(Press-News.org) OKLAHOMA CITY – A University of Oklahoma study published Sept. 3 in JAMA Surgery reports that acute normovolemic hemodilution (ANH) – a blood-saving method in which a patient’s blood is collected before going on heart-lung bypass and reinfused near the end of cardiac surgery – remains underused in the United States at 14.7%. Yet the study found that ANH lowered the likelihood of a transfusion by 27%, a decrease in blood use that could cut costs substantially while still protecting patient safety and outcomes.
Global demand for cardiac surgery is increasing, with more than 1 million procedures performed annually worldwide. In high-income countries like the United States, cardiac surgery remains the largest consumer of blood products, with 30% to 50% of patients receiving red blood cell transfusions.
The lead author of the study, Kenichi Tanaka, M.D., professor and chair of the Department of Anesthesiology at the University of Oklahoma College of Medicine, said he hopes the study jump-starts a new conversation about the validity of ANH in the United States. An international study published earlier this summer in the New England Journal of Medicine showed that ANH does not reduce the need for red blood cell transfusions. However, less than 5% of participants were from the United States, and U.S. patients differ in several important ways.
“We know that patients receiving ANH have survival rates and duration of hospitalization similar to those who receive transfusions, but I believe we are improving resource utilization by performing ANH,” Tanaka said. “That is especially true when we take a bleeding patient to the ICU, where we tend to use more resources, therefore leading to higher costs.
“Blood may look reasonably inexpensive compared to some of the medications we use every day, but when you think about how blood is administered, there are multiple steps involved, including testing and typing the blood, before we even purchase it,” he added. “Our study estimates that these costs associated with blood processing are almost three times higher than just the cost of acquiring the blood.”
In addition to a 27% lower chance of a blood transfusion among those receiving ANH, the study showed that platelet usage was lower in the ANH group. This is clinically significant, as platelets begin to lose functionality if stored in a blood bank for more than a few days.
“Most heart surgery patients are on aspirin prior to their procedures,” Tanaka said, “but with ANH, we can preserve the patient’s own platelets and protect them from damage caused by the heart-lung machine, allowing them to function more effectively at the end of surgery.”
The retrospective study analyzed 16,795 patients from 52 sites in the United States. ANH was performed at 28 sites, representing 2,463 cases, or 14.7%. A limitation of the study is that there is no standardized protocol for ANH, so the study team did not know how much blood was removed nor how much solution was given to maintain a normal volume while the patient was on bypass, Tanaka said.
Tanaka said he plans to continue performing ANH and hopes other centers start using it as well. Future research could combine ANH with clotting factor concentrates, which has been shown to reduce the need for transfusions.
“Even a small reduction in blood usage could significantly impact overall demand, particularly given the rising cost of blood components and the more than 300,000 adult cardiac surgical cases performed annually in the U.S.,” he said. “Blood donations are also declining, making an effort to reduce transfusions even more important.”
###
About the University of Oklahoma
Founded in 1890, the University of Oklahoma is a public research university with campuses in Norman, Oklahoma City and Tulsa. As the state’s flagship university, OU serves the educational, cultural, economic and health care needs of the state, region and nation. In Oklahoma City, OU Health Sciences is one of the nation’s few academic health centers with seven health profession colleges located on the same campus. OU Health Sciences serves approximately 4,000 students in more than 70 undergraduate and graduate degree programs spanning Oklahoma City and Tulsa and is the leading research institution in Oklahoma. For more information about OU Health Sciences, visit www.ouhsc.edu.
END
Using the first complete dataset of more than 415 million buildings across 50 countries in sub-Saharan Africa, researchers at the University of Chicago created an unprecedented approach to urban development, down to each street block.
The new analysis, published this week in Nature, pinpoints where rapidly developing nations lack “last mile” infrastructure and access to public services. It uses high-resolution data to measure street access to each building across the subcontinent, showing ...
