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Category: Blood

Blood CPB

Protamine Dosing and Its Impact in Cardiac Surgery Transfusion Practice: A Retrospective Bi-institutional Analysis

This study investigates the correlation between protamine dosing and transfusion requirements in cardiac surgery, analyzing data from 762 patients who underwent cardiopulmonary bypass (CPB)-assisted cardiac surgery across two institutions. Patients were categorized into low-ratio (Protamine: UFH ≤ 0.8) and high-ratio (Protamine: UFH > 0.8) groups, based on the amount of protamine used to neutralize unfractionated heparin. Results indicated a significant increase in blood transfusion requirements in the high-ratio group, encompassing red blood cells, plasma, platelets, and cryoprecipitate, highlighting the need for precise protamine dosing to reduce bleeding and transfusion rates post-surgery.

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February 5, 2024
CPU RBC

Development and Validation of a Machine Learning Method to Predict Intraoperative Red Blood Cell Transfusions in Cardiothoracic Surgery

A novel machine learning (ML) method has been developed to predict red blood cell (RBC) transfusion requirements in cardiothoracic surgery, enhancing blood inventory management and preoperative hemorrhage risk assessment. Utilizing data from 2410 surgeries between May 2014 and June 2019, with an additional 437 cases for validation, this method employs a hybrid approach combining Gaussian Process regression and classification algorithms. The model accurately predicts both minor (0 to 3 units) and significant (4+ units) RBC transfusions, showing promise for integrating ML into surgical planning and patient care optimization.

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February 4, 2024
Custom Blood

Association between Intraoperative Blood Salvage and Coagulation Disorder after Cardiopulmonary Bypass

This study assesses the relationship between intraoperative blood salvage and coagulation disorders following cardiopulmonary bypass (CPB), using conventional coagulation tests and thromboelastography (TEG). Enrolling 92 patients undergoing cardiovascular surgery with CPB, it explored coagulation function in scenarios with and without cell salvage blood transfusion. Despite 57.6% of patients receiving cell salvage, the occurrence of coagulation disorders post-CPB showed no significant difference between groups, indicating that intraoperative blood salvage does not significantly impact coagulation disorder risk as diagnosed by TEG or conventional tests.

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February 4, 2024
Blood Cells Lich

Low-Volume Acute Normovolemic Hemodilution Does Not Reduce Allogeneic Red Blood Cell Transfusion in Cardiac Surgery in the Modern Era of Patient Blood Management: A Propensity Score-Matched Cohort Study

In a retrospective cohort study of 542 elective cardiac surgery patients, acute normovolemic hemodilution (ANH) did not significantly reduce perioperative red blood cell transfusion rates compared to controls. This suggests that in the context of modern patient blood management practices, the benefits of ANH in minimizing transfusion requirements may be less significant than previously thought.

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February 2, 2024
Simpson Transfusion

Effects of Albumin and Crystalloid Priming Strategies on Red Blood Cell Transfusions in On-Pump Cardiac Surgery: A Network Meta-Analysis

In on-pump cardiac surgery, a network meta-analysis revealed that crystalloid priming strategies are associated with fewer perioperative red blood cell (RBC) transfusions compared to albumin priming, although the difference in postoperative blood loss between the two was not statistically significant. The study suggests that while albumin priming might reduce postoperative blood loss, its use leads to more RBC transfusions and a higher blood management burden, indicating the need for careful consideration of its application in this context.

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January 20, 2024
Factor VII

Trends in the Use of Recombinant Activated Factor VII and Prothrombin Complex Concentrate in Heart Transplant Patients in Virginia

The study investigated the use of procoagulant factors during heart transplants in Virginia and their potential link to postoperative thrombosis. It found a decrease in the use of off-label recombinant activated factor VII (rFVIIa) but an increase in off-label prothrombin complex concentrate (PCC) use, with rFVIIa associated with a higher risk of thrombosis, although patients receiving it were more critically ill, which may have influenced the results.

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January 16, 2024
Blood Hemolysis

Multi-Method Investigation of Blood Damage Induced by Blood Pumps in Different Clinical Support Modes

This study investigates the impact of different operational modes of an extracorporeal blood pump (CentriMag) on blood flow patterns and the associated risks of bleeding, thrombosis, and hemolysis using computational fluid dynamics and hemocompatibility models. It finds that venous-arterial (V-A) ECMO mode results in the highest risk of these complications, with heart failure (HF) mode being the least risky, largely due to variations in flow patterns affecting cell and protein functions.

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January 14, 2024
Blue CPB

Effects of Blood Transfusion, Cardiopulmonary Bypass Time, and Bypassed Vessels on Mortality Following Isolated and Combined Coronary Artery Bypass Grafting

This study analyzed 677 patients to investigate the correlation between the number of bypassed vessels, cardiopulmonary bypass duration, blood transfusion requirements, revision rates, and mortality in coronary artery bypass grafting surgeries. Results indicated that higher revision rates were associated with six-vessel bypasses, longer bypass and cross-clamp times, increased blood transfusions, and mortality, with specific blood thinners affecting transfusion needs and mortality outcomes.

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January 4, 2024
Heart Transfusion

The Effect of Perioperative Antithrombin Supplementation on Blood Conservation and Postoperative Complications After Cardiopulmonary Bypass Surgery: A Systematic Review, Meta-Analysis and Trial Sequential Analysis

This meta-analysis investigated the effect of perioperative antithrombin (AT) supplementation on patients undergoing cardiopulmonary bypass (CPB) surgery, analyzing 13 randomized controlled trials with 996 participants. The study found that perioperative AT did not significantly reduce postoperative blood loss or the need for blood transfusions, and it was associated with increased in-hospital mortality and acute kidney injury incidence.

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January 4, 2024
Blood Clot

Early Blood Clot Detection Using Forward Scattering Light Measurements Is Not Superior to Delta Pressure Measurements

This study investigates the use of forward scattered light (FSL) measurements for early blood clot detection in extracorporeal membrane oxygenators, a method potentially superior to the current standard of monitoring pressure differences (ΔP) which fails to detect smaller, early-stage clots. Despite several modifications, FSL measurements were unable to reliably detect clots in an in vitro test circuit, whereas the current clinical gold standard of pressure measurements successfully detected fulminant clot formation in multiple experiments.

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January 3, 2024
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