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Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients

BACKGROUND: Several studies have shown that restrictive transfusion policies are safe. However, in clinical practice, transfusion policies seem to be inappropriate. In order to assist in decision-making concerning red blood cell transfusions, we determined perioperative hemoglobin (Hb) levels during...

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Autores principales: Lammi, J.P., Eskelinen, Matti, Tuimala, Jarno, Selander, Tuomas, Saarnio, Juha, Rantanen, Tuomo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551432/
https://www.ncbi.nlm.nih.gov/pubmed/33118472
http://dx.doi.org/10.1177/1457496920964362
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author Lammi, J.P.
Eskelinen, Matti
Tuimala, Jarno
Selander, Tuomas
Saarnio, Juha
Rantanen, Tuomo
author_facet Lammi, J.P.
Eskelinen, Matti
Tuimala, Jarno
Selander, Tuomas
Saarnio, Juha
Rantanen, Tuomo
author_sort Lammi, J.P.
collection PubMed
description BACKGROUND: Several studies have shown that restrictive transfusion policies are safe. However, in clinical practice, transfusion policies seem to be inappropriate. In order to assist in decision-making concerning red blood cell transfusions, we determined perioperative hemoglobin (Hb) levels during major pancreatic and hepatic operations. METHODS: Patients who underwent major pancreatic or hepatic resections between 2002 and 2011 were classified into the transfused (TF+) and non-transfused (TF) groups. The perioperative Hb values of these patients were evaluated at six points in time. RESULTS: The study included 1596 patients, of which 785 underwent pancreatoduodenectomy, 79 total pancreatectomy, and 732 partial hepatectomy. Similar perioperative changes in Hb levels were seen in all patients regardless of whether they received a blood transfusion. In patients undergoing pancreatoduodenectomy and total pancreatectomy, the median of the lowest measured hemoglobin values was 89.2 g/L and in partial hepatectomy patients 92.6 g/L, and these were assumed to be the trigger points for red blood cell transfusion. CONCLUSIONS: Despite guidelines on blood transfusion thresholds, restrictive blood transfusion policies were not observed during our study period. After major pancreatic and hepatic surgery, Hb levels recovered without transfusions. This should encourage clinicians to obey the restrictive blood transfusion policies after major hepatopancreatic surgery.
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spelling pubmed-85514322021-10-29 Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients Lammi, J.P. Eskelinen, Matti Tuimala, Jarno Selander, Tuomas Saarnio, Juha Rantanen, Tuomo Scand J Surg Original Research Articles BACKGROUND: Several studies have shown that restrictive transfusion policies are safe. However, in clinical practice, transfusion policies seem to be inappropriate. In order to assist in decision-making concerning red blood cell transfusions, we determined perioperative hemoglobin (Hb) levels during major pancreatic and hepatic operations. METHODS: Patients who underwent major pancreatic or hepatic resections between 2002 and 2011 were classified into the transfused (TF+) and non-transfused (TF) groups. The perioperative Hb values of these patients were evaluated at six points in time. RESULTS: The study included 1596 patients, of which 785 underwent pancreatoduodenectomy, 79 total pancreatectomy, and 732 partial hepatectomy. Similar perioperative changes in Hb levels were seen in all patients regardless of whether they received a blood transfusion. In patients undergoing pancreatoduodenectomy and total pancreatectomy, the median of the lowest measured hemoglobin values was 89.2 g/L and in partial hepatectomy patients 92.6 g/L, and these were assumed to be the trigger points for red blood cell transfusion. CONCLUSIONS: Despite guidelines on blood transfusion thresholds, restrictive blood transfusion policies were not observed during our study period. After major pancreatic and hepatic surgery, Hb levels recovered without transfusions. This should encourage clinicians to obey the restrictive blood transfusion policies after major hepatopancreatic surgery. SAGE Publications 2020-10-29 2021-09 /pmc/articles/PMC8551432/ /pubmed/33118472 http://dx.doi.org/10.1177/1457496920964362 Text en © The Finnish Surgical Society 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Articles
Lammi, J.P.
Eskelinen, Matti
Tuimala, Jarno
Selander, Tuomas
Saarnio, Juha
Rantanen, Tuomo
Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
title Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
title_full Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
title_fullStr Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
title_full_unstemmed Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
title_short Perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
title_sort perioperative changes in hemoglobin levels during major hepatopancreatic surgery in transfused and non-transfused patients
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551432/
https://www.ncbi.nlm.nih.gov/pubmed/33118472
http://dx.doi.org/10.1177/1457496920964362
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