Transfusion
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Randomized Controlled Trial Multicenter Study
A multicenter pilot-randomized controlled trial of the feasibility of an augmented red blood cell transfusion strategy for patients treated with induction chemotherapy for acute leukemia or stem cell transplantation.
Anemia may be an important factor contributing to an increased risk of bleeding, particularly in patients with thrombocytopenia. ⋯ This pilot study thus indicated that it would be feasible to enroll the required number of patients to enable the performance of a large RCT to investigate the effect of Hb on bleeding risk in thrombocytopenic patients.
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Randomized Controlled Trial
Immune modulation and microchimerism after unmodified versus leukoreduced allogeneic red blood cell transfusion in cancer patients: results of a randomized study.
Transfusion of red blood cells (RBCs) has been associated with immunomodulatory effects. Persistence of donor cells in the recipient may be contributive. ⋯ UN-RBC-induced microchimerism is associated with specific immunomodulatory effects in cancer patients who received transfusions during surgery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Prevention of bedside errors in transfusion medicine (PROBE-TM) study: a cluster-randomized, matched-paired clinical areas trial of a simple intervention to reduce errors in the pretransfusion bedside check.
Transfusion of the incorrect blood component is a frequent serious incident associated with transfusion and often involves misidentification of the patient and/or the unit of blood. The objective of this study was to assess the effect of a simple intervention designed to improve performance of the bedside check and to observe the durability of any effect. The intervention was a tag on blood bags reminding staff to check the patient's wristband. The tag was positioned in such a way that the transfusionist was required to remove the tag to spike the unit. ⋯ A simple intervention in the form of a barrier warning label on blood bags reminding staff to check the patient's wristband failed to improve bedside transfusion practice. The robust study design developed for this study could be applied to investigate other interventions to improve the safety of bedside transfusion practice.
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Randomized Controlled Trial
Retransfusion of filtered shed blood in primary total hip and knee arthroplasty: a prospective randomized clinical trial.
Allogeneic blood transfusions are associated with a number of well-recognized risks and complications. Postoperative retransfusion of filtered shed blood is an alternative to (reduce) allogeneic blood transfusion. The objectives of this study were to evaluate the clinical efficacy of retransfusion of filtered shed blood and to evaluate the complications, in particular febrile reactions. ⋯ Postoperative retransfusion of filtered shed blood is effective for decreasing allogeneic blood transfusions after total hip and knee arthroplasty. There was no relationship between retransfusions and postoperative febrile reactions.
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Randomized Controlled Trial
Cardioprotective effects of acute normovolemic hemodilution in patients with severe aortic stenosis undergoing valve replacement.
After acute normovolemic hemodilution (ANH), improvement of the rheologic conditions may contribute to optimize tissue oxygen delivery and attenuate ischemia-reperfusion injuries. It was hypothesized that ANH would confer additional cardioprotection in patients with ventricular hypertrophy undergoing open heart surgery. ⋯ Besides conventional cardiac preservation techniques, preoperative ANH further attenuates myocardial injuries. Optimization of preischemic myocardial oxygen delivery and/or consumption and the postconditioning effects of endogenous EPO are potential mechanisms for ANH-induced cardioprotection.