1.
The safty profile of blood salvage applied for collected blood with amniotic fluid during cesarean section
Rong X, Guo X, Zeng H, Wang J, Li M, Wang Y
BMC pregnancy and childbirth. 2022;22(1):160
Abstract
BACKGROUND The guidelines of National Health Service(NHS, the United Kingdom) recommended for use in obstetrics at increased risk of bleeding, requiring two suction devices to reduce amniotic fluid contamination, however, when comes to massive hemorrhage, it is may difficult to operate because the complex operation may delay time. The aim of the study was to detect the effect of amniotic fluid recovery on intraoperative cell salvage in obstetrics and provide evidence for clinical applications. METHOD Thirty-four patients undergoing elective cesarean section were randomly divided into two groups. In group 1, the cumulative blood from the operation field, including the amniotic fluid, was collected using a single suction device for processing. In group 2, after suctioning away the amniotic fluid using another suction device for the cumulative blood from the operation field. From each group, four samples were taken, including maternal venous blood (sample I), blood before washing (sample II), blood after washing (sample III) and blood after filtration with a leukocyte filter (sample IV), to detect serum potassium (K +), hemoglobin (Hb), white blood cell (WBC), fetal hemoglobin (HbF), alpha fetoprotein (AFP) and squamous cell (SC) levels. RESULTS The AFP, K + and WBC levels of sample III and sample IV were significantly lower than sample I in group 1 and group 2 (P < 0.05). Significantly more SCs were found in sample III than in sample I in group 1 and group 2 (P < 0.05), but SCs of sample IV had no statistical difference compared to sample I in group 1 and group 2 (P > 0.05). There was no significant difference in the K + , Hb, WBC, AFP and SC levels of sample IV between group 1 and group 2 (P > 0.05). The HbF levels of sample III and sample IV were significantly higher in group 1 than in group 2 (P < 0.05). CONCLUSION There is little or no possibility for AF contamination to enter the re-infusion system when used in conjunction with a leucodepletion filter. For maternal with Rh-negative blood, we recommend two suction devices to reduce HbF pollution. TRIAL REGISTRATION ChiCTR1800015684 , 2018.4.15.
2.
Efficacy and safety of autologous blood products compared with corticosteroid injections in the treatment of lateral epicondylitis, a meta-analysis of randomized controlled trials
Qian X, Lin Q, Wei K, Hu B, Jing P, Wang J
Pm & R : the Journal of Injury, Function, and Rehabilitation. 2016;8((8):):780-91
Abstract
OBJECTIVE To compare the efficacy and safety between autologous blood products (ABPs) and corticosteroid injections (CSIs) in the treatment of lateral epicondylitis (LE). TYPE Meta-analysis. LITERATURE SURVEY We systematically searched the EMBASE, PubMed, the Cochrane Library and Web of Science to identify randomized controlled trials (RCTs) comparing ABPs versus CSIs for the treatment of LE without language and publication date restriction through April 2015. METHODOLOGY Two investigators independently included and assessed the quality of each eligible study according to the method recommended by the Cochrane Collaboration. Available data about the main outcomes were extracted from each study and heterogeneity was assessed using the Q statistic and the inconsistency index (I2). We also evaluated the publication bias and conducted a subgroup analysis. The Review Manager 5.2 software was used for data syntheses and analyses, the standardized mean difference (SMD) or mean difference (MD) were estimated by using random effects models with 95% confidence interval (CI). To investigate the efficacy among different trial durations, the follow-up times were therefore divided into short (2-4 weeks), intermediate (6-24 weeks) and long term (≥ 24 weeks). SYNTHESIS Ten RCTs (n = 509) were included in this meta-analysis. The pooled analysis showed that CSIs were more effective than ABPs on pain relief (SMD = 0.88; 95% CI = 0.31to1.46%; P = .003) in the short term. However, in the intermediate term, ABPs exhibited a better therapeutic effect for pain relief (SMD = -0.38; 95% CI = -0.70 to -0.07%; P = .02), function (SMD = -0.60; 95% CI = -1.13 to -0.08%; P = .03), DASH (MD = -11.04; 95% CI = -21.72 to -0.36%; P = .04), and Nirschl stage (MD = -0.81; 95% CI = -1.11 to -0.51%; P < .0001). In the long term, ABPs were superior to CSIs for pain relief (SMD = -0.94; 95% CI = -1.32 to -0.57%; P < .0001) and Nirschl stage (MD = -1.04; 95% CI = -1.66 to -0.42%; P = .001). Moreover, for grip strength recovery, there was no significant difference between the two therapies (p > .05). CONCLUSIONS There was limited evidence supporting the conclusion that CSIs were superior to ABPs for pain relief in the short term; however, this result was reversed in the intermediate and long term. ABPs seemed to be more effective at restoring function in the intermediate term. Due to the small sample size and the limited number of high-quality RCTs, more high-quality RCTs with large sample sizes are required to further validate this result.