BLOOD CARE AT ELECTIVE UROLOGICAL OPERATIONS
Authors:
MUDr. Bronislav Stibor; MUDr. Roman Gál, Ph.D.; doc. MUDr. Ivan Čundrle, CSc.
Authors place of work:
1. anesteziologicko-resuscitační oddělení FN Brno
Published in the journal:
Urol List 2005; 3(1): 47-52
Summary
In case of extensive or complicated urologic operation there may arise a need of blood tranfusion aplication. The new knowledge in physiology and pathophysiology found that even strong anaemia is quite well tolerated by human organism. Former dogma to apply blood when haemoglobin is lower than 100g/l does not govern anymore. In spite of all the progress in testing donors and blood conserves, the transfusion is relatively risk operation. Nowadays, it is especially the transfer of infectuous diseases which is threatening. After AIDS pandemy there are still new pathogenes occuring. They are transferred by blood and no routine and effective tests on them do not exist. Therefore there is a maximal effort to avoid the application of foreign blood.
In urology, the standard method of blood care has been preoperational autologous blood donorship or autotransfusion. However, nowadays it is often being replaced or complemented by acute normovolaemic haemodilution, since this method is very effective and at the same time safe and cheap.
An effective news are also the pharmacologic remedies, especially human recombinant erythropoetin or activated factor VII. Their disadvantage is that their price is still high. Suitable combination of various methods of blood care enables us to make the prevalent majority of mostly urologic operations as a part of bloodless medicine.
KEY WORDS:
blood care, anaemia, blood tranfusion, preoperational autologous blood donorship, acute normovolaemic haemodilutio, erythropoetin
Zdroje
1. Čundrle I. Peroperační autotransfuze ve spondylochirurgii. Habilitační spis 1994: 5.
2. Hébert PC, Wells G, Blajchman MA et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999; 340(6): 409-17.
3. Sandler SG. Risks of blood transfusion - 2002. Curr Opin Hematol 2002; 9(6): 509-10.
4. Hunter N, foster J, Chong A et al. Transmission of prion diseases by blood transfusion. J Gen Virol 2002; 83(11): 2897-905.
5. Chemeler SB, Prato BS, Cox PM jr et al. Association of bacterial infection and red blood cell transfusion after coronary artery bypass surgery. Ann Thorac Surg 2002; 73(1): 138-42.
6. Carson JL, Altman DG, Duff A et al. Risk of bacterial infection associated with allogeneic blood transfusion among patients undergoing hip fracture repair. Transfusion 1999; 39(7): 694-700.
7. Vamvakas EC, Blajchman MA. Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction? Blood 2001; 97(5): 1180-95.
8. Klein HG. Immunomodulatory aspects of transfusion: a once and future risk? Anesthesiology 1999; 91(3): 861-5.
9. Blumberg N, Heal JM. Transfusion immunomodulation. In: Anderson KC, Ness PM (eds). Scientific basis of transfusion medicine. 2. ed. Philadelphia: WB Saunders 2000: 427-43.
10. Van Aken H, Miller ED jr. Deliberate hypotension. In: Miller RD (ed). Anesthesia. 5. ed New York: Churchill Livingstone 2000: 1470-1486.
11. Goodnough LT, Grishaber JE, Birkmeyer JD, Monk TG, Catalona WJ. Efficacy and cost- effectiveness of autologous blood predeposit in patients undergoing radical prostatectomy procedures.Urology 1994; 44: 226-231.
12. Toy PTCY, Menozzi D, Strauss RG, Stehling LC, Kruskull M, Ahn DK. Efficacy of preoperative donation of blood for autologous use in radical prostatectomy. Transfusion 1993; 33: 721-724.
13. Monk TG, Goodnough LT, Brecher ME et al. Acute normovolemic hemodilution can replace preoperative autologous blood donation as a standard of care for autologous blood procurement in radical prostatectomy. Anesth Analg 1997; 85(5): 953-8.
14. Goodnough LT, Monk TG Brecher ME. Acute normovolemic hemodilution should replace the preoperative donation of autologous blood as a method of autologous-blood procurement. Transfusion 1998; 38(5): 473-6.
15. Avall A, Hyllner M, Bengtson JP, Carlsson L, Bengtson A. Postoperative inflammatory response after autologous and allogeneic blood transfusion. Anesthesiology 1997; 87: 511-6.
16. Monk TG, Goodnough LT. Acute normovolemic hemodilution. Clin Orthop 1998; 357: 74-81.
17. Lindahl S. Acute normovolemic haemodilution. Bailliere´s Clinical Anaesthesiology. 1996; 10: 717-723.
18. Monk TG, Goodnough LT, Birkmeyer JD, Brecher ME, Catalona JW. Acute normovolemic hemodilution is a cost - effective alternative to preoperative autologous donation in patients undergoing radical retropubic prostatectomy. Transfusion 1995; 35: 559-565.
19. Andrews CM, Lane DW, Bradley JG. Iron pre-load for major joint replacement. Transfus Med 1997; 7(4): 281-286.
20. Adamson JW, Spivak JL. Physiologic basis for the pharmacologic use of recombinant human erythropoietin in surgery and cancer treatment. Surgery 1994; 115: 7-15.
21. Price TH, Goodnough LT, Vogler WR et al. The effect of recombinant human erythropoietin on the efficacy of autologous blood donation in patients with low hematocrits: a multicenter, randomized, double-blind, controlled trial. Transfusion 1996; 36: 29-36.
22. Goodnough LT, Monk TG, Andriole GL. Erythropoietin therapy. N Engl J Med 1997; 336(13): 933-938.
23. Sans T, Bofill C, Joven J et al. Effectiveness of very low doses of subcutaneous recombinant human erythropoietin in facilitating autologous blood donation before orthopedic surgery. Transfusion 1996; 36: 822-826.
24. Stibor B, Cundrle I, Gal R, Pacik D. The use of erythropoietin and red blood cell count optimalization in urological surgery. Br J Anaesth 1999; 82(Supp 1): 80.
25. Goodnough LT, Monk TG, Andriole GL. Current concepts: erythropoietin therapy. N Engl J Med 1997; 336: 933-938.
26. Smith R. Applications od darbepoietin-alfa, a novel erythropoiesis-stimulating protein, in oncology. Curr Opin Hematol 2002; 9(3): 228-233.
27. Martinowitz U, Kenet G, Segal E et al. Recombinant activated factor VII for adjunctive hemorrhage control in trauma. J Trauma 2001; 51(3): 431-439.
28. Aldouri M. The use of recombinant factor VIIa in controlling surgical bleeding in non.haemophiliac patients. Pathophysiol Haemost Thromg 2002; 32(Suppl 1): 41-46.
29. Moscardo F, Perez F, de La Rubia J et al. Succesful treatment of severe intra-abdominal bleeding associated with disseminated intravascular coagulation using recombinant activated factor VII. Br J Haematol 2001; 114(1): 174-176.
30. Booke M, Ahlke C, Hagemann O, Hinder F. Intraoperative autotransfusion - influence of technique, speed, and hematocrit on quality. Infus Ther Transfus Med 2000; 27(6): 307-310.
Štítky
Paediatric urologist UrologyČlánok vyšiel v časopise
Urological Journal
2005 Číslo 1
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