lunes, 2 de mayo de 2016

Transfusión sanguínea / Blood transfusion


Mayo 2, 2016. No. 2314



Impacto de la edad de la sangre de banco sobre la mortalidad del traumatizado. Revisión sistemática
Impact of the age of stored blood on trauma patient mortality: a systematic review.
Can J Surg. 2015 Oct;58(5):335-42.
Abstract
BACKGROUND: The impact of the age of stored red blood cells on mortality in patients sustaining traumatic injuries requiring transfusion of bloodproducts is unknown. The objective of this systematic review was to identify and describe the available literature on the use of older versus newerblood in trauma patient populations. METHODS: We searched PubMed, Embase, Lilac and the Cochrane Database for published studies comparing the transfusion of newer versus older red blood cells in adult patients sustaining traumatic injuries. Studies included for review reported on trauma patients receiving transfusions of packed red blood cells, identified the age of stored blood that was transfused and reported patient mortality as an end point. We extracted data using a standardized form and assessed study quality using the Newcastle-Ottawa Scale. RESULTS: Seven studies were identified (6780 patients) from 3936 initial search results. Four studies reported that transfusion of older blood was independently associated with increased mortality in trauma patients, while 3 studies did not observe any increase in patient mortality with the use of older versus newer blood. Three studies associated the transfusion of older blood with adverse patient outcomes, including longer stay in the intensive care unit, complicated sepsis, pneumonia and renal dysfunction. Studies varied considerably in design, volumes of blood transfused and definitions applied for old and new blood. CONCLUSION: The impact of the age of stored packed red blood cells on mortality in trauma patients is inconclusive. Future investigations are warranted.
PDF 
 Transfusión perioperatoria de sangre. Lo que no conocemos
Perioperative Red Blood Cell Transfusion: What We Do Not Know.
Chin Med J (Engl). 2015 Sep 5;128(17):2383-6. doi: 10.4103/0366-6999.163384.
Abstract
OBJECTIVE: Blood transfusion saves lives but may also increase the risk of injury. The objective of this review was to evaluate the possible adverse effects related to transfusion of red blood cell (RBC) concentrates stored for prolonged periods. DATA SOURCES: The data used in this review were mainly from PubMed articles published in English up to February 2015. STUDY SELECTION: Clinical and basic research articles were selected according to their relevance to this topic. RESULTS: The ex vivo changes to RBC that occur during storage are collectively called storage lesion. It is still inconclusive if transfusion of RBC with storage lesion has clinical relevance. Multiple ongoing prospective randomized controlled trials are aimed to clarify this clinical issue. It was observed that the adverse events related to stored RBC transfusion were prominent in certain patient populations, including trauma, critical care, pediatric, and cardiac surgery patients, which leads to the investigation of underlying mechanisms. It is demonstrated that free hemoglobin toxicity, decreasing of nitric oxide bioavailability, and free iron-induced increasing of inflammation may play an important role in this process. CONCLUSION: It is still unclear whether transfusion of older RBC has adverse effects, and if so, which factors determine such clinical effects. However, considering the magnitude of transfusion and the widespread medical significance, potential preventive strategies should be considered, especially for the susceptible recipients.
Aun hay espacios disponibles para el curso
Committee for European Education in Anaesthesiology (CEEA)
Colegio de Anestesiólogos de León AC
MÓDULO V: Sistema nervioso, fisiología, anestesia locoregional y dolor.
Reconocimientos de: CEEA, CLASA, Consejo Nacional Mexicano de Anestesiología.  
En la Ciudad de Léon, Guanajuato. México del 6 al 8 de Mayo, 2016.
Informes en el tel (477) 716 06 16 y con el Dr. Enrique Hernández kikinhedz@gmail.com
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

Copyright © 2015
Publicar un comentario en la entrada