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Titolo:
The influence of homologous blood transfusion on immunity and clinical outcome in aortic surgery
Autore:
Haynes, SL; Wong, JCL; Torella, F; Dalrymple, K; Pilsworth, L; McCollum, CN;
Indirizzi:
S Manchester Univ Hosp, Acad Surg Unit, Manchester M20 2LR, Lancs, EnglandS Manchester Univ Hosp Manchester Lancs England M20 2LR R, Lancs, England
Titolo Testata:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
fascicolo: 3, volume: 22, anno: 2001,
pagine: 244 - 250
SICI:
1078-5884(200109)22:3<244:TIOHBT>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLORECTAL-CANCER; MAJOR SURGERY; INFECTION; ELASTASE; COMPLICATIONS; METAANALYSIS; NEUTROPHIL; RECURRENCE; RESPONSES; MORTALITY;
Keywords:
transfusion; aortic surgery; immune response; morbidity and mortality;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Haynes, SL S Manchester Univ Hosp, Acad Surg Unit, Manchester M20 2LR, Lancs, England S Manchester Univ Hosp Manchester Lancs England M20 2LR ngland
Citazione:
S.L. Haynes et al., "The influence of homologous blood transfusion on immunity and clinical outcome in aortic surgery", EUR J VAS E, 22(3), 2001, pp. 244-250

Abstract

Objectives: to evaluate the influence of homologous blood transfusion oil immune responses and post-operative morbidity ill aortic surgery. Design: analysis of the effects of homologous blood transfusion in 128 patients in a prospective randomised trial evaluating homologous and autologous blood transfusion in aortic surgery. Materials and methods: blood sampled before and at five times after surgery was assayed for C-reactive protein (CRP), neutrophil elastase, TNF-alpha,and IL-6. Transfusions, morbidity and mortality were recorded;;factors associated with poor outcome were identified by logistic regression. Results: homologous transfusion during surgery was required in 32 patientsand precipitated an increase in neutrophil elastase (p = 0.008) and TNF-alpha (p = 0.015) but not IL-6 and CRP. Elastase peaked early in transfused patients at 41.27 (13.92-52.11) Delta ng/ml by 2 h compared to a peak of 21.51 (10.64-31.13) Delta ng/ml by 24 h in those who were not transfused TNF-alpha peaked at 1.2 (0-4.33) Delta pg/ml by wound closure in transfused patients and at -0.1 (-2.05-2.52) Delta pg/ml by 2 h without transfusion. Intra-operative homologous transfusion was associated with increased mortality (p=0.01) and prolonged intensive care stay (p = 0.03). Mortality increased with age (p, = 0.003) and Was inversely related to the CRT peak (p = 0.007). Prolonged surgery predicted post-operative complications (p = 0.025). Conclusion: homologous transfusion increased the inflammatory response to aortic surgery and was associated with mortality.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 09:48:23