Blood Transfusion, Autologous

输血,自体
  • 文章类型: Case Reports
    背景技术血细胞保护者,或者自体输血系统,用于收集,wash,并返回从手术患者收集的自体血液。该报告描述了一名55岁的男子,他在体外循环下接受了二尖瓣和主动脉瓣联合置换手术,并在术中和术后使用血细胞保护者进行自体输血后获得了成功的结果。个案报告病人因宗教良心原因不接受输血,病情危重,接受姑息治疗。他需要二尖瓣和主动脉瓣联合置换手术。手术在术中和术后使用细胞保存器(SorinXtra自体输血系统)进行24小时,为了解决这个具有挑战性的案件,从技术和伦理的角度来看。术中回收的红细胞体积为1430mL,血细胞比容水平为40%,和690毫升,血细胞比容为35%,在术后期间。因此,回收了大量的自体血液。自体输血为患者带来了极好的临床结果,他在术后第九天出院。结论我们可以得出结论,在心脏手术中使用血细胞保护者,在术中和术后期间,导致维持足够的血红蛋白和血细胞比容水平,术后无感染,患者迅速完全恢复。因此,血细胞保护者的使用保证了个人安全拒绝血液制品的自主权,具有良好的临床效果,并且不依赖同种异体输血。
    BACKGROUND A blood cell saver, or autotransfusion system, is used to collect, wash, and return autologous blood collected from the surgical patient. This report describes a 55-year-old man who underwent combined mitral and aortic valve replacement surgery with cardiopulmonary bypass and had a successful outcome following intraoperative and postoperative autologous blood transfusion using a blood cell saver. CASE REPORT The patient did not accept blood transfusion for reasons of religious conscience and was in a critical condition, receiving palliative care. He needed combined mitral and aortic valve replacement surgery. The surgery was conducted using a cell saver (Sorin Xtra Autotransfusion System) in the intraoperative and postoperative periods for 24 h, to resolve this challenging case, from a technical and ethical point of view. The volume of red blood cells recovered intraoperatively was 1430 mL, with a hematocrit level of 40%, and 690 mL, with a hematocrit of 35%, in the postoperative period. Therefore, a significant volume of autologous blood was recovered. The autologous blood transfusion resulted in an excellent clinical outcome for the patient, who was discharged on the ninth postoperative day. CONCLUSIONS We can conclude that the use of a blood cell saver in cardiac surgery, in both intra- and postoperative periods, resulted in the maintenance of adequate hemoglobin and hematocrit levels, no infection postoperatively, and rapid and complete recovery of the patient. Thus, the use of the blood cell saver guaranteed the individual\'s autonomy to refuse blood products safely, with good clinical results, and without dependence on allogeneic blood transfusions.
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  • 文章类型: Case Reports
    背景:输血是实体器官移植受者同种免疫和不良结局的危险因素。
    目的:我们建议在移植候选人和接受择期手术的患者中采用自体输血(ABT)。
    方法:我们介绍了一例45岁男性多囊肾慢性肾病5期,谁在肾移植前有资格进行天然肾肾切除术(NKN)。在预定的手术之前,病人被转介到献血中心采血。
    结果:连续两次访视,自体血液收集顺利,这允许制备2个单位的红细胞浓缩物和一个单位的血浆。捐献前和捐献后的血红蛋白值分别为11.9和10.4g/dL,分别。NKN手术因肾脏副异常动脉的腹腔内出血而复杂化。血红蛋白降至6.8g/dL,用ABT治疗,其次是动脉栓塞。这允许血红蛋白增加至8.3mg/dL并避免同种异体输血。NKN六周后,患者接受了来自活体供体的成功肾移植.移植前组反应性抗体为0%,在20个月的观察中,移植物功能良好。
    结论:对于慢性肾脏病患者,自体血液采集是一种可行的选择。在对潜在的候补候选人和实体器官接受者进行选择性手术时,应将ABT视为首选程序。
    BACKGROUND: Blood transfusions are risk factors for alloimmunization and unfavorable outcomes in solid organ transplant recipients.
    OBJECTIVE: We propose the adoption of autologous blood transfusion (ABT) in transplant candidates and recipients referred to elective surgery.
    METHODS: We present a case of a 45-year-old man with chronic kidney disease stage 5 due to polycystic kidney disease, who was qualified for a native kidney nephrectomy (NKN) before kidney transplantation. Before the scheduled surgery, the patient was referred to a blood donation center for blood collection.
