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Alkalash SH, Alturki OA, Alzubaidi WS, Sabi NM, Almarhabi NA, Alnashri MH, Alsharidi BM, Alothman AO, Alzubaidi FM. Knowledge, Attitude, Motivators, and Barriers to Blood Donation Among Adults in Al-Qunfudah Governorate, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e58732. [PMID: 38779238 PMCID: PMC11110699 DOI: 10.7759/cureus.58732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Blood transfusion is one of the most important aspects of managing patients with a variety of medical disorders like thalassemia and sickle cell anemia. Despite this fact, many Saudis hesitate to donate blood and do not know whether blood banks need blood. OBJECTIVES To evaluate the knowledge, attitude, motivators, and barriers to blood donation among adults in Al-Qunfudah governorate, Saudi Arabia. METHODS A descriptive cross-sectional study was performed on a convenience sample of 416 adults living in Al-Qunfudah governorate and its dependence, using an online self-administered questionnaire. The obtained data were analyzed statistically using SPSS version 21 (IBM Corp., Armonk, New York, USA). RESULTS Among 416 respondents, exactly 232 (55.8%) had overall good knowledge regarding blood donation, and 334 (80.3%) positively perceived it. The best knowledge about blood donation was detected among those aged 21-24 years (p = 0.012), males (p = 0.008), university-educated (p = 0.048), having a government job (p = 0.001), and having a history of donating blood (p = 0.001). The motivators included religious motives (88.2%, n = 367), feelings of self-satisfaction (63.2%, n = 263), and restoring blood circulation (56.7%, n = 236). Barriers to blood donation were fear of being infected (27.6%, n = 115), needle phobia (23.6%, n = 98), fear of general weakness (22.8%, n = 95), didn't know how to donate (16.8%, n = 70), and fear of seeing blood (13.2%, n = 55). CONCLUSION Although adults in the Al-Qunfudah governorate of Saudi Arabia had positive attitudes toward blood donation, they possessed inadequate knowledge about it. Being younger, male, university-educated, having government jobs, and having a past history of donating blood were factors associated with good knowledge of blood donation. The most common motivators were religious, financial, and maintaining health. However, fear of infection, needle sticks, fear of pain, and hemophobia were the recorded barriers. Public health education is recommended to tackle public concerns regarding blood donation and present its benefits.
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Affiliation(s)
- Safa H Alkalash
- Family Medicine, Menoufia University, Shibin El Kom, EGY
- Community Medicine and Health Care, Umm Al-Qura University, Al-Qunfudah, SAU
| | - Omar A Alturki
- Medicine and Surgery, Umm Al-Qura University, Al-Qunfudah, SAU
| | | | - Noor M Sabi
- Medicine and Surgery, Umm Al-Qura University, Al-Qunfudah, SAU
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Buseman M, Blong AE, Yuan L, Mochel JP, Walton RAL. Retrospective evaluation of admission total plasma protein as a predictor of red blood cell transfusion requirement in dogs diagnosed with traumatic and nontraumatic hemoabdomen: 90 dogs (2009-2019). J Vet Emerg Crit Care (San Antonio) 2024; 34:76-80. [PMID: 37961036 DOI: 10.1111/vec.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/06/2022] [Accepted: 08/22/2022] [Indexed: 11/15/2023]
Abstract
OBJECTIVE To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point-of-care parameters associated with red blood cell transfusion administration. DESIGN Retrospective study between 2009 and 2019. SETTING University veterinary teaching hospital. ANIMALS Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH). MEASUREMENTS AND MAIN RESULTS Medical records were retrospectively reviewed; signalment, point-of-care diagnostics, and transfusion administration information was recorded. A total of 47 dogs (traumatic hemoabdomen 11/26; NTH 36/64) received packed red blood cell transfusions. For each 1 g/dL unit decrease in TPP, dogs had an increased odds ratio (OR) of 2.14 (95% confidence interval [CI]: 1.44-3.40, P < 0.001) of receiving a red blood cell transfusion. Dogs diagnosed with NTH were more likely to receive a red blood cell transfusion than dogs with a traumatic hemoabdomen (OR: 2.78, 95% CI: 1.11-7.141, P = 0.03). Lower PCV values (OR: 1.08, 95% CI: 1.04-1.12, P < 0.001), bicarbonate values (OR: 1.3, 95% CI: 1.09-1.56, P = 0.003), and base excess (OR: 1.27, 95% CI: 1.1-1.49, P = 0.003) were associated with a higher likelihood of red blood cell transfusion. Additionally, higher lactate (OR: 1.35, 95% CI: 1.16-1.63, P < 0.001) and Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast scores (OR: 1.10, 95% CI: 1.04-1.17, P < 0.001) were associated with increased red blood cell transfusion administration. CONCLUSIONS Low admission TPP, independent of low PCV, was associated with red blood cell transfusions regardless of underlying cause. For each 1 g/dL unit decrease in TPP on presentation, dogs were approximately 2 times more likely to receive a red blood cell transfusion during hospitalization. Other factors that were associated with increased transfusion administration included presenting PCV, PCV/TPP ratio, bicarbonate, base excess, lactate, and APPLEfast scores.
