Vox sanguinis
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There is wide variation in the use of red cell transfusions for the same clinical indication. The purpose of the study was to comment on preoperative and discharge haemoglobin (Hb) levels and perioperative blood loss, and to project the Hb level if transfusions were not administered. ⋯ For surgical procedures involving moderate blood loss, transfusions should not be given as a routine and the decision to transfuse should take into consideration the clinical state of the patient, blood loss and pre- and postoperative Hb levels.
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Analysis of reports of incidents, involving ABO incompatibility suggests that the main problem is poor interpretation of the pretransfusion bedside compatibility test (PBCT). We studied sources of error as experienced by nurses as to the blood groups of donor blood and of the recipient. ⋯ PBCTs cannot be considered a valid safety procedure. We need other, more effective methods to reduce the risk of incompatibility accidents.
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Red blood cells are ideal vehicles for delivering oxygen to tissues, but their functions deteriorate during liquid preservation. In this article, we review the role of red blood cells in oxygen delivery and methods to evaluate the effectiveness of red blood cell transfusion. ⋯ We also describe the benefits of transfusion of red blood cells having a higher oxygen-delivering capacity. Phosphoenolpyruvate is a promising component to prepare red blood cells having a higher oxygen-delivering capacity.
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Transfusion of red blood cells continues to be an important therapy for treatment of anemia in intensive care settings. The critically ill are a population predisposed to the adverse outcomes of anemia and, as such, the risks imposed on them by transfusion therapy is one of great interest. ⋯ The Transfusion Requirements in Critical Care (TRICC) trial clearly established the safety of a restrictive transfusion strategy, suggesting that physicians could easily minimize exposure to allogeneic RBCs by lowering their transfusion threshold. Further research will add to the generalizability of this study as well as explore the possible mechanism to explain why red cell transfusions did not improve outcomes in the critically ill.
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Transfusion practices and thresholds in common elective surgical procedures were investigated in a nationwide multicenter survey in Finland. ⋯ The transfusion thresholds in all operations were liberal compared to recent international recommendations. Inappropriate thresholds were reflected in the high transfusion rates. This study accentuates the need for continuous discussion and educational measures to find optimal indications for transfusion in surgery, and to rationalize the transfusion policy in Finland.