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Perioperative Blood Transfusions - When, why & outcome in do

  • October 15, 2015 10:58 AM EDT

    This week's Evidence Based Update is Part I of a two part discussion on red blood cell transfusions in clinical practice. A recent paper in the veterinary literature reported on the requirement of red blood cell transfusions for dogs undergoing various surgical procedures and associated outcomes.

    The perioperative period for a patient undergoing a surgical procedure includes the preoperative time frame (leading up to anesthetic induction of the patient), the intraoperative period (from anesthetic induction to surgical closure), and the postoperative period (the first 24 hours following surgery). Reasons or indications for a red blood cell transfusion at any point during the perioperative period include blood loss, anemia from any cause, or the expectation / anticipation of blood loss during a surgical procedure.

    A red blood cell transfusion may be considered for any patient with a low PCV, clinical signs of anemia (tachypnea, tachycardia), and hypotension in spite of intravenous fluid therapy. Furthermore, it's commonly believed that certain surgical procedures may be associated with an increased of risk of associated hemorrhage. Examples include splenectomy, surgeries involving the liver, nasal cavity, lung (pulmonary mass excision), and heart (heart based tumors or vascular anomaly revision).

    In this week's Evidence Based Update the findings reported in a retrospective study that examined perioperative red blood cell (RBC) transfusions in dogs are discussed including:

    • Clinical parameters and recommended monitoring of patients
    • Indications for perioperative red blood cell transfusions
    • Surgical procedure type and association with a need for RBC transfusion
      • Intrabdominal surgeries - stomach, liver, spleen
      • Intrathoracic surgeries - lung, heart, esophagus, mediastinum
      • Others - nasal cavity, thyroid, perineal 
    • Perioperative transfusion effect on outcome and patient survival

    View this Evidence Based Update (running time 11 mins; Approved for CE credit in New York and by the NJVMA, pending approval for CE credit by AAVSB RACE).

  • October 22, 2015 11:40 AM EDT

    Just posted - Part II on the topic of transfusion medicine.  This week the discussion is on autologous blood transfusions (ABT) in dogs including various causes for intracavitary (abdominal or thoracic) hemorrhage, advantages of ABT, how it's performed, complications, and outcomes for patients that receive autologous blood transfusions based on findings of a recent retrospective study published in the Journal of Veterinary Emergency and Critical Care.  

    View this Evidence Based Update - Autologous Blood Transfusions in Dogs (running time 11 mins)