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Affiliation(s)
- Miranda Buseman
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - April E Blong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Lingnan Yuan
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Jonathan P Mochel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Rebecca A L Walton
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
- VCA West Los Angeles, VCA West Los Angeles Animal Hospital, CA, USA
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Xu XP, Que WJ, Yu ZB, Shen JL, Hu ZM, Yang XL, Hao J. Clinical application of a modified predeposit autologous red blood cell apheresis in multistage spinal fusion: a single-center retrospective study. Front Med (Lausanne) 2023; 10:1149093. [PMID: 37256088 PMCID: PMC10225601 DOI: 10.3389/fmed.2023.1149093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/12/2023] [Indexed: 06/01/2023] Open
Abstract
Purpose This study aimed to evaluate the efficacy and safety of predeposit autologous RBC apheresis (PARA) in patients undergoing multilevel spinal fusion surgery. Methods A total of 112 patients from January 2020 to June 2022 were divided into two groups according to PARA: the PARA group (n = 51) and the control group (n = 61). The baseline characteristics of the patients, outcomes, transfusion cost, hospitalization cost, length of stay, complications, and changes in hemoglobin and hematocrit levels between the two groups were compared. Results The baseline characteristics were similar in both groups. No significant differences were found in functional outcomes, including VAS score (p = 0.159), ODI score (p = 0.214), JOA score (p = 0.752), and SF-36 score (p = 0.188) between the PARA and control groups. The amount and rate of intraoperative and perioperative allogeneic RBC transfusion were significantly higher in the control group than in the PARA group (p < 0.001). The postoperative (9.04 ± 3.21 vs. 11.05 ± 3.84, p = 0.004) and total length of stay (15.78 ± 3.79 vs. 17.36 ± 4.08, p = 0.038) in the PARA group were significantly lower than those in the control group, respectively. Despite no difference in hospitalization cost (p = 0.737), the total blood transfusion cost in the PARA group was significantly lower, compared with the control group (p < 0.001). For safety evaluation, there were no significant differences in Hb and Hct levels between the two groups at admission, on postoperative day 1, and postoperative day 3, respectively (p > 0.05). Moreover, the number of postoperative infections in the PARA group was significantly lower than that in the control group (p = 0.038). Conclusion PARA was a novel, safe, and highly efficient technique for mass autologous blood preparation in a quite short preparation time. This method could significantly reduce the amount of allogeneic blood transfusion and length of stay, which could provide a theoretical basis for following clinical practice about the technique.
