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Autotransfusion

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Dick Menzies – 1st expert on this subject based on the ideXlab platform

  • Autotransfusion of shed mediastinal blood a risk factor for mediastinitis after cardiac surgery results of a cluster investigation
    Chest, 2003
    Co-Authors: Sandra Dial, Dao Nguyen, Dick Menzies

    Abstract:

    Rationale After the introduction of Autotransfusion of shed mediastinal blood following cardiac surgery, the incidence of mediastinitis increased. The role of Autotransfusion in the increased occurrence of this serious complication was examined. Methods Using a case-control design, the preoperative, intraoperative, and postoperative characteristics of 11 patients with mediastinitis were compared to those of 33 randomly selected patients undergoing cardiac surgery between September 1, 2000, and April 15, 2001 (control subjects). Results Patients with mediastinitis were significantly more likely to have a body mass index > 30 (unadjusted odds ratio [OR], 9.9; 95% confidence interval [CI], 2.3 to 42.5), to have received antibiotic therapy during the 2 weeks prior to cardiac surgery (OR, 12.0; 95% CI, 1.1 to 131), or to have required re-exploration within 24 h of the original operation (OR, 8.3; 95% CI, 1.8 to 39). Patients with mediastinitis had 3.4 known risk factors for mediastinitis, compared to only 1.4 risk factors per control subject (p = 0.0001), and longer duration of Autotransfusion. After adjustment for other risk factors, Autotransfusion for > 6 h was significantly associated with the development of mediastinitis (adjusted OR, 11.9; 95% CI, 1.4 to 97.2). Conclusion Retransfusion of shed mediastinal blood for > 6 h after cardiac surgery was an independent risk factor for mediastinitis.

P E Mortensen – 2nd expert on this subject based on the ideXlab platform

  • the inflammatory cytokine response after Autotransfusion of shed mediastinal blood
    Acta Anaesthesiologica Scandinavica, 1998
    Co-Authors: Henrik Schmidt, K Bendtzen, P E Mortensen

    Abstract:

    Background: The inflammatory response in patients undergoing cardiac surgery with cardiopulmonary bypass is well known and increased levels of inflammatory cytokines have been shown. High levels of cytokines have been reported in blood drained from the surgical field. The present study aimed to elucidate whether Autotransfusion of shed mediastinal blood in itself causes increased cytokine levels in coronary artery bypass graft (CABG) patients. Methods: A prospective, randomized controlled study was performed in 23 patients having elective uncomplicated CABG. Autotransfusion of shed mediastinal blood was done every hour for 18 h in group I. In group II, the shed mediastinal blood was accumulated for 4 h in the cardiotomy reservoir and then autotransfused every hour for the next 14 h. Plasma levels of tumour necrosis factor-α (TNFα) and interleukin (IL)-1α, IL-1β, IL-6 were measured. In vitro study of cytokine production was performed with or without stimulation (phytohaemagglutinin (PHA) and Escherichia coli (E. coli) lipopolysaccharide (LPS)). Results: We found high levels of IL-6 in the shed mediastinal blood. However, Autotransfusion of shed mediastinal blood did not lead to increased level of cytokines (TNFα, IL-1α, IL-1β and IL-6) in plasma in group I nor in group II. In vitro study showed activation of the leucocytes in the shed mediastinal blood with a significantly increased production of TNFα and IL-6 both in the stimulated and non-stimulated samples. Conclusion: Shed mediastinal blood contains high levels of IL-6. However, Autotransfusion of shed mediastinal does not cause measurable elevations in plasma levels of IL-6. In vitro study shows that Autotransfusion activates leucocytes, which may enhance production of inflammatory cytokines.

