Sex‐mismatched red blood cell transfusions and mortality: A systematic review and meta‐analysis
Michelle P. ZellerBram RochwergErin JamulaNa LiChristopher HillisJason P. AckerRyan J. R. RuncimanShannon LaneNaveen AhmedDonald M. ArnoldNancy M. Heddle
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Background and Objectives Selection of a compatible red blood cell ( RBC ) unit does not include matching for donor sex. This systematic review and meta‐analysis aims to summarize the evidence examining the impact of sex‐mismatched RBC transfusion on recipient mortality. Materials and Methods Ovid MEDLINE , Ovid EMBASE , CINAHL , PubMed, Web of Science and the Cochrane Database of Systematic Reviews were searched from inception up to 23 November 2018. Randomized controlled trials and observational studies were included in the search. Eligible studies reported on the impact of sex‐matched compared to sex‐mismatched RBC transfusion on recipient mortality. Two investigators independently extracted data and assessed study quality. A three‐level meta‐analytic model was applied to emphasize the unknown dependence among the effect sizes. Results Five retrospective observational studies ( n = 86 737) were included; no RCT s were found. Sex‐mismatched RBC transfusions were associated with a higher risk of death compared with sex‐matched transfusions (pooled hazard ratio [ HR ]: 1·13; 95% confidence interval [ CI ]: 1·02–1·24). In the subgroup of cardiovascular surgery ( n = 57 712), there was no significant increase in mortality with sex‐mismatched transfusions (pooled HR : 1·08; 95% CI : 0·95–1·22). The data were prone to confounding, selection bias and reporting bias. Certainty of the evidence was very low. Conclusion Sex‐mismatched RBC transfusions were associated with an increased risk of death in this pooled analysis. However, the certainty of the evidence was very low from observational studies. The need to match donor and recipient sex for transfusions requires further investigation because of the potential widespread impact.Objective:To discuss the efficiency of red blood cell transfusion in order to provide the basis for the clinical reasonable effective blood transfusion.Method:The transfusion conditions and effects of 1056 patients received red blood cell transfusion from January, 2010 to December period were retrospectively analyzed.Result:Red blood cell transfusion effectiveness was 85.5%. There was invalid blood transfusion phenomenon in the majority of clinical departments. The effective blood transfusion rate of pediatrics department was highest (100%), while of surgical department was lowest (82.1%).Transfusion effectiveness had no relation with sex and age, and decreased with the increases of the blood transfusion number.Conclusion:Clinical safe, reasonable individuation blood transfusion plan would be helpful to enhance the efficiency of red blood cell transfusion.
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Red blood cells are ideal vehicles for delivering oxygen to tissues, but their functions deteriorate during liquid preservation. In this article, we review the role of red blood cells in oxygen delivery and methods to evaluate the effectiveness of red blood cell transfusion. Quantitative estimation of transfusion effects could avoid unnecessary transfusion and reduce the risk of transfusion-associated disorders. We also describe the benefits of transfusion of red blood cells having a higher oxygen-delivering capacity. Phosphoenolpyruvate is a promising component to prepare red blood cells having a higher oxygen-delivering capacity.
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SUMMARY The aim of the present article is to summarize existing evidence of benefits of red blood cell transfusion and to dicuss studies that failed to document such effects. In specific situations with organ dysfunction caused by extreme acute anemia, transfusion of red blood cells has been shown to be an efficacious treatment. In most of these studies, this was achieved by transfusion of fresh, mostly autologous, red blood cells. Large studies have failed to demonstrate an outcome benefit in liberally transfused patients; in contrast, there is strong evidence that liberal transfusion of red blood cells adversely affects morbidity and mortality in surgical and critically ill patients. Judicious and restrictive use of red blood cell transfusion is thus indicated.
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Abstract Red blood cells are ideal vehicles for delivering oxygen to tissues, but their functions deteriorate during liquid preservation. In this article, we review the role of red blood cells in oxygen delivery and methods to evaluate the effectiveness of red blood cell transfusion. Quantitative estimation of transfusion effects could avoid unnecessary transfusion and reduce the risk of transfusion‐associated disorders. We also describe the benefits of transfusion of red blood cells having a higher oxygen‐delivering capacity. Phosphoenolpyruvate is a promising component to prepare red blood cells having a higher oxygen‐delivering capacity.