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Affiliation(s)
- Xiao-Ping Xu
- The Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wen-Jun Que
- The Department of Blood Transfusion, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ze-Bo Yu
- The Department of Blood Transfusion, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie-Liang Shen
- The Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhen-Ming Hu
- The Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Liang Yang
- The Department of Blood Transfusion, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Hao
- The Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Reece J, Pavlick M, Penninck DG, Webster CRL. Hemorrhage and complications associated with percutaneous ultrasound guided liver biopsy in dogs. J Vet Intern Med 2020; 34:2398-2404. [PMID: 33125175 PMCID: PMC7694835 DOI: 10.1111/jvim.15942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 10/02/2020] [Accepted: 10/09/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Liver biopsy is often necessary to obtain a diagnosis in dogs with hepatobiliary disease. Hemorrhage after biopsy is a concern. OBJECTIVE To describe the extent of hemorrhage and incidence of complications after percutaneous ultrasound guided liver biopsy (PUGLB) in dogs and to examine risk factors for hemorrhage or complications. ANIMALS One hundred two client owned dogs with suspected hepatobiliary disease that underwent PUGLB. METHODS Medical records were retrospectively reviewed. Using human guidelines, major hemorrhage was defined as an absolute decrease in the PCV (ΔPCV) ≥ 6%. Complications were defined separately as clinically relevant physiologic compromise that necessitated intervention or death. The relationship between ΔPCV and the occurrence of complications and the initial PCV, coagulation variables, serum activity of liver-derived enzymes, serum bilirubin concentration, number of biopsies, biopsy needle gauge, radiologist experience, histological diagnosis, and ultrasound variables were compared. RESULTS Before PUGLB, most aberrations in coagulation variables were mild. After biopsy a decrease in PCV occurred in 87/102 (85.3%) dogs. The mean ΔPCV was -7.2% ± 4.5%. Major hemorrhage occurred in 43/102 (42.2%) dogs and complications in 2/102 (1.9%). ΔPCV was significantly positively correlated with PCV before biopsy (r = .47, P = .004). There was no correlation between ΔPCV or complications with any of the variables examined. CONCLUSION AND CLINICAL IMPORTANCE Percutaneous ultrasound guided liver biopsy in the population of dogs in the current study, with normal or mild abnormalities in coagulation, results in a high incidence of clinically silent, major hemorrhage (42.5%), but few complications (1.9%).
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Affiliation(s)
- Jonjo Reece
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Michelle Pavlick
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Dominique G Penninck
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Cynthia R L Webster
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
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Zhu Z, Li L, Xu J, Ye W, Zeng J, Chen B, Huang Z. Laparoscopic versus open approach in gastrectomy for advanced gastric cancer: a systematic review. World J Surg Oncol 2020; 18:126. [PMID: 32534587 PMCID: PMC7293787 DOI: 10.1186/s12957-020-01888-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Additional studies comparing laparoscopic gastrectomy (LG) versus open gastrectomy (OG) for advanced gastric cancer (AGC) have been published, and it is necessary to update the systematic review of this subject. OBJECTIVE We conducted the meta-analysis to find some proof for the use of LG in AGC and evaluate whether LG is an alternative treatment for AGC. METHOD Randomized controlled trials (RCT) and high-quality retrospective studies (NRCT) compared LG and OG for AGC, which were published in English between January 2010 and May 2019, were search in PubMed, Embase, and Web of Knowledge by three authors independently and thoroughly. Some primary endpoints were compared between the two groups, including intraoperative time, intraoperative blood loss, harvested lymph nodes, first flatus, first oral intake, first out of bed, post-operative hospital stay, postoperative morbidity and mortality, rate of disease recurrence, and 5-year over survival (5-y OS). Besides, considering for this 10-year dramatical surgical material development between 2010 and 2019, we furtherly make the same analysis based on recent studies published between 2016 and 2019. RESULT Thirty-six studies were enrolled in this systematic review and meta-analysis, including 5714 cases in LAG and 6094 cases in OG. LG showed longer intraoperative time, less intraoperative blood loss, and quicker recovery after operations. The number of harvested lymph nodes, hospital mortality, and tumor recurrence were similar. Postoperative morbidity and 5-y OS favored LG. Furthermore, the systemic analysis of recent studies published between 2016 and 2019 revealed similar result. CONCLUSION A positive trend was indicated towards LG. LG can be performed as an alternative to OG for AGC.
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Affiliation(s)
- Zhipeng Zhu
- Department of Gastrointestinal Surgery, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, 55 Zhen Hai Road, Si Ming District, Xiamen, 361003, Fujian, People's Republic of China
| | - Lulu Li
- Department of Gastrointestinal Surgery, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, 55 Zhen Hai Road, Si Ming District, Xiamen, 361003, Fujian, People's Republic of China
| | - Jiuhua Xu
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, 350004, Fujian, People's Republic of China
| | - Weipeng Ye
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, 350004, Fujian, People's Republic of China
| | - Junjie Zeng
- Department of Gastrointestinal Surgery, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, 55 Zhen Hai Road, Si Ming District, Xiamen, 361003, Fujian, People's Republic of China
| | - Borong Chen
- Department of Gastrointestinal Surgery, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, 55 Zhen Hai Road, Si Ming District, Xiamen, 361003, Fujian, People's Republic of China
| | - Zhengjie Huang
- Department of Gastrointestinal Surgery, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, 55 Zhen Hai Road, Si Ming District, Xiamen, 361003, Fujian, People's Republic of China. .,Department of Clinical Medicine, Fujian Medical University, Fuzhou, 350004, Fujian, People's Republic of China.
