The Experts below are selected from a list of 198 Experts worldwide ranked by ideXlab platform
Dick Menzies - One of the best experts on this subject based on the ideXlab platform.
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Autotransfusion of shed mediastinal blood a risk factor for mediastinitis after cardiac surgery results of a cluster investigation
Chest, 2003Co-Authors: Sandra Dial, Dao Nguyen, Dick MenziesAbstract: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 - One of the best experts on this subject based on the ideXlab platform.
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the inflammatory cytokine response after Autotransfusion of shed mediastinal blood
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: Henrik Schmidt, K Bendtzen, P E MortensenAbstract: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.
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Autotransfusion after coronary artery bypass grafting halves the number of patients needing blood transfusion
The Annals of Thoracic Surgery, 1996Co-Authors: Henrik Schmidt, P E Mortensen, Soren Lars Folsgaard, Esther A JensenAbstract: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 - One of the best experts on this subject based on the ideXlab platform.
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the inflammatory cytokine response after Autotransfusion of shed mediastinal blood
Acta Anaesthesiologica Scandinavica, 1998Co-Authors: Henrik Schmidt, K Bendtzen, P E MortensenAbstract: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.
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Autotransfusion after coronary artery bypass grafting halves the number of patients needing blood transfusion
The Annals of Thoracic Surgery, 1996Co-Authors: Henrik Schmidt, P E Mortensen, Soren Lars Folsgaard, Esther A JensenAbstract: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.
Sandra Dial - One of the best experts on this subject based on the ideXlab platform.
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Autotransfusion of shed mediastinal blood a risk factor for mediastinitis after cardiac surgery results of a cluster investigation
Chest, 2003Co-Authors: Sandra Dial, Dao Nguyen, Dick MenziesAbstract: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.
William C Allen - One of the best experts on this subject based on the ideXlab platform.
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a comparison of transfusion requirements after total knee arthroplasty using the solcotrans Autotransfusion system
Journal of Arthroplasty, 1990Co-Authors: Gordon I Groh, Peter K Buchert, William C AllenAbstract:Twenty-five consecutive total knee arthroplasties were performed with the Solcotrans unit for scavenging postoperative drainage (study group) and were compared with the previous 25 arthroplasties performed without the Solcotrans unit (control group). Mean preoperative hematocrits, estimated blood loss, and fluid replacement for both control and study groups were nearly identical. When the Autotransfusion system was not used, 10 patients in the control group required transfusion of a total of 20 units of packed red blood cells, while only two patients utilizing the Solcotrans unit required transfusion of five units of packed red blood cells (P < .01). The total amount autotransfused in the study group averaged 607.9 mm, and the hematocrit of the scavenged drainage was 29.3%. Samples from all Autotransfusions were sent to the microbiology lab for routine culture and were finalized as no growth after 14 days. Serial postoperative hematocrits, platelet counts, prothrombin, partial thromboplastin, blood urea nitrogen, and creatinine values were compared between the two groups. No significant differences were found, and no evidence of coagulopathy, thrombocytopenia or renal dysfunction was found in the study group.
