دورية أكاديمية
Blood Conservation in Neurosurgery: Erythropoietin and Autologous Donation
| العنوان: | Blood Conservation in Neurosurgery: Erythropoietin and Autologous Donation |
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| المؤلفون: | McGirr, Alexander, Pavenski, Katerina, Sharma, Bhanu, Cusimano, Michael D. |
| المصدر: | Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ; volume 41, issue 5, page 583-589 ; ISSN 0317-1671 2057-0155 |
| بيانات النشر: | Cambridge University Press (CUP) |
| سنة النشر: | 2014 |
| الوصف: | Background Neurosurgery may involve significant blood loss and frequently requires allogeneic red blood cell (RBC) transfusion. Preoperative recombinant erythropoietin (EPO) may be used to improve erythroid status and recovery, and used either alone or in combination with preoperative autologous donation (PAD) it may reduce exposure to allogeneic RBC. We wished to study the use of EPO with and without PAD and the risk of RBC transfusion in neurosurgery. Methods Using a retrospective case-control design, 57 patients who received EPO preoperatively were matched 2:1 for age, sex, year of surgery, and International Classification of Diseases code most responsible for surgery (three were excluded because of stringent matching criteria, leaving 54 cases and 108 comparison subjects). Thirty-two cases participated in PAD. Medical and anesthetic records as well as laboratory investigations were reviewed and extracted. Results Allogeneic RBC exposure was identical for EPO cases and comparison subjects (18.5%). Concomitant PAD and EPO did not reduce allogeneic RBC exposure (21.9%), and resulted in a greater number of RBC units transfused. Last recorded hemoglobin levels suggested that autologous RBCs were not more liberally used. Patients who engaged in PAD and EPO suffered from iatrogenic anemia. A significant proportion (58.6%) of the autologous RBCs was ultimately not used and discarded. Conclusion Further research is needed to determine the efficacy of EPO in neurological surgery. PAD does not appear to reduce the risk of allogeneic RBC transfusion, despite concomitant EPO. Indeed, PAD resulted in iatrogenic anemia and increased transfusion requirements. The cost-effectiveness of blood conservation efforts in neurosurgery deserves additional research. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1017/cjn.2014.14 |
| الإتاحة: | https://doi.org/10.1017/cjn.2014.14Test https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0317167114000146Test |
| حقوق: | https://www.cambridge.org/core/termsTest |
| رقم الانضمام: | edsbas.55F34A78 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1017/cjn.2014.14 |
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