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‣ Early experience of intraoperative autotransfusion.

Wilson, A J; Cuddigan, B J; Wyatt, A P
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1988 Português
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Intraoperative autotransfusion of whole blood was performed using the Solcotrans device in 45 patients undergoing major vascular surgery or other procedures in which there was a clean operative field. Overall, 60% of the blood shed during these operations was reinfused. Approximately 50% of patients avoided the potential complications of homologous transfusion. There were no complications attributable to the use of this device although in a sample of 13 patients, 30% of the erythrocytes were haemolysed and there were other minor haematological abnormalities. In conclusion this device provides a simple method of autotransfusing 2 or 3 litres of blood aspirated from an uncontaminated operative field.

‣ A Clinical Experience with Intraoperative Autotransfusion

Duncan, S. Edwin; Klebanoff, Gerald; Rogers, Waid
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1974 Português
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Utilizing a disposable unit, intraoperative autotranfusion was employed during surgery in 53 patients admitted to the Bexar County Teaching Hospital at the University of Texas Health Science Center at San Antonio. During the two-year period of study, 26 patients underwent surgery for major traumatic injuries, 8 for ruptured ectopic pregnancy and 19 for miscellaneous emergency or elective conditions. The indication for intraoperative autotransfusion was an anticipated blood loss of 1,000 ml or more. Contraindications for its use were colon injury or localized infection. Over 325 units of blood were salvaged and returned directly to these patients during surgery. One death related to the use of the autotransfusor unit was due to massive air embolism. Twenty other deaths were associated with severe injuries and irreversible shock requiring greater than 3,600 ml of both autologous and homologous blood. Eight of these patients demonstrated severe pancoagulopathies. In the remaining patients, clotting factors and plasma or urine hemoglobin levels were transiently abnormal. However, there were no clinically apparent bleeding defects or renal problems detected. Postoperative blood cultures were consistently negative. It is concluded that intraoperative autotransfusion...

‣ Intraoperative autotransfusion. Experience in 725 consecutive cases.

Keeling, M M; Gray, L A; Brink, M A; Hillerich, V K; Bland, K I
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/1983 Português
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Autologous intraoperative transfusion employing the Haemonetics Cell Saver is reported in 725 patients from a general hospital population, of which 75% were cardiovascular patients. The remaining cases included various orthopedic procedures, splenectomy, craniotomy, ectopic pregnancies, Caesarian sections, and exploratory laparotomy. On occasion, this method was utilized in trauma and in pediatric surgery. The product of washed red blood cells gave an average yield of 573 cc per case with an average hematocrit of 55 cc/dl available for autologous infusion. In 100 consecutive open heart procedures operated prior to the Cell Saver period, an average of 1.97 units of bank blood was utilized during operation, as compared with 0.75 units in 100 consecutive cases studied employing the Cell Saver (p less than 0.0001). Homologous blood utilization during cardiac surgery declined more than 50% with the use of the Cell Saver. Quality control was monitored scrupulously and included special precautions against air embolism, abnormal coagulation, and sepsis. The overall mortality rate was 2.8%, and in no instance was mortality or morbidity ascribable to the autologous transfusion. Numerous advantages offered by autotransfusion include prevention of sensitization of the recipient to various antigens in donor erythrocytes...

‣ Evaluation of cell salvage autotransfusion utility during liver transplantation

Massicotte, Luc; Thibeault, Lynda; Beaulieu, Danielle; Roy, Jean-Denis; Roy, André
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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Background: Orthotopic liver transplantation (OLT) may be associated with massive blood loss and the need for allogenic blood product transfusions. Cell salvage autotransfusion (CS) is an attractive alternative to allogenic red blood cell (RBC) transfusion. However, controversy surrounds its usefulness during OLT; some studies stated that CS decreased transfusions of allogenic blood products and others stated that blood loss was increased. The aim of this study was to evaluate the efficiency of the CS during OLT. Patients and methods: After approval by the institutional ethics committee, a prospective survey was undertaken. A total of 150 consecutive OLTs were included in the study. Two groups of patients were formed. Period 1 included patients 1–75 with no CS use. Period 2 comprised patients 76–150 with systematic CS use. Results: Patients from both periods were comparable. CS was used in all cases in period 2, and there was enough salvaged blood to retransfuse 65% of these OLTs. The mean volume of retransfused blood was 338±339 ml. The transfusion rate did not change from period 1 to period 2. The mean number of RBC units transfused per patient was 0.4±0.9 vs 0.4±1.2 with 78.7% vs 81.3% of cases not receiving transfusion of any blood product. The threshold for RBC transfusions was the same. The length of surgery and blood loss were greater in period 2 than in period 1 (associated with the arrival of two junior surgeons)...

