Research Proposal on "Bloodless Surgery"
Research Proposal 6 pages (1770 words) Sources: 4 Style: APA
[EXCERPT] . . . .
Bloodless SurgeryBlood transfusion is a life saving intervention for many seriously injured patients, patients undergoing complex invasive surgeries, people with hemophilia and other blood related diseases. More recently though, the focus has shifted on the potential side effects of blood transfusion including allogenic transfusion associated with sepsis, immunosupression, and other complications including multiple organ dysfunction syndrome, respiratory distress syndrome, etc. The growing literature in the field of blood transfusion has contributed to an increase in our understanding of the negative consequences of blood transfusion. Some recent studies have also ascribed a possible role of blood transfusion in the onset of atrial fibrillation post cardiac surgery. In particular, the role of blood transfusion in increasing the inflammatory response post surgery as a contributory mechanism in the development of new onset atrial fibrillation is now studied more seriously. Some studies have also indicated a high risk for developing septic complications in trauma patients receiving blood transfusion that is independent of the injury severity. Overall, these studies have recommended a restrictive strategy of red blood cells transfusion to minimize the side effects. A brief review of some recent research studies pertaining to the blood transfusion, discussion of the methods and clinical significance of the results would help provide better insight into this important medical topic.
Red Blood Cell Transfusion (Review of studies)
Blood transfusion is a life saving intervention for many but it also has some serious side effects. One recent study by Hassan et.a
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l (2009) focused on the possible effects of red blood transfusion on the onset of atrial fibrillation (AF) post cardiac surgery. Statistics suggest that new onset atrial fibrillation occurs in 10 to 43% of all patients who underwent cardiac surgery. Though atrial fibrillation is well recognized as a postoperative complication in some patients who underwent Coronary Artery Bypass Graft (CABG), the causative mechanisms have not been clearly understood. The study researchers hypothesized that the increase in plasma concentrations of the inflammatory mediators due to red blood cells transfusion may be implicated in the new onset AF. To prove this hypothesis, the researchers included a total of 1692 patients who had undergone CABG at the Imam Khomeini Medical Center, at the Tehran University of medical sciences between Jan 2005 and July 2007. All the patients were regularly monitored for their heart rhythm in the ICU and the postoperative ward and long lead 11 was recorded upon identification of any irregular pattern. Based on this, patients were segregated into two groups -- those with new onset AF and those without AF irrespective of the use of blood transfusion. Also for those patients who had blood transfusion, the amount of transfusion products used was also noted down from hospital records.download full paper ⤓
Of the 487 patients who had received blood transfusion, 223 (45.9%) developed AF. AF was also manifest in 571 (37.9%) of the 1508 patients who did not receive blood transfusion. After adjusting the study results for age and previous history of AF, it transpires that blood transfusion in the ICU had a direct impact on developing AF. (odds ratio unit transfused, 1.16; 95% confidence limits, 1.14, 1.24; P<