• Clinical and Experimental Pediatrics
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• v.61 no.9
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• pp.265-270
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• 2018

Neonates, especially extremely low birth weight infants, are among the groups of patients undergoing transfusion frequently. Since they are exposed to higher specific transfusion risks compared to the patients of other age groups, there are many special aspects that must be considered for transfusion therapy in neonates. The transfusion risks in neonates include adverse outcomes specific for preterm infants as well as increased metabolic, immunologic, and infectious complications. To reduce the risks of transfusion-transmitted cytomegalovirus infection and transfusion-associated graft-versus-host disease, leukoreduced and irradiated cellular blood products should be used for all neonates. This review summarizes the risks of neonatal transfusion therapy, specific methods to reduce risk, and current trends and practices of red blood cell and platelet transfusions in neonates, to facilitate decision-making for neonatal transfusion.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.350-357
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• 2014

Background: Conservation of blood during cardiac surgery is important because of the shortage of donor blood, risks associated with transfusion, and the costs of allogeneic blood products. This retrospective study explored the feasibility of off-pump coronary artery bypass (OPCAB) without transfusion. Methods: One hundred and two consecutive patients underwent OPCAB from January 2007 to June 2012 at Hallym University Sacred Heart Hospital. Excluding 10 chronic renal failures patients, 102 patients were enrolled. Their characteristics, clinical data, and laboratory data were analyzed. We investigated the success rate of OPCAB without transfusion according to preoperative hemoglobin (Hb), and the cutoff point of the Hb level and the risk factors for transfusion. We implemented multidisciplinary blood-saving protocols. Results: The overall operative mortality and the success rate of OPCAB without transfusion were 2.9% (3/102) and 73.5% (75/102). The success rates in patients with Hb<11, 11 70 years, diagnosis of acute myocardial infarction, preoperative Hb and creatinine levels, and operation time. The events precipitating the need for transfusion were low Hb level in 9 patients and hypotension or excessive bleeding in 18 patients. Conclusion: The preoperative Hb level of >11 facilitates OPCAB without transfusion. These results suggest that transfusion-free OPCAB can be performed by modifying the risk factors and correctable causes of transfusion and improving various blood salvage methods.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4251-4254
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• 2014

Background: Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established. Objective: We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death. Results: Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). Conclusions: Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.196-205
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• 2010

Purpose: We did a retrospective study to understand the prognostic effects of preoperative blood transfusions in stomach cancer surgery. Materials and Methods: Data for 1,360 patients who underwent gastrectomy for stomach cancer between 2001 and 2009 were retrospectively reviewed. We analyzed factors that affect preoperative transfusion and clinicopathologic features. We also analyzed 5-year and overall survival rates of the transfusion and non transfusion subgroups. Results: Sixty patients (4.4%) required blood transfusion within the preoperative period. The transfused group included patients who took aspirin or clopidogrel (P<0.001), with more advanced T stages (P<0.001), with more advanced nodal metastasis (P=0.00), and with more advanced stages (P=0.00) than the non transfusion group. On multivariate analysis, preoperative transfusion was a statistically significant negative influence on 5-year survival and overall survival rates (58.2% vs 79.9% (P=0.00), 58.2% vs 76.8% (P=0.00)). Applying Cox-regression analyses, blood transfusion did appear to have an effect on prognosis and on 5-year and overall survival rates. Conclusions: We found a direct negative relation between preoperative transfusion and long term prognosis in patients receiving gastric cancer surgery.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.19 no.8
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• pp.1845-1852
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• 2015

From bar code systems and radio frequency identification (RFID) to beacons utilizing low power bluetooth technology, the fusion of information technology and health and medical treatment is spreading through advances such as automated treatment and examination stages and the use of treatment information connected to smart devices. In this paper, designed and implemented a mobile health care system for the safe management of blood transfusions to prevent accidental problems that can occur during patient blood transfusions. It makes safe and effective blood transfusion possible by using smart devices to read information saved on patient bracelets, blood-collecting containers, blood transfusion bags, and medical personnel identification cards so that they match patient information. By applying the blood transfusion management mobile health care system presented and implemented in this paper to blood transfusion processes in hospitals, it was verified that it allows for safe and effective blood transfusion, preventing accidents which may occur in blood transfusion processes.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.418-423
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• 1984

Appreciation of the large volume deficits which may occur in surgical or trauma patients due to blood loss has led to vigorous transfusion techniques designed to overt hypovolemic shock and ischemic damage to vital organs which may develop in minutes during the hypovolemic state. In a significant proportion of patients treated with massive rapid blood or fluid transfusion, hypervolemia occurs and life threatening pulmonary edema may develop. Especially, hypervolemia may occur during transfusion for preventing development of the so-called low output syndrome following cardiac surgery. However, the most effective indicator which reveals the adequate level of transfusion is not settled yet. The present study was aimed to compare the effectiveness of the indicators suggested thus far and to determine the most sensitive one. Eight dogs were experimentally studied in terms of left atrial pressure, pulmonary arterial systolic pressure, central venous pressure, mean systemic arterial pressure and heart rate before and after induced hypervolemia with infusion of 600ml heparinized homologous blood. Immediately after induced overtransfusion of the blood, pulmonary arterial systolic pressure increased 75.0%, in omparison with the control before transfusion, left atrial pressure 58.8%, central venous pressure 44.6%, and mean systemic arterial pressure 10.1%, one hour after transfusion, pulmonary arterial systolic pressure 40.0%, left atrial pressure 21.2%, central venous pressure 14.5%, and mean systemic arterial pressure 3.2%, central venous pressure 14.5%, and mean systemic arterial pressure 3.2%, respectively. Heart rate showed no significant change throughout the experiment. These result suggested that the changes of the pulmonary arterial systolic pressure is the most sensitive indicator for detection of hypervolemia during blood transfusion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.1
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• pp.9-14
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• 2011