‣ Effect of shed blood retransfusion on pulmonary perfusion after total knee arthroplasty: a prospective controlled study

Altinel, Levent; Kaya, Eser; Kose, Kamil Cagri; Fidan, Fatma; Ergan, Volkan; Fidan, Hüseyin
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Português
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Postoperative shed blood retransfusion (autotransfusion) is a commonly used salvage method following major surgical operations, such as total knee arthroplasty (TKA). The systemic effects of shed blood are still unclear. We studied the effect of residual substances in the retransfused shed blood, on lung perfusion after TKA. Fifteen unilateral and one bilateral TKAs were performed with autotransfusion (the study group) and 15 unilateral and three bilateral TKAs were performed in a control group. Lung X-rays, arterial blood gases (ABG), D-dimer values, and lung perfusion scintigraphies were performed preoperatively and postoperatively. A mean of 300.0 ± 335.6 ml of bank blood was needed in the autotransfusion group and a mean of 685.7 ± 365.5 ml of bank blood was needed in the control group (p=0.001). There was a postoperative segmental perfusion defect at the lateral segment of the superior lobe of the left lung in one patient of the control group and he also had risk factors for thrombosis. Although both groups had a decrease in lung perfusion postoperatively, there were no significant differences among the groups regarding the lung perfusion scintigraphy, chest X-rays, ABG, and D-dimer values. In conclusion, although pulmonary perfusion diminishes following TKA...

‣ Blood Conservation Using Autotransfusion In Total Joint Arthroplasty

Cotton, Ralph L.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1991 Português
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Recent publications have established that intraoperative autotransfusion (IAT) may be applied to reduce homologous banked blood utilization for patients undergoing major orthopaedic surgery.

‣ Autotransfusion, an experience of seventy six cases.

Dale, R. F.; Lindop, M. J.; Farman, J. V.; Smith, M. F.
Fonte: Royal College of Surgeons of England Publicador: Royal College of Surgeons of England
Tipo: Artigo de Revista Científica
Publicado em /11/1986 Português
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The use of autotransfusion with a centrifugal cell washer in a series of 76 cases is reviewed. The requirement for bank blood is reduced in patients with major operative haemorrhage, although it does not appear to be able to provide the main source of blood replacement in such cases. The major impact of autotransfusion may lie in reducing the amount of blood that needs to be crossmatched for elective operations. Nevertheless in certain cases its use can be life saving.

‣ Reinfusion of unwashed salvaged blood after total knee arthroplasty in patients with rheumatoid arthritis

Matsuda, Keiji; Nozawa, Masahiko; Katsube, Sadanobu; Maezawa, Katsuhiko; Kurosawa, Hisashi
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Português
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Autotransfusion with unwashed salvaged blood (USB) is effective for avoiding allogeneic blood transfusion (ABT) in patients undergoing total knee arthroplasty (TKA). We performed a retrospective study to determine the percentage of patients receiving ABT and the volume of postoperative blood drainage after introduction of autotransfusion with USB for patients with rheumatoid arthritis (RA) undergoing TKA. In 100 patients without autotransfusion (group 1) and 100 patients receiving autotransfusion of USB (group 2), we compared the number of patients who required ABT, as well as the postoperative drainage volume, ABT volume, and autotransfusion volume. In group 1, 83% of the patients received ABT, while only 47% received ABT in group 2, and there was a significant decrease (p < 0.001). However, the postoperative drainage volume was significantly increased in group 2 (p < 0.001).