    RESULTS: During 2 consecutive visits, autologous blood was collected uneventfully, and this allowed for the preparation of 2 units of red blood cell concentrates and a unit of plasma. Pre- and post-donation hemoglobin values were 11.9 and 10.4 g/dL, respectively. The NKN procedure was complicated by intra-abdominal bleeding from an accessory aberrant artery of the kidney. Hemoglobin dropped to 6.8 g/dL and was treated with ABT, followed by artery embolization. This allowed for an increase of hemoglobin to 8.3 mg/dL and avoidance of allotransfusion. Six weeks after NKN, the patient underwent successful kidney transplantation from a living donor. Panel reactive antibodies before transplantation were 0%, and graft function has been excellent during 20 months of observation.
    CONCLUSIONS: An autologous blood collection is a feasible option for patients with chronic kidney disease. ABT should be considered the procedure of choice when qualifying potential waiting list candidates and solid organ recipients for elective surgeries.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    To report maternal outcomes in a cohort of women who received autotransfusion of vaginally shed blood and to describe the feasibility of blood collection and cell salvage processing at the time of vaginal hemorrhage.
    We conducted a retrospective case series of patients who received autotransfusion of vaginally shed blood at the time of obstetric hemorrhage from January 2014 to August 2020. Maternal data and cell salvage utilization characteristics were abstracted from the electronic medical record.
    Sixty-four cases were identified in which autotransfusion of vaginally shed blood occurred during an obstetric hemorrhage. Median quantitative blood loss was 2175 ml (interquartile range 1500-2250 ml) with 89% of cases having a blood loss greater than 1000 ml. Patients on average received approximately 1.3 units of autologous blood product (384 ml, interquartile range 244-520 ml) and no direct adverse events were observed during transfusion. We observed heterogeneity in autologous blood volume across all values of quantitative blood loss. The need for allogenic blood transfusion was common and occurred in 72% of all cases (N = 46). There were no documented cases of maternal sepsis or severe infectious morbidity.
    In 64 cases where autotransfusion of vaginally shed blood occurred, autotransfusion was well tolerated. Heterogeneity in autologous blood volume collection likely represents the lack of standardized protocols for blood collection in the delivery room. Autotransfusion of vaginally shed blood is a feasible and reasonable technique to employ during severe obstetric hemorrhage.
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  • 文章类型: Journal Article
    BACKGROUND: There is increasing evidence regarding the wound healing potential of platelet-derived autologous by-products. We provide preliminary data regarding the use of a new plasma rich in growth factors-derived autologous topical ointment for the management of hard-to-heal wounds.
    METHODS: Four patients suffering from difficult-to-heal wounds were treated with the autologous ointment. Within 2 to 8 weeks, all wounds healed completely with no signs of infection or functional impairment of the affected limbs. No adverse events were reported.
    CONCLUSIONS: Randomized and controlled trials are needed to determine the clinical efficacy of the autologous ointment. Nevertheless, results from this multiple case series indicate that this approach may be useful for accelerating the re-epithelization of difficult-to-heal wounds.
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  • 文章类型: Journal Article
    报告一系列手术中血液挽救(IOS)在手术中用于治疗髋关节脱位的滑脱性股骨epi(SCFE)的病例。确定其功效,并发症,以及SCFE患者的概况。
    描述性研究报告病例系列,包括2016年1月至2018年3月期间确诊为SCFE的患者,并使用IOS进行控制的髋关节脱位手术治疗。
    样本由15名患者组成,平均年龄13.1岁.受累最重的一侧为左侧8例。在术后期间,没有患者需要同种异体血液。术前和术后平均血红蛋白分别为13.2和11.2g。分别为dL-1,平均血红蛋白差异为1.8g。dL-1.术前和术后平均血细胞比容分别为39.13%和33.20%,分别,平均血细胞比容差异为5.52%。术中无并发症发生。一名患者出现呕吐,另一名患者出现呕吐,术后伤口感染。
    IOS是一种替代的血液回收方法,可以防止同种异体输血,减少潜在的并发症。
    To report a case series of Intraoperative Blood Salvage (IOS) in surgeries during the treatment for Slipped Capital Femoral Epiphysis (SCFE) with controlled dislocation of the hip, identifying its efficacy, complications, and the profile of patients with SCFE.
    Descriptive study reporting a case series, comprising patients seen between January 2016 and March 2018, diagnosed with SCFE, and treated with controlled surgical dislocation of the hip using IOS.
    Sample comprised of 15 patients, with a mean age of 13.1 years. The most affected side was the left with 8 cases. None of the patients required allogeneic blood in the postoperative period. Mean pre- and postoperative hemoglobin were 13.2 and 11.2 g.dL-1, respectively, and mean hemoglobin difference was 1.8 g.dL-1. Mean pre- and postoperative hematocrit were 39.13% and 33.20%, respectively, and mean hematocrit difference was 5.52%. No intraoperative complications were observed. One patient presented vomiting and another one, wound infection in the postoperative period.
    IOS was an alternative blood salvage approach and prevented allogeneic blood transfusion, enabling reduction of potential complications.