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Zeiler GE, Fuller A, Rioja E, Kamerman P, Buck RK, Pohlin F, Dzikiti BT. Development of a severity scoring system for acute haemorrhage in anaesthetized domestic cats: the CABSS score. Vet Anaesth Analg 2020; 47:499-508. [PMID: 32507719 DOI: 10.1016/j.vaa.2019.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 11/02/2019] [Accepted: 11/07/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine whether physiological, haematological, biochemical or electrolyte variables can predict severe haemorrhage in cats. STUDY DESIGN Randomized crossover study whereby each cat underwent mild and severe haemorrhage, with a 2 month period between events. ANIMALS A group of six domestic cats aged 21 ± 1 months and weighing 4.9 ± 1.2 kg, mean ± standard deviation. METHODS Cats were anaesthetized (buprenorphine, alfaxalone, isoflurane in oxygen at a fixed end-tidal concentration of 1.7%) before the haemorrhage event. In total, 34 variables were measured twice (prehaemorrhage and posthaemorrhage). The difference and percent change for each variable were compared between haemorrhage events (paired t test). Significant variables were placed into 13 different ratios (posthaemorrhage value of one variable divided by a posthaemorrhage value of a second variable) and compared (paired t test), and Cohen's d (d) was calculated. Receiver operating characteristic curves were plotted and cut-off values for weak, moderate and strong indicators of severe haemorrhage were obtained. RESULTS The blood loss was 4.5 ± 1.1 mL kg-1 and 26.8 ± 5.5 mL kg-1 for mild and severe haemorrhage events, respectively. The most significant variables with large effect sizes were heart rate (HR), systolic arterial blood pressure (SAP), end-tidal carbon dioxide (Pe'CO2), serum albumin, haematocrit and actual bicarbonate ion concentration [HCO3-(act)]. The most robust ratios were: 1) shock index (d = -2.8; HR:SAP); 2) HR:Pe'CO2 (d = -2.9); 3) serum albumin: haematocrit (d = 1.5); and 4) HR:HCO3-(act) (d = -1.6). These ratios were included in the final proposed Cat Acute Bleeding Scoring System (CABSS). CONCLUSIONS and clinical relevance Cats subjected to mild and severe haemorrhage demonstrated statistically and clinically relevant changes whereby four ratios could be created to make up the CABSS. The ratios detected and quantified the presence of severe haemorrhage in anaesthetized cats.
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Affiliation(s)
- Gareth E Zeiler
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa; Anaesthesia and Critical Care Services, Valley Farm Animal Hospital, Pretoria, South Africa; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
| | - Andrea Fuller
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Eva Rioja
- Optivet Referrals, Havant, Hampshire, United Kingdom
| | - Peter Kamerman
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Roxanne K Buck
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Friederike Pohlin
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Brighton T Dzikiti
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa; Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
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Ghosal RDK, Bos A. Successful management of catastrophic peripheral vascular hemorrhage using massive autotransfusion and damage control surgery in a dog. J Vet Emerg Crit Care (San Antonio) 2019; 29:439-443. [PMID: 31228336 DOI: 10.1111/vec.12861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe a case of massive transfusion using unwashed, non-anticoagulated, nonsterile autologous blood in a dog with catastrophic hemorrhage from a peripheral vessel during orthopedic surgery. A damage control surgical strategy was also employed. CASE SUMMARY A 6-year-old, 48 kg neutered male Labrador Retriever experienced massive hemorrhage after transection of a large blood vessel while undergoing femoral head and neck osteotomy. Blood was collected from clean, but not sterile, suction canisters and clots were skimmed off. The blood was then transfused back to the dog using a standard in-line blood filter. Approximately 58% of the dog's blood volume was autotransfused in less than 2 hours, thereby meeting the criteria for massive transfusion. Surgery was aborted after hemostasis was achieved by ligation of the vessel and packing of the surgical site. Two units of fresh frozen plasma were administered postoperatively due to the development of a coagulopathy. Hemoglobinuria developed but resolved within 18 hours. Three days later, completion of the surgical procedure was performed without incident. The dog was discharged 4 days after the initial surgery. Marked swelling of the affected limb developed, but resolved after the sixth day. No other significant complications developed. NEW OR UNIQUE INFORMATION PROVIDED In this case report, the authors describe the successful management of catastrophic hemorrhage with autotransfusion performed in the absence of sterile collection, cell washing, or anticoagulation. Although not ideal, autotransfusion under these conditions can be lifesaving in situations of massive hemorrhage. This case also highlighted the employment of a damage control surgical strategy.