‣ Application of the continuous autotransfusion system (CATS) to prevent transfusion-related hyperkalemia following hyperkalemic cardiac arrest in an infant -A case report-

Sohn, Hye-Min; Park, Yong-Hee; Byon, Hyo-Jin; Kim, Jin-Tae; Kim, Hee-Soo; Kim, Chong Sung
Fonte: The Korean Society of Anesthesiologists Publicador: The Korean Society of Anesthesiologists
Tipo: Artigo de Revista Científica
Português
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Transfusion-induced hyperkalemia can lead to cardiac arrest, especially when the patient rapidly receives a large amount of red blood cells (RBCs), previously stored for a long period of time, irradiated or both. We report on a case of application of the Continuous AutoTransfusion System (CATS) to wash RBCs, in order to lower the high potassium (K+) level in the packed RBCs unit, during massive transfusion following transfusion-induced hyperkalemic cardiac arrest. After the washing process using CATS, there was no more electrocardiographic abnormality or cardiac arrest due to hyperkalemia. This case emphasizes the potential risk to develop transfusion-related hyperkalemic cardiac arrest, during massive transfusion of irradiated, pre-stored RBCs. CATS can be effectively used to lower the K+ concentration in the packed RBCs unit, especially when the risk of transfusion-induced hyperkalemia is high.

‣ Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty

Breindahl, Torben; Simonsen, Ole; Hindersson, Peter; Brødsgaard Dencker, Bjarne; Brouw Jørgensen, Mogens; Rasmussen, Sten
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
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Aims. To study the safety of autotransfusion following local infiltration analgesia (LIA) with ropivacaine. Background. Knowledge of blood concentrations of ropivacaine after LIA and autotransfusion is crucial. However, very limited data are available for toxicological risk assessment. Methods. Autotransfusion was studied in patients after total knee arthroplasty (TKA: n = 25) and total hip arthroplasty (THA: n = 27) with LIA using 200 mg ropivacaine, supplemented with two postoperative bolus injections (150 mg ropivacaine). Drainage blood was reinfused within 6 h postoperatively. Results. Reinfusion caused a significant increase in the serum concentration of total ropivacaine for TKA from 0.54 ± 0.17 (mean ± SD) to 0.79 ± 0.20 μg/mL (P < 0.001) and a nonsignificant increase for THA from 0.62 ± 0.17 to 0.63 ± 0.18 μg/mL. The maximum free (unbound) concentration after reinfusion was 0.038 μg/mL. Peak total and free venous ropivacaine concentrations after 8 h and 16 h postoperative bolus injections were 2.6 μg/mL and 0.11 μg/mL, respectively. All concentrations observed were below the threshold for toxicity and no side effects were observed. Conclusion. Autotransfusion of patients undergoing knee or hip arthroplasty after local infiltration analgesia with 200 mg ropivacaine can be performed safely...

‣ Clinical evaluation of the Sorin Xtra® autotransfusion system

Overdevest, EP; Lanen, PWJ; Feron, JCM; van Hees, JWH; Tan, MESH
Fonte: SAGE Publications Publicador: SAGE Publications
Tipo: Artigo de Revista Científica
Publicado em /07/2012 Português
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The performance of the Sorin Xtra® Autotransfusion System (ATS) was studied in 62 patients undergoing coronary artery bypass grafting. Blood was collected intraoperatively and washed using three different wash sets in 4 groups. Both collected and washed blood were analysed for hemoglobin levels and hematocrit, concentrations of proteins, albumin, heparin and plasma free hemoglobin (PFH) were determined, erythrocytes, platelets and leukocytes were counted.

‣ Effect of autotransfusion system on tumor recurrence and survival in hepatocellular carcinoma patients

Akbulut, Sami; Kayaalp, Cuneyt; Yilmaz, Mehmet; Ince, Volkan; Ozgor, Dincer; Karabulut, Koray; Eris, Cengiz; Toprak, Huseyin Ilksen; Aydin, Cemalettin; Yilmaz, Sezai
Fonte: Baishideng Publishing Group Co., Limited Publicador: Baishideng Publishing Group Co., Limited
Tipo: Artigo de Revista Científica
Português
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AIM: To investigate the therapeutic efficacy and safety of continuous autotransfusion system (CATS) during liver transplantation of hepatocellular carcinoma patients.

