(Press-News.org) Patients with heart disease who receive transfusions during surgeries do just as well with smaller amounts of blood and face no greater risk of dying from other diseases than patients who received more blood, according to a new Rutgers study.
The research, published in the journal Lancet, measures overall mortality and mortality from cardiovascular disease, cancer and severe infection, and offers new validation to a recent trend toward smaller transfusions.
For the study, led by Jeffrey Carson, chief of the Division of Internal Medicine at Rutgers Robert Wood Johnson Medical School, researchers followed 2,016 patients for as long as four years. Half received larger quantities of transfused blood; half received transfusions that were smaller by as much as two thirds.
Carson and his team found no evidence of increased mortality from cardiovascular disease, cancer or severe infection due to the amount of the blood given after surgery. This study supports Carson's 2011 research published in the New England Journal of Medicine which demonstrated the safety of fewer transfusions in the short term - 60 days - and was one of the driving forces behind a change in blood transfusion practice nationally.
"There has been a steady decline in the amount of blood in transfusions given to patients in the past three to five years," Carson says. "I think it is very reassuring that we have found that using less blood is okay not just from a short term perspective, but also a long term perspective."
In the United States, an estimated 5 million people receive transfusions each year, according to the Centers for Disease Control and Prevention. They include surgery patients; accident, burn and trauma victims; mothers and babies during and after childbirth; and others whose blood counts reach levels low enough to threaten their health.
Carson says physicians performing surgeries and other procedures judge whether blood is needed based on how much they have seen the patient lose and by closely watching vital signs such as blood pressure. If physicians overestimate and provide too much blood, the patient's circulatory system can be overloaded and breathing can be affected.
The risk of infection can also increase. "There are definite risks associated with transfusion," says Carson. "The classic ones are hepatitis and HIV. They are as rare as being hit by lightning, but even so - why give more blood to anyone if you can't show it benefits them?"
Carson - who chaired the American Association of Blood Banks' official guidelines committee in 2012 - says the rule he follows is that fewer transfusions are better than more, as long as rigorous studies show no added health risk. Fewer transfusions also benefit society, he says, by preserving the blood supply and preventing shortages.
Medical experts had worried that larger amounts of transfused blood might suppress immune function - which could lead to death from infection or cancer - or whether smaller transfusions might worsen a patient's chronic heart disease by depriving the heart of oxygen and other nutrients that it might have absorbed by pumping more blood. But in both instances Carson found no difference in long term death rates regardless of the number of transfusions.
There still are health conditions, like heart attacks, that need further research, he says. Preliminary evidence suggests those patients need more blood, not less. "We need additional studies; we need a big trial to settle that question," Carson says.
INFORMATION:
A class of drug for treating arthritis - all but shelved over fears about side effects - may be given a new lease of life, following the discovery of a possible way to identify which patients should avoid using it.
The new study, led by Imperial College London and published in the journal Circulation, sheds new light on the 10-year-old question of how COX-2 inhibitors - a type of non-steroidal anti-inflammatory drug (NSAID) - can increase the risk of heart attack in some people.
NSAIDs - which include very familiar drugs such as ibuprofen, diclofenac and aspirin - are ...
Typhoon Hagupit soaked the Philippines, and a NASA rainfall analysis indicated the storm dropped almost 19 inches in some areas. After Hagupit departed the Philippines as a tropical storm, NASA's Terra satellite passed over and captured a picture of the storm curled up like a cat waiting to pounce when it landfalls in Vietnam on Dec. 11.
The Tropical Rainfall Measuring Mission or TRMM satellite, managed by NASA and the Japan Aerospace Exploration Agency gathered over a week of rainfall data on Hagupit. That rainfall data along with data from other satellites was compiled ...
COLUMBIA, Mo. - Previous cancer research has revealed that women are less likely than men to suffer from non-sex specific cancers such as cancer of the colon, pancreas and stomach. Scientists theorized that perhaps this trend was due to a protecting effect created by female hormones, such as estrogen, that help prevent tumors from forming. Now, researchers at the University of Missouri have found evidence suggesting that the male hormone testosterone may actually be a contributing factor in the formation of colon cancer tumors.
In his study, James Amos-Landgraf, an assistant ...
Ants: Ever since agriculture evolved ca 10.000 years ago, plants have been artificially selected to become the fast growing and highly productive varieties we know today. However, humans were not the first to see merit in cultivating their own food, as ants have been doing this for 50 million years. A lineage of South-American ants collect leaves and recycle their own feces to manure a fungus garden for food. New research shows that these ants have an evolutionary history of improvement of their fungal crops.
A joint effort by researchers at the Universities of Copenhagen ...
ANN ARBOR, Mich. - Urinary tract infections can occur with no apparent cause, and as effectiveness of antibiotics fades, treating them is also becoming less predictable.
University of Michigan Medical School researchers have identified bacterial genes that help the infections spread, providing a potential new target for treating UTIs, a global public health concern mostly affecting women. UTIs lead to lost work time, emergency room visits and health care spending of $3.5 billion in the United States.
The research findings, published in this week's Proceedings of the ...
A new study by Robert Stahelin, an adjunct associate professor of chemistry and biochemistry at the University of Notre Dame and an associate professor at the Indiana University School of Medicine-South Bend, as well as a member of Notre Dame's Eck Institute for Global Health, investigates how the most abundant protein that composes the Ebola virus, VP 40, mediates replication of a new viral particle.
"In brief, the Ebola virus has just seven proteins that encode in its genome," Stahelin said. "VP40 is critical to the formation of a new viral particle and it does this ...
Ads can communicate their main message in as little as a tenth of a second, helped by color, according to a new study published in Marketing Science, a publication of the Institute for Operations Research and the Management Sciences (INFORMS).
The Buffer Effect: The Role of Color When Advertising Exposures Are Brief and Blurred is by Michel Wedel, Pepsico Chaired Professor of Marketing at the Robert H. Smith School of Business of the University of Maryland and Rik Pieters, Professor of Marketing at the Tilburg School of Economics and Management of the University of Tilburg ...
A sex-changing fish called California sheephead (Semicossyphus pulcher) plays a vital role in the food web of kelp forests along the Pacific coast. Commonly found in the waters from Baja California to Point Conception -- although they can sometimes be found as far north as Monterey Bay -- sheephead feed on sea urchins, whose grazing habits can wreak havoc on community composition in kelp forests.
A new study by UC Santa Barbara research biologist Jenn Caselle uses data from three decades of research to document differential exploitation and recovery of sheephead populations ...
Recent research from the University of Alberta reveals that contrary to current scientific knowledge, there's no atmospheric lead pollution in the province's oil sands region.
William Shotyk, a soil and water scientist who specializes in heavy metal pollution, examined sphagnum moss from 21 separate peat bogs in three locations around the oil sands area, near open pit mines and processing facilities.
After measuring the heavy metal content in the moss samples in his ultra-clean lab at the University of Alberta, Shotyk, based in the Faculty of Agricultural, Life and ...
A University of Colorado Cancer Center study being presented at the San Antonio Breast Cancer Symposium shows that triple negative breast cancer cells process tryptophan to promote survival while traveling through the body in order to seed new tumor sites.
"I'm not saying that people with metastatic breast cancer shouldn't eat turkey during the holidays, but triple-negative breast cancer appears to have found a way to process tryptophan more quickly, equipping cancer cells to survive while in circulation, which allows them to metastasize," says Thomas Rogers, the paper's ...
