masimo.cn)
- Even if survival with extremely low hemoglobin concentrations has been reported in literature, in case reports, case series, and retrospective studies [ 3 - 6 ], very low level of hemoglobin and consequent reduction in O 2 delivery, are nearly unanimously considered detrimental for patient quoad vitam prognosis and, where sudden significant bleeding occurs, can be reached very quickly. (omicsonline.org)
- 100 g/L) or moderate (85-100 g/L) reductions in hemoglobin concentrations. (cmaj.ca)
- The invention relates to novel hemoglobin compositions, particularly novel recombinant mutant hemoglobin compositions, which eliminate or substantially reduce 1) the creation of heart lesions, 2) gastrointestinal discomfort, 3) pressor effects, and 4) endotoxin hypersensitivity associated with the administration of extracellular hemoglobin compositions in various therapeutic applications. (freepatentsonline.com)
- The present invention relates to storage stable hemoglobin solutions which contain partially deoxygenated and surprisingly low amounts of reducing agents. (google.com.au)
- Acute normovolemic hemodilution involves withdrawing blood and replacing it with crystalloid or colloid solution to maintain the volume. (ccjm.org)
- Most transfusion guidelines suggest looking at the combination of haemoglobin or haematocrit levels in addition to clinical signs in the decision making process for a blood transfusion. (signavitae.com)
- Evidence supports a parsimonious approach to blood use for managing anemia, contrasting with the long-standing practice of blood transfusion targeting arbitrary hemoglobin levels. (ccjm.org)
- Assessing serum hemoglobin levels without venipuncture: accuracy and reliability of Pronto-7 noninvasive spot-check device. (masimo.co.jp)
- One of the most important techniques in order to avoid the hemodilution caused by priming solutions during Cardiopulmonary Bypass (CPB) is Retrograde Autologous Priming (ROP). (clinicsinsurgery.com)
- Hemodilution occurs during cardiac surgery when cardiopulmonary bypass (CPB) is instituted. (biomedcentral.com)