‣ Audit of autotransfusion in spine surgery

Shulman, G.; Solanki, D. R.; Nicodemus, C. L.; Flores, I. M.; Hadjipavlou, A. G.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Publicado em /12/1998 Português
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A prospective evaluation has been undertaken of 382 patients undergoing reconstructive spine surgery during a thirty-six month period. Acute normovolaemic haemodilution and haemapheresis for blood component sequestration was used in 80 patients in the operating theatre. An average of two units each of freshly collected autologous red cells and fresh plasma together with a therapeutic dose of a plateletpheresis product were prepared for each patient prior to surgical incision. The same supplies and equipment were subsequently used for conventional blood salvage and autotransfusion. The other 302 patients received salvaged blood only. Of the total blood transfused, autologous red cells comprised 87% of sequestration and 49% of autotransfusion-only patients. Each group received the same total perioperative red blood cell support. The cost for one red cell equivalent by intraoperative autologous transfusion was competitive with that of providing one unit of cross-matched allogeneic red cells. As compared with salvage alone, sequestration combined with salvage was even more cost effective and decreased reliance on allogenic products and preoperative autologous blood donations. The rate of transfusing autologous blood products was markedly increased.

‣ Controversy over the use of intraoperative blood salvage autotransfusion during liver transplantation for hepatocellular carcinoma patients

Zhai, Bo; Sun, Xue-Ying
Fonte: Baishideng Publishing Group Co., Limited Publicador: Baishideng Publishing Group Co., Limited
Tipo: Artigo de Revista Científica
Português
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Intraoperative blood salvage autotransfusion (IBSA) is used in various surgical procedures. However, because of the risk of reinfusion of salvaged blood contaminated by tumor cells, the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial. The critical points include whether tumor cells can be cleared by IBSA, whether IBSA increases the risk of recurrence or metastasis, and what are the indications for IBSA. Moreover, is it warranted to take the risk of tumor dissemination by using IBSA to avoid allogeneic blood transfusion? Do the remaining tumor cells after additional filtration by leukocyte depletion filters still possess potential tumorigenicity? Does IBSA always work well? We have reviewed the literature and tried to address these questions. The available data indicate that IBSA is safe in LT for HCC, but randomized, controlled and prospective trials are urgently required to clarify the uncertainty.

‣ Immunologische und rheologische Konsequenzen von Leukozytenkontaminationen bei maschineller Autotransfusion; Immunological and rheological consequences of leucocyte contamination during mechanical autotransfusion

Ries, Reiner
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
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Die Adhäsion von Leukozyten an Endothelzellen trägt zu Störungen der Mikrozirkulation und zu Gewebeschäden bei schwerem Schock, Sepsis und Reperfusion bei. Ebenso wie inflammatorische Reize durch Bakterien und Zytokine induzieren auch mechanische Reize wie der Kontakt mit Fremdoberflächen, Filtration und Zentrifugation die Stimulation von Leukozyten. So wurden auch nach maschineller Autotransfusion von aufbereitetem Wundblut erhöhte Zytokinspiegel sowie systemische Entzündungsreaktionen, Schock und beeinträchtigte Mikrozirkulation beobachtet. Ziel dieser Arbeit war die Untersuchung der funktionellen und immunologischen Auswirkungen auf die Leukozyten im Transfusat. Von 27 Patienten mit orthopädischen Eingriffen unter Verwendung eines Autotransfusionsgerätes wurden Proben von Transfusatblut und venösem Blut entnommen. Mittels Durchflusszytometrie bestimmten wir die Expression der leukozytären Adhäsionsmoleküle CD62L (L-Selektin) sowie der beta-Integrine CD11b und CD18. Zur Untersuchung der Rheologie wurden die Leukozyten mit Calcein AM angefärbt. Anschließend perfundierten wir die Vollblutproben in einer mikroskopierbaren Flusskammer unter Fluoreszenzlicht über TNFalpha-stimulierte (4h; 25 ng/ml) humane Nabelschnurendothelzellen (HUVEC). Im Bereich postkapillärer Strömungsbedingungen (shear rates von 300 s-1 bis 50 s-1) verglichen wir die Leukozytenadhäsion und führten danach einen Ablösungsversuch (detachment assay) bei steigenden Flussraten (50 s-1 bis 1600 s-1) durch. Die Auswertung erfolgte mit Hilfe einer Software zur computergestützten Bildanalyse. Im Flusskammerversuch zeigte sich im Transfusat bei niedriger shear rate eine signifikant höhere Geschwindigkeit rollender Leukozyten. Ein schwächer ausgeprägtes Sticking (feste Adhäsion) sowie ein erhöhter Anteil rollender Leukozyten an allen adhärenten Leukozyten (rolling fraction) wurde bei allen Strömungsbedingungen beobachtet...