Recently, the population of patients who refuse transfusion has increased for both religious and non-religious reasons, even in life threatening emergency situations. Their refusal has highlighted the need to develop nonblood transfusion surgery techniques to decrease the risk from blood transfusions. A 57-year woman with an ulcerative lesion on the gingiva of the right upper molar area visited the department of oral and maxillofacial surgery in Dankook University Dental Hospital. After a preliminary evaluation, the patient was diagnosed with squamous cell carcinoma. As she refused blood transfusion during surgery for religious reasons, surgery was planned using recombinant human erythropoietin (rHuEPO) without a blood transfusion. The patient underwent a partial maxillectomy, supraomohyoid neck dissection, free radial forearm flap and split thickness skin graft under general anesthesia. rHuEPO and iron were used before and after surgery. The hemoglobin/hematocrit (Hb/Hct) level, iron (Fe) and total iron-binding capacity (TIBC) were assessed. The patient recovered completely without any blood transfusions. rHuEPO is a viable alternative for patients with religious objections to receiving blood transfusions.

• Journal of Chest Surgery
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• v.28 no.2
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• pp.125-130
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• 1995

Autotransfusion system is a common method of reducing the need of intraoperative and postoperative homologous blood transfusion in cardiac operation. Between August 1991 and August 1993, a series of 51 adults undergoing open heart surgery was selected. Autotransfusion using Cell Saver [COBE Baylor Rapid Autologous Transfusion System was done with homologous blood transfusion in 15 cases [Group II or without homologous blood transfusion in 17 cases [Group III . The other 19 cases were taken without Cell Saver for control [Group I . The shed blood in the operative field, remained blood in the oxygenator after cardiopulmonary bypass, and blood drained from chest tubes in postoperative care were aspirated by means of a locally heparinized collection system. After the salvaged blood was washed and centrifuged, the processed blood subsequently reinfused. Composition of processed blood by Cell Saver was hemoglobin 16.9gm%, hematocrit 49%, RBC 5,140,000/ml, WBC 670/ml, and platelet 30,000/ml. In three group, hemoglobin, hematocrit, and platelet counts were decreased postoperatively, but no significant differences between three group. Postoperatively, the amounts of drainage from chest tubes was 543$\pm$121ml in Group I, 809$\pm$201ml in Group II, and 631$\pm$147ml in Group III. In Group II, there was large amount of drainage compared with Group I [p<0.05 . The amount of homologous blood transfused was 1116$\pm$219 ml in Group I, 791$\pm$183 ml in Group II [p<0.05 . The homologous blood was not transfused in 17 cases [53% with Cell Saver.Preoperative and postoperative, coagulation parameters showed no significant differences between three group. And there was no complication related to Cell Saver. We conclude that the autotransfusion using Cell Saver is effective for reducing the homologous blood transfusion in cardiac surgery.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.158-162
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• 2004

The over-preparation of blood for elective surgery causes some problems such as returning of blood, inefficient task and loss of reagents. In recent blood transfusion practice, there has been changing patterns of blood use in elective surgery as various side effects of transfusion have become known and operation techniques are developed. This study was performed to evaluate the optimal utilization of blood for various elective and/or emergency surgery. We surveyed the quantity of blood transmitted to wards, returned to blood bank, and the number of crossmatching test done for the elective surgery of the patients at the D. University Hospital, the tertiary teaching hospital from August 1, 2001 to October 31, 2001. Crossmatched to transfusion ratio (C/T ratio) was calculated, in which C means the unit of accomplished crossmatching test and T means the unit of transfused blood component. The unit of transfused blood was analysed in terms of issuing time, sex, age, clinical department, and blood component type. The usage of bloods for the emergency surgery was also analyzed. In our study, C/T ratio was highest on Monday (1.54) and Tuesday (1.53), and higher in female patients(1.54) than in male patients (1.32). No significant relationship was observed between age groups. Among clinical departments, thoracic and cardiovascular surgery showed the highest C/T ratio (1.54). From above results, we could be sure that the management of transfusion practice was relatively appropriate in recent years, although the entire introduction of type and screen (T&S) method was desirable. If the T&S method is performed, the C/T ratio would be almost 1.00 and it would also relieve the duty of blood bank.

• The Korean Journal of Blood Transfusion
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• v.29 no.3
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• pp.240-252
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• 2018

Viscoelastic coagulation tests provide simultaneous measurements of multiple aspects of whole-blood coagulation, including interactions between the plasma components and cellular components of the coagulation cascade. This can be carried out immediately using a point of care technique. Viscoelastic tests could predict the patient's outcome, including mortality, and detect coagulopathy more sensitively, resulted in reduced blood loss. The transfusion strategy based on the viscoelastic parameters rather than a conventional coagulation test has been shown to reduce the transfusion requirements. Although there are concerns about the reliability and accuracy of this method, viscoelastic tests, including ROTEM, would be a useful method to guide patient blood management strategies.