Blood Transfusion
Conditions
Keywords
blood loss，transfusion，oncological surgery
Brief summary
Investigators aimed to compare the effect on different indications (blood volume loss based VS hemoglobin concentration based ) based blood transfusion practices in patients undergoing major oncological surgery for pelvic or spinal tumor and investigate their postoperative complications.
Detailed description
260 patients underwent major oncological surgery for open pelvic or spinal tumor resection were included in this study. We looked at white blood cells, hemoglobin, hematocrit, neutrophil ratio, C-reactive protein, erythrocyte sedimentation rate, and IL-6 levels 1 day, 3 days, and 7 days after surgery The main question it sought to answer was whether there was a difference in postoperative complications 30 days after surgery between patients who received blood transfusions based on volume loss and those who received blood transfusions based on hemoglobin concentration during surgery.
Interventions
PROCEDUREblood volume loss based blood transfusion
Blood transfusion is indicated based on the estimated intraoperative blood loss. When intraoperative blood loss exceeds 400ml, blood transfusion begin. At the end of the operation, we ensure that the volume of blood transfusion is no greater than the anticipated blood loss.
PROCEDUREhemoglobin concentration based blood transfusion
Blood transfusion is indicated based on the intraoperative hemoglobin concentration. Intraoperative blood transfusion begins when hemoglobin concentration is blow 70g/L. Intraoperative blood transfusion stops when hemoglobin concentration reaches 80g/L
Sponsors
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* age between 18 and 70 * patients with pelvic or spinal tumor * conduct open resection surgery for tumor removal * with expected surgery duration greater than 3 hours * with expected blood loss greater than 400 ml
Exclusion criteria
* age \< 18 or \>70 * Limb tumor patients or patients with pelvic and spinal tumors undergoing closed internal fixation or vertebroplasty or minimally invasive surgery * received chemotherapy or immunotherapy before surgery * with expected surgery length less than 3 hours * with expected intraoperative blood loss less than 400ml
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| percentage of the postoperative complication | patients were carefully followed for complication occurrence 1 month after surgery. | Major postoperative complications include but are not limited to surgical site infection, lung infection, deep vein thrombosis, pressure ulcers and so on |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| length of hospital stay | during hospitalization after surgery, an averagy of 1 week | Number of days patients stay in hospital after surgery. |
| White blood cell count | 1 day，3 days，7 days，and 30 days after surgery | White blood cell count was measured in patients 1 day, 3 days, and 7 days and 30 days after surgery. |
| hemoglobin level | 1 day，3 days，7 days，and 30 days after surgery | hemoglobin level was measured in patients 1 day, 3 days, and 7 days and 30 days after surgery. |
| hematocrit | 1 day，3 days，7 days，and 30 days after surgery | hematocrit was measured in patients 1 day, 3 days, and 7 days and 30 days after surgery. |
| transfusion of red packed blood cells | during hospitalization after surgery, an averagy of 1 week | total volume of blood transfusion calculated after surgery |
| C-reactive protein | 1 day，3 days，7 days，and 30 days after surgery | C-reactive protein was measured in patients 1 day, 3 days, and 7 days and 30 days after surgery. |
| erythrocyte sedimentation rate | 1 day，3 days，7 days，and 30 days after surgery | erythrocyte sedimentation rate was measured in patients 1 day, 3 days, and 7 days and 30 days after surgery. |
| nterleukin-6 level | 1 day，3 days，7 days，and 30 days after surgery | Interleukin-6 level was measured in patients 1 day, 3 days, and 7 days and 30 days after surgery. |
| neutrophil ratio | 1 day，3 days，7 days，and 30 days after surgery | the neutrophil ratio was measured in patients 1 day, 3 days, and 7 days and 30 days after surgery. |
Contacts
Primary ContactXiaobo Yan, MD
Outcome results
None listed