‣ Vor- und Nachteile autologer Transfusionsverfahren; Advantages and disadvantages of autologous transfusion

Endele, Dominick Felix
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
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Der hohe Blutverlust, die hohe Wahrscheinlichkeit eine Bluttransfusion zu erhalten und der elektive Charakter der Hüfttotalendoprothesenoperation prädestiniert diese für den Einsatz autologer Transfusionsverfahren. Autologes Blut kann zu verschiedenen Zeitpunkten gewonnen werden. Präoperativ wird die Eigenblutspende und die normovolämische Hämodilution durchgeführt, intraoperativ die maschinelle Autotransfusion und postoperativ die direkte, also ungewaschene Retransfusion von gewonnenem Wundblut. Bisher fanden die präoperative Eigenblutspende und die maschinelle Autotransfusion von Drainageblut ihre Anwendung in der Orthopädischen Universitätsklinik Tübingen. Ab August 2002 wurde ein System zur direkten, postoperativen Rücktransfusion von ungewaschenem Drainageblut eingeführt. Diese Arbeit hat zum Ziel, die Grenzen und Möglichkeiten der präoperativen Eigenblutspende, der maschinellen Autotransfusion und der direkten, postoperativen Rücktransfusion von ungewaschenem Drainageblut bei der Implantation einer Hüft-Totalendoprothese zu untersuchen. Dazu wurden die Krankenakten von 241 Patienten, die sich einem geplanten orthopädischen Eingriff mit totalem Hüftgelenksersatz unterzogen, ausgewertet. Je nach angewendetem Transfusionsregime wurden die Patienten auf acht verschiedene Gruppen aufgeteilt. Die Effizienz der einzelnen Transfusionsverfahren - alleine oder kombiniert wurde auf zweierlei Art bewertet: über den Bedarf an allogenen Bluttransfusionen in den jeweiligen Gruppen und über den postoperativen Verlauf der erhobenen Laborparameter. Von den untersuchten autologen Transfusionsverfahren senkte die Eigenblutspende den Bedarf an allogenem Blut am effizientesten...

‣ Autotransfusión y terapia de componentes sanguíneos autológos en cirugía cardíaca: consideraciones generales y experiencia en el Hospital México

Induni López,Eduardo; Alvarado,Manuel; Méndez,Edgar; Pucci,Juan
Fonte: Revista Costarricense de Cardiología Publicador: Revista Costarricense de Cardiología
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2003 Português
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Introducción: La autotransfusión sanguínea y terapia de componentes autólogos ha sido una modalidad que se ha utilizado desde hace más de 2 siglos experimentando gracias a los avances técnicos recientes, su implementación en maniobras que redundan en ahorro y eliminación de pérdidas sanguíneas en procedimientos quirúrgicos extensos, así como los riesgos inherentes a la transfusión homóloga. Objetivos: Disminuír el número de días de estancia hospitalaria en pacientes preparándose para cirugía extracorpórea, y emplear plaquetoferésis preoperatoria y gomas biológicas plaquetarias para disminuir el sangrado y los requerimientos transfusionales en cirugía cardíaca. Material y métodos: De los pacientes sometidos a cirugía cardíaca con circulación extracorpórea en el Hospital México en un período comprendido entre Febrero de 1997 y Febrero del 2003, fue utilizada la autotransfusión de glóbulos rojos por recuperación intraoperatoria en un total de 150 pacientes. A todos se les realizó autotransfusión de globulos rojos lavados para lo cual se utilizó la máquina tipo Cell Saver, Secuestra 1000, (Medtronic, Minneapolis, Mn.). Se incluyeron pacientes con reoperaciones cardíacas, cirugía coronaria múltiple o complicada...

