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Joseph A Caprini - One of the best experts on this subject based on the ideXlab platform.
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evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
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Evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients.
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
Lakshman R. Sehgal - One of the best experts on this subject based on the ideXlab platform.
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evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
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Evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients.
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
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Oxygen Extraction Ratio: a valid indicator of transfusion need in limited coronary vascular reserve?
The Journal of trauma, 1992Co-Authors: P S Levy, Lakshman R. Sehgal, Hansa L. Sehgal, R. Chavez, G J Crystal, S-j Kim, P K Eckel, M R Salem, Steven A. GouldAbstract:We have described whole body oxygen (O2) Extraction Ratio (ER) as a reliable indicator of transfusion need in acute normovolemic anemia. In normal hearts, myocardial lactate production (-LACT), indicating anaerobic metabolism, does not occur until the ER greater than 50% and Hct less than 10%. It is not known if the ER is valid in the setting of limited coronary vascular reserve. This study assesses the effect of a critical left anterior descending (LAD) coronary stenosis on the compensation to acute blood loss anemia. Adult dogs were anesthetized, paralyzed, and mechanically ventilated. A critical LAD stenosis was created in seven animals (STEN). There were seven controls (CON). Animals underwent isovolemic exchange transfusion with 6% HES until cardiac failure (CF). Catheters were placed in the aorta, pulmonary artery, and anterior interventricular coronary vein. Cardiac failure occurred at Hct = 8.6% +/- 0.4% in the CON and 17.0% +/- 0.5% in the STEN animals. Cardiac output increased in the CON, but not in the STEN animals. Blood flow in the LAD increased in the CON but not the STEN animals. -LACT began in the CON and STEN animals at Hct less than 20% and coincided with an ER greater than 50% in both groups. We conclude that CF occurs at a higher hematocrit with a critical LAD stenosis. The whole body ER greater than 50% remains a valid indicator of myocardial metabolism in anemia in the presence of limited coronary vascular reserve. The ER may be a useful guide to transfusion therapy.
Guobin Shang - One of the best experts on this subject based on the ideXlab platform.
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equal split of gas liquid two phase flow at variable Extraction Ratio
Chemical Engineering Research & Design, 2018Co-Authors: Fachun Liang, Guobin ShangAbstract:Abstract In this work, a special distributor is proposed to distribute gas–liquid two-phase flow equally at different Extraction Ratio. A swirl vane is inserted at the entrance to achieve uniform swirling annular flow and ensure all the splitting holes have identical inlet conditions. A balance pipe is also applied to balance the pressure difference between the sample fluid loop and main fluid loop. Experiments were conducted in an air–water two-phase flow loop. The effect of gas and liquid superficial velocity, inlet flow pattern and splitting hole’s diameter were investigated. The results demonstrate that the Extraction Ratio is only dependent on the Ratio of sample fluid hole number to that of main fluid. The fraction of gas and liquid taken off is not influenced by flow gas and liquid velocity, inlet flow pattern and size of the splitting hole. The desired Extraction Ratio can be obtained by regulating the number of sample fluid holes.
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Equal split of gas–liquid two-phase flow at variable Extraction Ratio
Chemical Engineering Research and Design, 2018Co-Authors: Fachun Liang, Shitao Sun, Gao Jifeng, Han Luyuan, Guobin ShangAbstract:Abstract In this work, a special distributor is proposed to distribute gas–liquid two-phase flow equally at different Extraction Ratio. A swirl vane is inserted at the entrance to achieve uniform swirling annular flow and ensure all the splitting holes have identical inlet conditions. A balance pipe is also applied to balance the pressure difference between the sample fluid loop and main fluid loop. Experiments were conducted in an air–water two-phase flow loop. The effect of gas and liquid superficial velocity, inlet flow pattern and splitting hole’s diameter were investigated. The results demonstrate that the Extraction Ratio is only dependent on the Ratio of sample fluid hole number to that of main fluid. The fraction of gas and liquid taken off is not influenced by flow gas and liquid velocity, inlet flow pattern and size of the splitting hole. The desired Extraction Ratio can be obtained by regulating the number of sample fluid holes.
Luke P Zebala - One of the best experts on this subject based on the ideXlab platform.
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evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
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Evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients.
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
Ippei Takagi - One of the best experts on this subject based on the ideXlab platform.
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evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
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Evaluation of oxygen Extraction Ratio as a physiologic transfusion trigger in coronary artery bypass graft surgery patients.
Transfusion, 2001Co-Authors: Lakshman R. Sehgal, Luke P Zebala, Ippei Takagi, Ronald D Curran, Timothy V Votapka, Joseph A CapriniAbstract:BACKGROUND: Approximately 20 percent of all allogeneic blood transfusions are administered in connection with coronary artery bypass graft (CABG) opeRations. Transfusion practices vary across the country. The whole-body oxygen Extraction Ratio (O 2 ER) reflects the adequacy of the patient's response to acute normovolemic anemia with an O 2 ER of approximately 50 percent being shown to be an appropriate transfusion trigger. The present study monitored the O 2 ER in patients undergoing CABG and determined if transfusion practices would have been different if an O 2 ER ≥45 percent were used as a transfusion trigger. STUDY DESIGN AND METHODS: Seventy patients with a postoperative Hct ≤25 percent were the test subjects. Arterial and mixed venous contents were determined before the opeRation, in the intensive care unit after the opeRation, and 12 hours after the opeRation. RESULTS: There were no deaths. Forty-one patients received allogeneic transfusion. These patients were older, weighed less, and had a preoperative Hct lower than the nontransfused patients. There were no significant differences between transfused and nontransfused patients with respect to postoperative Hct (21.0 ± 0.4 vs. 22.2 ± 0.4), cardiac index (2.5 ± 0.1 vs. 2.7 ± 0.1), O 2 delivery (6.4 ± 0.3 vs. 6.7 ± 0.3), O 2 consumption (2.5 ± 0.1 vs. 2.5 ± 0.1), and O 2 ER (38.3 ± 1.7 vs. 37.5 ± 1.5). In the transfusion group, 7 of 21 patients had a postoperative O 2 ER >45 percent, while 3 of 35 in the nontransfused group had that result. CONCLUSION: The use of O 2 ER as a transfusion trigger as part of a transfusion algorithm could lead to a reduction in allogeneic blood transfusion.