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Affiliation(s)
- Rita D K Ghosal
- Department of Critical Care, Mississauga-Oakville Veterinary Emergency Hospital, Oakville, Ontario, Canada
| | - Alexandra Bos
- Department of Critical Care, Mississauga-Oakville Veterinary Emergency Hospital, Oakville, Ontario, Canada
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Abstract
OBJECTIVES The objectives of this study were to describe the clinical use and outcome of autologous transfusions in cats with intracavitary haemorrhage. METHODS A retrospective descriptive study was performed. Computerised medical records of a single referral centre were searched for cats receiving an autotransfusion. Medical records were evaluated for underlying disease process, autotransfusion technique, autotransfusion volume, time period over which the autotransfusion was given, packed cell volume (PCV) pre- and post-autotransfusion, percentage rise in PCV, use of other blood products and any complications of the procedure. Survival to discharge and survival at 2 months was documented. RESULTS Between July 2012 and March 2018 a total of 12 autotransfusions were performed in eight cats. All patients were diagnosed with haemoperitoneum. Four of the eight cats were diagnosed with abdominal neoplasia, three had postoperative haemorrhage and one had a traumatic haemoperitoneum. Three cats received more than one autotransfusion. Blood was collected using a 23 G butterfly catheter and 20 ml syringe in 7/12 collections, a 23 G needle and 20 ml syringe in 2/12 collections and directly into syringes from the open abdomen at the time of surgery in 3/12 collections. A median volume of 50 ml (range 25-80 ml) was collected and administered, meaning a median volume of 16.5 ml/kg (range 9-26 ml/kg) was administered. The autologous transfusions were given over a median of 3 h (0.25-6 h). Five cats were given another blood product alongside the autotransfusion. Median percentage PCV increase was 5% (range 1-7%). Anticoagulant was used in 5/12 autotransfusions. No clinically relevant adverse effects were reported. Six of the eight cats survived to discharge. Two month survival was 60% (3/5). CONCLUSIONS AND RELEVANCE Autologous transfusion appears to be a safe and effective technique for stabilising cats with haemoperitoneum. This technique allows rapid and cheap provision of blood and avoids the need for an allogenic blood donor.
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Affiliation(s)
- Laura P Cole
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
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Laparoscopic versus open gastrectomy for advanced gastric cancer: A meta-analysis based on high-quality retrospective studies and clinical randomized trials. Clin Res Hepatol Gastroenterol 2018; 42:577-590. [PMID: 30146236 DOI: 10.1016/j.clinre.2018.04.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/28/2018] [Accepted: 04/12/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Additional studies comparing laparoscopic gastrectomy (LG) with open gastrectomy (OG) have been published, and the meta-analysis of this subject should be improved. METHODS Randomized controlled trials and high-quality retrospective studies, which compared LG and OG for advanced gastric cancer (AGC) treatment and were published in English and Chinese between January 2000 and February 2017, were selected through PubMed, EMBASE, and the Cochrane Library database by two reviewers independently. The Jadad Composite Scale and the Newcastle-Ottawa scale were used to evaluate the quality and risk of bias for all included studies. Operative outcomes, postoperative outcomes, postoperative morbidity, harvested lymph nodes and 5-year overall survival (OS) were considered as primary endpoints and were compared. RESULTS Fifteen studies including a total of 9337 cases (5000 in LG and 4337 in OG) were enrolled. LG showed longer operative time, less intraoperative blood loss, and quicker recovery after operations. Based on the subgroup analysis of the sample size, however, there was no difference in operative time between LG and OG. The number of harvested lymph nodes, 5-year OS, and postoperative morbidity were similar. CONCLUSION LG can be performed as an alternative to OG for AGC, with quicker postoperative recovery and comparable safety and efficacy.