‣ Autotransfusión sanguínea en cirugía ortognática: necesario

Naval,L.; González,R.; Rodríguez Campo,F.; Muñoz,M.; Sastre,J.
Fonte: Revista Española de Cirugía Oral y Maxilofacial Publicador: Revista Española de Cirugía Oral y Maxilofacial
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/12/2006 Português
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El ahorro de sangre es un asunto que puede simplificar la asistencia médica diaria y mejorar su calidad tanto desde el punto de vista de morbilidad, seguridad y coste económico y social para los pacientes, profesionales de la salud como anestesistas, cirujanos, banco de sangre y de los equipos de dirección de hospitales públicos y privados. Inicialmente el interés por evitar los efectos adversos secundarios a la transfusión alogénica (TAL) (transmisión de enfermedades infecciosas, reacciones transfusionales, como el Distress Respiratorio Agudo asociado a transfusión, costes, sensibilizaciones…) y posteriormente el ahorro de recursos limitados hacen que múltiples grupos de trabajo desarrollen nuevas estrategias frente a un problema común: la reposición o el ahorro de la sangre perdida durante las intervenciones quirúrgicas y el postoperatorio inmediato. Asistimos en los últimos años a un menor uso durante las cirugías de cualquier tipo de sangre, especialmente la alogénica, gracias a la mejora de las técnicas quirúrgicas y anestésicas. Entre ellas la utilización de sangre del propio paciente (autóloga o autotransfusión) (AUT) en sus distintas modalidades. ¹ Llevamos a cabo una revisión de las distintas modalidades de AUT mostrando la experiencia de nuestro Servicio en el que se lleva practicando desde finales de los años 80.²

‣ Autotransfusión sanguínea en cirugía ortognática: no necesario

Hernández Alfaro,F.; Rosario Regalado,R. del; Mair,D.
Fonte: Revista Española de Cirugía Oral y Maxilofacial Publicador: Revista Española de Cirugía Oral y Maxilofacial
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/12/2006 Português
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La cirugía de las deformidades maxilofaciales ha evolucionado de manera importante en las últimas décadas y el número de pacientes que reciben este tipo de tratamiento ha aumentado de forma considerable. Uno de los temas más debatidos en la literatura reciente se refiere a la necesidad de autodonación sanguinea preoperatoria. hacemos una revisión de las publicaciones relevantes en años recientes, que demuestran puntos de vista opuestos.

‣ ¿Podemos predecir la pérdida de sangre en la cirugía ortognática utilizando parámetros preoperatorios?

Stavaru Marinescu,Bogdan; Sastre Pérez,Jesús; Fernández Díaz,Juan Oscar; García Jimenez,Tamara; Naval Gías,Luís; Díaz González,Francisco Javier
Fonte: Revista Española de Cirugía Oral y Maxilofacial Publicador: Revista Española de Cirugía Oral y Maxilofacial
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/09/2013 Português
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Objetivos: El presente artículo estudia la posibilidad de restringir la inclusión de los pacientes sometidos a intervenciones de cirugía ortognática en el protocolo de autotransfusión con predepósitos utilizando parámetros preoperatorios (la mayor edad, el sexo femenino, el tipo de cirugía más invasiva) y valora la necesidad cuantitativa de sangre (número de bolsas utilizadas). Material y método: Realizamos un estudio descriptivo retrospectivo que comprende 91 de intervenciones de cirugía ortognática realizadas entre el junio del 2007 y el diciembre de 2010 en el Hospital de La Princesa - Madrid que describe en términos analíticos el manejo de las pérdidas sanguíneas y busca una relación entre varios parámetros como: edad, tipo de cirugía, tiempo de cirugía, los valores de hemoglobina pre-, intra- y postoperatoria, el número de bolsas de sangre recibidas y el sexo. Resultados: No se han encontrado correlaciones estadísticamente significativas entre la necesidad de transfusión y: la mayor edad (p = 0,23), el sexo femenino (p = 0,11), el mayor tiempo de cirugía (p = 0,93), el tipo de cirugía más invasiva (p = 0,284) con lo cual estos parámetros no suponen un mayor riesgo de sangrado ni de ser transfundido. Conclusión: En nuestro grupo de estudio los parámetros enumerados no sirven en el preoperatorio para delimitar un grupo de pacientes para los cuales la inclusión en el protocolo de autotransfusión sería beneficiosa. Los resultados indican la posibilidad de reducir la cantidad de sangre ahorrada por protocolo e indican una probable sobreindicación del procedimiento.