Red Cell
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Blood cell
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Red blood cell transfusion is an important method to treat anemia of prematurity.However, there are 3 areas of controversy: (1) complications associated with red blood cell transfusion in preterm infants; (2) indications of red blood cell transfusion in preterm infants; (3)which kind of red blood cell products is more suitable for preterm infants.In recent years, with the deepening of research, these problems above have made some new progress and they have been applied to clinic.The implementation of these ideas and measures makes the premature infants with anemia get reasonable treatment, and reduces incidence of complications associated with red blood cell transfusion in preterm infants, and improves the prognosis of those sick preterm infants.Now, the new progress of red blood cell transfusion in preterm infants was reviewed.
Key words:
Infant, preterm; Red blood cell transfusion; Complication
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Objective To investigate the clinical factors affecting RBC transfusion,and invalid red blood cell transfusion corresponding clinical counter measures.Methods A retrospective analysis of September 2009-September 2011 Department of Hematology in our hospital 926 cases of red blood cell transfusion clinical data collation,analysis of clinical factors affecting red blood cell transfusion.Results A total of 926 patients were given red blood cell transfusion 1289 times,194 times invalid infusion,invalid infusion rate 15.05%;And two Logistic Regression analysis:multiple transfusions,multiple pregnancies,with 2 or more autoimmune diseases and red blood cell products storation time are factors affecting red blood cell transfusion.Conclusions Invalid red blood cell transfusion rate is high,in clinical work,strict control of red blood cell transfusion indications and take appropriate preventive measures can effectively prevent the occurrence of red blood cell transfusion.
Hematology
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Objective To evaluate the clinical factors associated with red blood cell transfusion effectiveness.Methods446 patients(566 transfusions) received red blood cell transfusion from Jan 2008 to Jun 2010 were analyzed retrospectively.807 and 85 patients were in the effective transfusion and ineffective transfusion group respectively.The potential factors associated with red blood cell transfusion effectiveness were evaluated by the method of Logistic regression.Results The single factor analysis showed that blood transfusion history(χ2= 81.49,P = 0.00),the infection(χ2= 33.32,P =0.00),the splenohepatomegalia(χ2= 4.81,P = 0.03),and the malignant disease(χ2= 105.7,P = 0.00) were associated with the effectiveness of red blood cell transfusion.Binary conditional logistic regression analysis showed that the blood transfusion history(OR = 2.41,P = 0.001) and the malignant disease(OR = 2.86,P = 0.00) were independent factors for effectiveness of red blood cell transfusion.Conclusion The patients with blood transfusion history and malignant disease were at the high risk for ineffectiveness of red cell blood transfusion.
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Abstract Background Results of new studies should be interpreted in the context of what is already known to compare results and build the state of the science. This systematic review and meta-analysis aimed to identify and synthesise results from meta-research studies examining if original studies within health use systematic reviews to place their results in the context of earlier, similar studies. Methods We searched MEDLINE (OVID), EMBASE (OVID), and the Cochrane Methodology Register for meta-research studies reporting the use of systematic reviews to place results of original clinical studies in the context of existing studies. The primary outcome was the percentage of original studies included in the meta-research studies using systematic reviews or meta-analyses placing new results in the context of existing studies. Two reviewers independently performed screening and data extraction. Data were synthesised using narrative synthesis and a random-effects meta-analysis was performed to estimate the mean proportion of original studies placing their results in the context of earlier studies. The protocol was registered in Open Science Framework. Results We included 15 meta-research studies, representing 1724 original studies. The mean percentage of original studies within these meta-research studies placing their results in the context of existing studies was 30.7% (95% CI [23.8%, 37.6%], I 2 =87.4%). Only one of the meta-research studies integrated results in a meta-analysis, while four integrated their results within a systematic review; the remaining cited or referred to a systematic review. The results of this systematic review are characterised by a high degree of heterogeneity and should be interpreted cautiously. Conclusion Our systematic review demonstrates a low rate of and great variability in using systematic reviews to place new results in the context of existing studies. On average, one third of the original studies contextualised their results. Improvement is still needed in researchers’ use of prior research systematically and transparently—also known as the use of an evidence-based research approach, to contribute to the accumulation of new evidence on which future studies should be based. Systematic review registration Open Science registration number https://osf.io/8gkzu/
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