The impact of massive intraoperative RBC transfusion on laboratory results and prognosis in patients underwent surgery for malignancies
Journal Title: Chinese Journal of Blood Transfusion - Year 2022, Vol 35, Issue 6
Abstract
Objective To explore the effects of massive intraoperative RBC transfusion on multiple clinical test indicators and prognosis of patients, underwent tumor surgery in order to provide evidence for rational blood transfusion and effective intervention of complications caused by massive blood transfusion in tumor patients. Methods A total of 208 patients who underwent tumor resection in our hospital from January 2019 to December 2020 and received intraoperative RBC transfusion(>10 U) were selected as the study subjects. According to the amount of blood transfusion, they were divided into group A: 10~15 U, 144 patients; Group B: >15~25 U, 48 people; Group C: >25 U, 16 people. Data of liver function, coagulation, electrolyte, platelet count and short-term prognosis were collected and compared among 3 groups before and after surgery. Results No significant difference was noticed in patient pre-operation variables including ALT (U/L), AST (U/L) and TBIL (μmol/L) among three groups recieved massive blood transfusion (P>0.05), while AST was significantly lower than that after operation (P<0.05) : 105.33±238.18 vs 113.50±185.04 vs 291.25±457.33 (P<0.05). After operation, PT (s) (14.12±2.10, 14.79±2.67 and 16.10±4.06), INR(1.25±0.20, 1.31±0.26 and 1.44±0.38) and APTT (s) (30.52±5.63, 34.57±12.80 and 34.80±10.49) extended significantly than those before operation (P<0.05), while Plt (×109/L) decreased significantly (142.32±70.07, 100.04±57.50 and 85.40±41.10)(P<0.05). After operation, serum K+ and Ca2+ decreased significantly, Na+ and Cl- increased significantly, and pH value decreased (P < 0.05). Hospital stay of group C (d) was 33.73±34.62 vs 17.74±14.83 vs 20.92±17.69 (P<0.05). The mortality rate was 2.8%(4/44) vs 6.3%(3/48) vs 18.8%(3/16)(P<0.05), and mortality rate of group C was higher than the other two groups. Conclusion Postoperative dysfunction of liver and coagulation in tumor patients may be related to intraoperative RBC transfusions and consequent acid-base imbalance and electrolyte disturbance. The more the units of RBC transfused, the more abnormal the patients' clinical indicators, also the longer the hospital stay and the worse the short-term prognosis.
Authors and Affiliations
Xuezi WENG, Zhoupei MO, Yongneng LIANG, Miaola KE, Wenqian LIN
Keywords
Related Articles
- EP ID EP738262
- DOI 10.13303/j.cjbt.issn.1004-549x.2022.06.004
- Views 33
- Downloads 0
Evaluation of CLIA plus NAT for detecting HBsAg single-ELISA-reactive samples of blood donors
Objective To study the detection performance of HBsAg single-ELISA-reactive samples of blood donors. Methods Two kinds of ELISA reagents from different manufacturers (named as reagents A and B) were used for HBsAg screen...
Establishment of a multi-rule quality control mechanism for blood nucleic acid screening results based on Poisson distribution
Objective To establish a quality control mechanism based on the Poisson distribution for monitoring contamination in nucleic acid testing (NAT) laboratories. Methods The study collected NAT single-reactivity rates and di...
In vitro quality evaluation of leucocyte-reduced pooled platelet concentrates prepared from whole blood stored at 4℃
Objective To investigate the feasibility of leucocyte-reduced pooled platelet concentrates from whole blood stored at 4℃, and provide theoretical basis for the components preparation. Methods The collected 400 mL ACD-B a...
Effect of ion-exchange chromatography on removal of fibronectin in von Willebrand factor
Objective To study the removal effect of fibronectin(Fn) from von willebrand factor(vWF) by ion-exchange chromatography through processing human coagulation factor Ⅷ chromatographic washing products, in order to select a...
Double plasma molecular adsorption system and sequential half-dose plasma exchange improves short-term prognosis of patients with hepatitis B associated acute-on-chronic liver failure
Objective To investigate the effect of double plasma molecular adsorption system and sequential half-dose plasma exchange (DPMAS+HPE) on the short-term survival rate of patients with hepatitis B associated acute-on-chron...