  • Autotransfusion after coronary artery bypass grafting halves the number of patients needing blood transfusion
    The Annals of Thoracic Surgery, 1996
    Co-Authors: Henrik Schmidt, P E Mortensen, Soren Lars Folsgaard, Esther A Jensen

    Abstract:

    Background. Several randomized studies about Autotransfusion of shed mediastinal blood in patients undergoing coronary artery bypass grafting have resulted in divergent findings concerning reduction of the need for homologous blood transfusions. Most of these studies used less strict criteria for homologous blood transfusion than applied in daily clinical practice. Methods. A prospective, randomized, controlled study involving 120 patients having elective, uncomplicated coronary artery bypass grafting was performed. The Autotransfusion group received transfusion of shed mediastinal blood for 18 hours. Criteria for homologous blood transfusion were hemoglobin concentration less than 5.0 mmol/L in the intensive care unit and less than 5.5 mmol/L during the rest of the hospital stay. Results. Twenty-eight percent of patients in the Autotransfusion group received homologous blood transfusion versus 55% in the control group ( p = 0.007). Ninety-five percent of the shed mediastinal blood was transfused. In the Autotransfusion group, a total of 26 units of homologous blood was used versus 78 units in the control group ( p Conclusions. Autotransfusion of shed mediastinal blood in patients undergoing elective, uncomplicated coronary artery bypass grafting halves the number of patients needing homologous blood and reduces the amount of homologous blood given.

Henrik Schmidt – 3rd expert on this subject based on the ideXlab platform

  • the inflammatory cytokine response after Autotransfusion of shed mediastinal blood
    Acta Anaesthesiologica Scandinavica, 1998
    Co-Authors: Henrik Schmidt, K Bendtzen, P E Mortensen

    Abstract:

    Background: The inflammatory response in patients undergoing cardiac surgery with cardiopulmonary bypass is well known and increased levels of inflammatory cytokines have been shown. High levels of cytokines have been reported in blood drained from the surgical field. The present study aimed to elucidate whether Autotransfusion of shed mediastinal blood in itself causes increased cytokine levels in coronary artery bypass graft (CABG) patients. Methods: A prospective, randomized controlled study was performed in 23 patients having elective uncomplicated CABG. Autotransfusion of shed mediastinal blood was done every hour for 18 h in group I. In group II, the shed mediastinal blood was accumulated for 4 h in the cardiotomy reservoir and then autotransfused every hour for the next 14 h. Plasma levels of tumour necrosis factor-α (TNFα) and interleukin (IL)-1α, IL-1β, IL-6 were measured. In vitro study of cytokine production was performed with or without stimulation (phytohaemagglutinin (PHA) and Escherichia coli (E. coli) lipopolysaccharide (LPS)). Results: We found high levels of IL-6 in the shed mediastinal blood. However, Autotransfusion of shed mediastinal blood did not lead to increased level of cytokines (TNFα, IL-1α, IL-1β and IL-6) in plasma in group I nor in group II. In vitro study showed activation of the leucocytes in the shed mediastinal blood with a significantly increased production of TNFα and IL-6 both in the stimulated and non-stimulated samples. Conclusion: Shed mediastinal blood contains high levels of IL-6. However, Autotransfusion of shed mediastinal does not cause measurable elevations in plasma levels of IL-6. In vitro study shows that Autotransfusion activates leucocytes, which may enhance production of inflammatory cytokines.

  • Autotransfusion after coronary artery bypass grafting halves the number of patients needing blood transfusion
    The Annals of Thoracic Surgery, 1996
    Co-Authors: Henrik Schmidt, P E Mortensen, Soren Lars Folsgaard, Esther A Jensen

    Abstract:

    Background. Several randomized studies about Autotransfusion of shed mediastinal blood in patients undergoing coronary artery bypass grafting have resulted in divergent findings concerning reduction of the need for homologous blood transfusions. Most of these studies used less strict criteria for homologous blood transfusion than applied in daily clinical practice. Methods. A prospective, randomized, controlled study involving 120 patients having elective, uncomplicated coronary artery bypass grafting was performed. The Autotransfusion group received transfusion of shed mediastinal blood for 18 hours. Criteria for homologous blood transfusion were hemoglobin concentration less than 5.0 mmol/L in the intensive care unit and less than 5.5 mmol/L during the rest of the hospital stay. Results. Twenty-eight percent of patients in the Autotransfusion group received homologous blood transfusion versus 55% in the control group ( p = 0.007). Ninety-five percent of the shed mediastinal blood was transfused. In the Autotransfusion group, a total of 26 units of homologous blood was used versus 78 units in the control group ( p Conclusions. Autotransfusion of shed mediastinal blood in patients undergoing elective, uncomplicated coronary artery bypass grafting halves the number of patients needing homologous blood and reduces the amount of homologous blood given.