Vox sanguinis
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Randomized Controlled Trial Multicenter Study
Silent myocardial ischaemia and haemoglobin concentration: a randomized controlled trial of transfusion strategy in lower limb arthroplasty.
Red cell transfusion is commonly used in orthopaedic surgery. Evidence suggests that a restrictive transfusion strategy may be safe for most patients. However, concern has been raised over the risks of anaemia in those with ischaemic cardiac disease. Perioperative silent myocardial ischaemia (SMI) has a relatively high incidence in the elderly population undergoing elective surgery. This study used Holter monitoring to compare the effect of a restrictive and a liberal red cell transfusion strategy on the incidence of SMI in patients without signs or symptoms of ischaemic heart disease who were undergoing lower limb arthroplasty. ⋯ In patients without preoperative evidence of myocardial ischaemia undergoing elective hip and knee replacement surgery, a restrictive transfusion strategy seems unlikely to be associated with an increased incidence of SMI. A proportion of these patients experience moderate SMI, regardless of the transfusion trigger. Use of a restrictive transfusion strategy did not increase length of hospital stay, and use of this strategy would lead to a significant reduction in red cell transfusion in orthopaedic surgery. Our data did not indicate any potential for harm in employing such a strategy in patients with no prior evidence of cardiac ischaemia who were undergoing elective orthopaedic surgery.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The SAFE study: saline vs. albumin for fluid resuscitation in the critically ill.
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Randomized Controlled Trial Comparative Study Clinical Trial
Humoral immune response to autologous blood transfusion in hip surgery: whole blood versus packed red cells and plasma.
The immune response to the transfused autologous buffy coat content in whole blood has, to date, not been studied in detail. ⋯ In comparison to the impact of surgery on cytokine and complement levels, the transfusion of autologous buffy coat is not relevant.
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Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of solvent/detergent-treated plasma in patients with a prolonged prothrombin time.
To compare the laboratory and clinical outcome of patients who received solvent/detergent-treated plasma (SDP) and fresh-frozen plasma (FFP). ⋯ No clinical or statistically significant differences were observed after infusion with SDP or FFP in patients with acquired coagulation deficits.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lactated Ringer's solution versus hydroxyethyl starch for volume replacement in autologous blood donors with cardiovascular disease: a controlled, randomized trial.
The study was designed to evaluate whether volume replacement following blood donation can prevent arterial hypotension in autologous blood donors with cardiovascular disease. ⋯ Both LRS and HES, administered at a volume ratio to blood loss of 3:1 and 1:1, respectively, significantly reduced the incidence of systolic hypotensive episodes in autologous blood donors with cardiovascular disease. LRS at a 3:1 volume ratio to blood loss was associated with a high rate of systolic hypertension.