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Rosenstein PG, Tennent-Brown BS, Hughes D. Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement. J Vet Emerg Crit Care (San Antonio) 2018. [PMID: 29533512 DOI: 10.1111/vec.12708] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review the current literature with respect to the physiology, pathophysiology, and measurement of lactate. DATA SOURCES Data were sourced from veterinary and human clinical trials, retrospective studies, experimental studies, and review articles. Articles were retrieved without date restrictions and were sourced primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS Lactate is an important energy storage molecule, the production of which preserves cellular energy production and mitigates the acidosis from ATP hydrolysis. Although the most common cause of hyperlactatemia is inadequate tissue oxygen delivery, hyperlactatemia can, and does occur in the face of apparently adequate oxygen supply. At a cellular level, the pathogenesis of hyperlactatemia varies widely depending on the underlying cause. Microcirculatory dysfunction, mitochondrial dysfunction, and epinephrine-mediated stimulation of Na+ -K+ -ATPase pumps are likely important contributors to hyperlactatemia in critically ill patients. Ultimately, hyperlactatemia is a marker of altered cellular bioenergetics. CONCLUSION The etiology of hyperlactatemia is complex and multifactorial. Understanding the relevant pathophysiology is helpful when characterizing hyperlactatemia in clinical patients.
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Affiliation(s)
- Patricia G Rosenstein
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Brett S Tennent-Brown
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Dez Hughes
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
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Higgs VA, Rudloff E, Kirby R, Linklater AKJ. Autologous blood transfusion in dogs with thoracic or abdominal hemorrhage: 25 cases (2007-2012). J Vet Emerg Crit Care (San Antonio) 2015; 25:731-8. [PMID: 26193912 DOI: 10.1111/vec.12338] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 05/12/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the use and outcome following autologous blood transfusion (ABT) in dogs. DESIGN Retrospective study (January 2007-July 2012). SETTING Private veterinary referral center. ANIMALS Twenty-five dogs that underwent ABT secondary to thoracic or abdominal hemorrhage. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The hospital transaction database was searched using the keyword "autotransfusion" from January 2007 to July 2012. Data collected included signalment, body weight, etiology of hemorrhage, source and method of collection, volumes and method of ABT administration, use of anticoagulant, reported complications, and outcome. Twenty-five dogs were included for a total of 27 ABTs. Causes of hemorrhage included vascular trauma (14/25 dogs, 56%), ruptured tumor (8/25, 32%), and coagulopathy attributed to brodifacoum toxicosis (3/25, 12%). Autologous blood was collected from the abdominal (19/25, 76%), thoracic (5/25, 20%), or abdominal and thoracic cavities (1/25, 4%). Anticoagulant was added to the ABT blood in 13 of 25 (52%) cases. A median ABT volume of 29.3 mL/kg (range 2.9-406.9 mL/kg) was infused through either a 210 μm blood administration filter (21/27, 78%) or an 18 μm hemonate filter (6/27, 22%). Reported complications that may have been associated with ABT included hypocalcemia (4/17, 24%), hemolyzed serum (5/19, 26%), and prolonged coagulation times (4/5, 80%). These complications were considered of minimal clinical significance. Additional blood products were administered in 17 of 25 (68%) dogs. Seventeen (68%) dogs survived to discharge. Cause of death in the remaining cases was euthanasia or cardiac arrest secondary to uncontrollable hemorrhage. CONCLUSIONS ABT is an adjunct to volume replacement in dogs with thoracic or abdominal hemorrhage secondary to vascular trauma, ruptured tumor, or anticoagulant rodenticide toxicosis. ABT may be used as bridge to definitive hemorrhage control, particularly when other blood products are not available or affordable. Complications may include hypocalcemia, prolonged coagulation times, and hemolysis.
