Dataset Information

Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study.

ABSTRACT:

Purpose

This study was conducted to time-course changes of clotting function of withdrawing blood for acute normovolemic hemodilution (ANH).

Methods

Twelve enrolled patients who underwent ANH from August, 2018 to January, 2019. Blood was withdrawn into blood collection pack and shaken at 60-80 rpm for 24 h in room temperature. Clot formation was evaluated using rotational thromboelastometry (ROTEM™) just after blood withdrawal (control) and 4, 8, 12 and 24 h after blood withdrawal. We compared with the control value and each value of extrinsically-activated test with tissue factor (EXTEM), intrinsically-activated test using ellagic acid (INTEM) and fibrin-based extrinsically activated test with tissue factor (FIBTEM).

Results

Maximum clot firmness (MCF) of FIBTEM did not change significantly. MCF of EXTEM was significantly decreased time-dependent manner but all MCF of EXTEM were within a normal range. Maximum percent change in MCF of EXTEM was 12.4% [95% confidence interval (CI): 9.0-15.8%]. The difference in the maximum clot elasticity (MCE) between EXTEM and FIBTEM (MCE_EXTEM-MCE_FIBTEM) was significantly decrease from 8 h after blood withdrawal. Maximum percent change in MCE_EXTEM-MCE_FIBTEM was 30.2% (95% CI:17.6-42.9%) at 24 h after blood withdrawal.

Conclusion

Even though the MCE significantly decreased in a time-dependent manner, MCF of FIBTEM and EXTEM was normal up to 24 h storage. The blood of ANH can use for the purpose of hemostasis at least 8 h stored at room temperature after blood withdrawal. Future studies are needed to elucidate the clinical impact on the patient after delayed transfusion of ANH blood with regard to patient's hemostasis.

SUBMITTER: Kinoshita H

PROVIDER: S-EPMC7840648 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study.

Kinoshita Hirotaka H Saito Junichi J Nakai Kishiko K Noguchi Satoko S Takekawa Daiki D Tamai Yoshiko Y Kitayama Masato M Hirota Kazuyoshi K

Journal of anesthesia 20200925 1

<h4>Purpose</h4>This study was conducted to time-course changes of clotting function of withdrawing blood for acute normovolemic hemodilution (ANH).<h4>Methods</h4>Twelve enrolled patients who underwent ANH from August, 2018 to January, 2019. Blood was withdrawn into blood collection pack and shaken at 60-80 rpm for 24 h in room temperature. Clot formation was evaluated using rotational thromboelastometry (ROTEM™) just after blood withdrawal (control) and 4, 8, 12 and 24 h after blood withdrawal ...[more]

PMID: 32975715

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Project description:ObjectiveTo describe oncologic outcomes after using acute normovolemic hemodilution (ANH) to reduce requirement for allogenic red blood cell transfusions (ABT) in patients undergoing primary debulking surgery (PDS) for advanced ovarian cancer.MethodsWe performed a post-hoc analysis of a recent prospective trial investigating the safety and feasibility of ANH during PDS for advanced ovarian cancer. We report long-term survival outcomes. We compared demographics, clinicopathological characteristics, survival outcomes in this cohort of Stage IIIB-IVB high-grade serous ovarian cancer patients undergoing ANH (ANH group), with a retrospective cohort of all other patients (standard group) undergoing PDS during the same time period (01/2012-04/2017). Standard statistical tests were used.ResultsThere were no demographic or clinicopathological differences between ANH (n = 33) and standard groups (n = 360), except for higher median age at diagnosis (57 vs. 62 years, respectively; p = 0.044) and shorter operative time (357 vs. 446 min, respectively; p < 0.001) in the standard group. Cytoreductive outcomes (ANH vs. standard): 0 mm, 69.7 vs. 63.9%; gross residual disease (RD) ≤1 cm, 21.2 vs. 26.9%; >1 cm, 9.1 vs. 9.2% (p = 0.78). RD after PDS was the only independent factor associated with worse progression-free survival (PFS) on multivariable analysis (p < 0.001). Patients with BRCA mutations trended towards improved PFS (p = 0.057). Significant factors for overall survival (OS) on multivariable analysis: preoperative CA125 (p = 0.004), ascites (p = 0.018), RD after PDS (p = 0.04), BRCA mutation status (p < 0.001). After adjustment for potential confounders, ANH was not independently associated with PFS or OS [PFS: HR 0.928 (0.618-1.395); p = 0.721; OS: HR 0.588 (95%CI: 0.317-1.092); p = 0.093].ConclusionsANH is an innovative approach in intraoperative management. It was previously proven to decrease need for ABT while maintaining the ability to achieve complete gross resection and associated benefits.

Dataset Information

Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study.

Purpose

Methods

Results

Conclusion

Publications

Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study.

Similar Datasets

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