Transfusion
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Editorial Randomized Controlled Trial Clinical Trial
Albumin--does the bell toll for thee?
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Randomized Controlled Trial Clinical Trial
Perioperative myocardial ischemic episodes are related to hematocrit level in patients undergoing radical prostatectomy.
The anemia associated with perioperative blood conservation has raised concerns regarding the safety of these strategies in patients with ischemic cardiovascular disease. Therefore the relationship between hematocrit level and myocardial ischemic episodes in a group of elderly patients undergoing elective noncardiac surgery was studied. ⋯ A hematocrit level < 28 percent is independently associated with risk for myocardial ischemia during and after noncardiac surgery. Avoidance of cardiac complications may require higher transfusion thresholds, closer attention to tachycardia, or better monitoring for ischemia.
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Randomized Controlled Trial Clinical Trial
A prospective randomized trial of the surgical blood order equation for ordering red cells for total hip arthroplasty patients.
The majority of crossmatched blood is for surgical patients, and most of it is never transfused. An alternative system for ordering red cell (RBC) units, called the surgical blood order equation (SBOE), which incorporates specific patient variables for surgical patients, has been developed. ⋯ Incorporation of patient factors in the use of the SBOE system resulted in increased efficiency of blood-ordering practices for total hip arthroplasty.
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Randomized Controlled Trial Comparative Study Clinical Trial
A pilot randomized trial comparing symptomatic vs. hemoglobin-level-driven red blood cell transfusions following hip fracture.
The indications for transfusion have never been evaluated in an adequately sized clinical trial. A pilot study was conducted to plan larger clinical trials. ⋯ Symptomatic transfusion may be an effective blood-sparing protocol associated with the transfusion of appreciably fewer units of RBCs and lower mean hemoglobin levels than are associated with the threshold transfusion policy. However, it is unknown whether these two clinical strategies have comparable mortality, morbidity, or functional status. A definitive trial is needed.
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Randomized Controlled Trial Clinical Trial
The effect of an intraoperative treatment algorithm on physicians' transfusion practice in cardiac surgery.
Inappropriate transfusion in cardiac surgery may, in part, be due to empiric transfusion therapy instituted in the absence of timely laboratory data. Therefore, the effect of a transfusion decision algorithm based on intraoperative coagulation monitoring of physicians' transfusion practice and the transfusion outcome was evaluated. ⋯ The use of algorithms by transfusion decision makers can serve as an effective physician education intervention.