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  • 文章类型: Controlled Clinical Trial
    背景:除支持性管理外,仍没有针对COVID-19的具体治疗策略。
    方法:一项前瞻性病例对照研究,根据床位的可用性通过入院确定。
    方法:2020年3月20日至4月19日,18例COVID-19感染(实验室确诊)重症肺炎患者入院。在研究期间入院的患者根据床的可用性被分配到不同的床。根据病人入院的情况,治疗为臭氧自血疗法或标准治疗.病例组的患者从入院当天开始每天两次接受臭氧血,中位数为四天。每种治疗包括给予富含200mL氧-臭氧混合物的200mL自体全血,其臭氧浓度为40μg/mL。
    结果:主要结局是从入院到临床改善的时间。
    结果:9例患者(50%)在入院当天开始接受臭氧化自血治疗。臭氧化自血疗法与临床改善时间较短相关(中位数[IQR]),7天[6-10]vs28天[8-31],p=0.04)和更好的结果在14天(88.8%vs33.3%,p=0.01)。在风险调整分析中,臭氧化自血疗法与临床改善的平均时间较短(-11.3天,p=0.04,95%CI-22.25至-0.42)。
    结论:在这项前瞻性病例对照研究中,臭氧自血疗法与临床改善时间显著缩短相关。鉴于样本量小和研究设计,这些结果需要在更大的随机对照试验中进行评估.
    背景:NCT04444531。
    BACKGROUND: There is still no specific treatment strategies for COVID-19 other than supportive management.
    METHODS: A prospective case-control study determined by admittance to the hospital based on bed availability.
    METHODS: Eighteen patients with COVID-19 infection (laboratory confirmed) severe pneumonia admitted to hospital between 20th March and 19th April 2020. Patients admitted to the hospital during the study period were assigned to different beds based on bed availability. Depending on the bed the patient was admitted, the treatment was ozone autohemotherapy or standard treatment. Patients in the case group received ozonated blood twice daily starting on the day of admission for a median of four days. Each treatment involved administration of 200 mL autologous whole blood enriched with 200 mL of oxygen-ozone mixture with a 40 μg/mL ozone concentration.
    RESULTS: The primary outcome was time from hospital admission to clinical improvement.
    RESULTS: Nine patients (50%) received ozonated autohemotherapy beginning on the day of admission. Ozonated autohemotherapy was associated with shorter time to clinical improvement (median [IQR]), 7 days [6-10] vs 28 days [8-31], p = 0.04) and better outcomes at 14-days (88.8% vs 33.3%, p = 0.01). In risk-adjusted analyses, ozonated autohemotherapy was associated with a shorter mean time to clinical improvement (-11.3 days, p = 0.04, 95% CI -22.25 to -0.42).
    CONCLUSIONS: Ozonated autohemotherapy was associated with a significantly shorter time to clinical improvement in this prospective case-control study. Given the small sample size and study design, these results require evaluation in larger randomized controlled trials.
    BACKGROUND: NCT04444531.
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  • DOI:
    文章类型: Case Reports
    In the past, many case series have reported the effectiveness of autologous blood patch pleurodesis (ABPP) in recurrent secondary spontaneous pneumothorax (SSP), particularly in those who were unfit for surgery. We describe two cases of persistent air leak in pneumoconiosis and pulmonary fibrosis with bronchiectasis, whereby the techniques employed had improved the success rate of ABPP. The determining factors that lead to the success of ABPP were determined by the volume of autologous blood instilled, Trendelenburg position post instillation, and early chest physiotherapy with mobilisation by application of pneumostat.
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  • 文章类型: Case Reports
    Partial priapism is a rare disorder in literature and generally described as a contusion or thrombosis of the cavernous body of the penis secondary to blunt trauma. Because of the rarity of disease, there is not much information about the treatment. Conservative management with nonsteroidal anti-inflammatory drug is often applied treatment. Here, we presented a proximal partial priapism treated successfully with autologous clot embolisation secondary to pelvic trauma.
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  • 文章类型: Case Reports
    BACKGROUND: Autologous platelet-rich plasma (PRP) separation technology has been widely used in various clinical therapies, and has achieved good results, especially in aortic surgeries.
    UNASSIGNED: A 50-year-old man who was diagnosed with aortic dissection (Stanford B type), a thoracoabdominal aortic aneurysm, and grade 2 hypertension underwent 2 complicated aortic surgeries within 4 months. DIAGNOSES:: aortic dissection (Stanford B type).
    METHODS: PRP separation used as a blood protection measure was employed in both 2 surgeries.
    RESULTS: The patient\'s coagulation function recovered well after the surgeries. The amount of allogeneic blood products used in the perioperation was small.
    CONCLUSIONS: PRP separation technology combined with blood salvage and warming of blood and fluid transfusion in the aortic surgery has been proved to be feasible and beneficial.
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