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Haley AL, Mann FA, Middleton J, Nelson CA. Perioperative red blood cell transfusion requirement for various surgical procedures in dogs: 207 cases (2004-2013). J Am Vet Med Assoc 2015; 247:85-91. [PMID: 26086233 DOI: 10.2460/javma.247.1.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare perioperative RBC transfusion among dogs undergoing liver lobectomy, splenectomy, partial gastrectomy, rhinotomy, thyroidectomy, perineal herniorrhaphy, and intrathoracic surgery. DESIGN Retrospective case series. ANIMALS 207 client-owned dogs that underwent various surgeries. PROCEDURES Medical records were reviewed for dogs that had undergone liver lobectomy, splenectomy, partial gastrectomy, rhinotomy, neoplastic thyroidectomy, perineal herniorrhaphy, or intrathoracic surgery. Transfusion requirement (packed RBC, whole blood, and bovine hemoglobin-based oxygen carrier) and survival rate at 2 weeks after surgery were compared among dogs undergoing the various surgeries. RESULTS Patients undergoing splenectomy and liver lobectomy were significantly more likely to receive RBC transfusion when each was compared with patients undergoing all other procedures. A significant association was found between body weight and perioperative RBC transfusion, with greater odds of transfusion as body weight increased. Dogs receiving perioperative RBC transfusions were significantly less likely to survive to 2 weeks after surgery. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs undergoing splenectomy and liver lobectomy may require RBC transfusion perioperatively. Veterinarians who perform these procedures should plan accordingly and have packed RBCs or whole blood donors readily available.
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Herold LV, Devey JJ, Kirby R, Rudloff E. Clinical evaluation and management of hemoperitoneum in dogs. J Vet Emerg Crit Care (San Antonio) 2008. [DOI: 10.1111/j.1476-4431.2007.00265.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pang DS, Boysen S. Lactate in veterinary critical care: pathophysiology and management. J Am Anim Hosp Assoc 2007; 43:270-9. [PMID: 17823476 DOI: 10.5326/0430270] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The measurement of blood lactate in people has proven to be a useful tool in the diagnosis, monitoring, and prognosis of a wide range of clinical syndromes. Its use in small animals is increasing, and several studies have been completed that demonstrate its potential role in critical care. This article summarizes the current state of knowledge regarding the physiology and pathophysiology of lactate production and lactic acidosis; current indications and the utility of measurement in a critical care setting are described; novel applications in the evaluation of cavitary effusions are highlighted; and a guide to the therapy of lactic acidosis is presented.
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Affiliation(s)
- Daniel S Pang
- Department of Anaesthesia, Faculty of Veterinary Medicine, Companion Animal Clinic, University of Montreal, Saint-Hyacinthe, Quebec, Canada
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Cruz JR, Pérez-Rosales MD, Zicker F, Schmunis GA. Safety of blood supply in the Caribbean countries: Role of screening blood donors for markers of hepatitis B and C viruses. J Clin Virol 2005; 34 Suppl 2:S75-80. [PMID: 16461244 DOI: 10.1016/s1386-6532(05)80038-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Blood transfusions carry risks of untoward reactions, including the transmission of infections, such as hepatitis B and C. Proper blood donor recruitment and selection, and adequate laboratory screening for infectious markers diminish the risk of transfusion-transmitted infections. OBJECTIVES To estimate the potential risk of acquiring transfusion-transmitted infections by hepatitis B or hepatitis C in 24 Caribbean countries during the period of 1996 to 2003. STUDY DESIGN Official national reports for 1996, 2000-2003 of the yearly number of blood donors, screening coverage, and prevalence of serological markers for infectious diseases were used to estimate the risk of patients receiving an HBV- or HCV-positive unit of blood, and of developing an infection after receiving a positive unit. Estimates of number of infections transmitted through transfusion and number of infections prevented by screening of blood were also obtained. RESULTS During the period analyzed, HBV screening coverage among blood donors was 100% in all countries with the exception of Grenada (0% in 1996) and Saint Lucia (99.5% in 2002). For HCV, only 10 countries reported universal screening in 1996, while 15 did in 2003. The number of countries that did not screen any units for HCV decreased from 11 in 1996 to five in 2003. In general, high prevalence rates of HBV (10-75 per 1000 donors) and HCV (7-19.3 per 1000 donors) markers were found in the majority of countries. We estimated that 235 infections by HCV (1:12471 donations) and two infections by HBV (1:1465373) were transmitted through transfusion because of lack of screening. On the other hand, screening of blood for transfusion prevented 21 005 HCV and 22 100 HBV infections. CONCLUSIONS Blood donor recruitment and coverage of screening for transfusion-transmitted infections, especially HCV, must be improved in the Caribbean countries.
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Affiliation(s)
- Jose R Cruz
- Pan American Health Organization, Regional Office of the World Health Organization for the Americas. 525 23rd. St, NW, Washington, DC 20037, USA.
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