The first complete activity map of the brain has been unveiled by a large international collaboration of neuroscientists. The International Brain Laboratory (IBL) researchers published their findings today in two papers in Nature, revealing insights into how decision-making unfolds across the entire brain in mice at the resolution of single cells. This brain-wide activity map challenges the traditional hierarchical view of information processing in the brain and shows that decision-making is distributed across many regions in a highly coordinated ...
ANN ARBOR, Mich. – Children with sickle cell disease are more likely to have dental problems — but fewer than half of those covered by Michigan Medicaid got dental care in 2022, according to a new study.
The findings, led by Michigan Medicine and non-profit RAND Corporation, appear in JAMA Network Open.
“Sickle cell disease is known to increase the risk of dental complications in children, which underscores the importance of preventive dental care for this population,” said senior author Sarah Reeves, Ph.D., M.P.H., an associate professor of pediatrics ...
PRINCETON, NJ - Mice turning tiny steering wheels to move shapes on a screen have helped scientists produce the first brain-wide map of decision-making at single-cell resolution in a mammal.
For decades, most neuroscience studies have focused on small clusters of cells in isolated brain regions.
“But this method is flawed,” said Ilana Witten, Ph.D., a professor of neuroscience at Princeton University and a Howard Hughes Medical Institute investigator. “The brain is constantly making decisions during everyday ...
To the point:
Small fold – big role: A tissue fold known as the cephalic furrow, an evolutionary novelty that forms between the head and the trunk of fly embryos, plays a mechanical role in stabilizing embryonic tissues during the development of the fruit fly Drosophila melanogaster.
Combining theory and experiment: Researchers integrated computer simulations with their experiments and showed that the timing and position of cephalic furrow formation are crucial for its function, preventing mechanical instabilities in the embryonic tissues.
Evolutionary response ...
A new IIASA-led study for the first time maps safe areas that can practically be used for underground carbon storage, and estimates that using them all would only cut warming by 0.7°C. The result is almost ten times lower than previous estimates of around 6°C, which considered the total global potential for geological storage, including in risky zones, where storing carbon could trigger earthquakes and contaminate drinking water supplies. The researchers say the study shows geological storage is a scarce, finite resource and warn countries must use ...
A new study has revealed a "hidden extinction crisis" in China's flora, showing that habitat decline over the past four decades has sharply increased extinction risks nationwide. The findings, published in One Earth on September 3, suggest that current conservation efforts are failing to keep pace with biodiversity threats.
Led by Dr. SHEN Guozhen from the Institute of Botany of the Chinese Academy of Sciences, along with international collaborators, the researchers combined satellite-based land-cover data (1980–2018) with species-composition models to quantify—for ...
“My body is all used up, and I have no will left to live.” Those are the first words of a new essay written by Cold Spring Harbor Laboratory Associate Professor Tobias Janowitz. They’re the words of his late mother during the final days of her life. “A perceptive woman who survived a childhood shaped by war, malnutrition, and displacement, she was not given to complaint. Her words reflected insight and recognition, not resignation,” Janowitz writes.
In a new essay published in the journal Neuron, Janowitz dives into our current understanding of a condition called cachexia. Known as a wasting syndrome, the condition typically occurs ...
FOR IMMEDIATE RELEASE
Contact:
Dan Verello
Mount Sinai Press Office
212-241-9200
daniel.verello@mountsinai.org
Journal: Nature
Title: Amygdala–liver signaling orchestrates glycemic responses to stress
Authors: Sarah Stanley, MBBCh, PhD, Associate Professor, Co-Director, Human Islet and Adenovirus Core, Diabetes, Obesity and Metabolism Institute, and The Friedman Brain Institute at Mount Sinai
Paul J. Kenny, PhD, Ward-Coleman Professor and Chair of the Nash Family Department of Neuroscience at the Icahn School of Medicine at Mount Sinai
Bottom line: This study discovered a circuit in the brain that connects stress with increased ...
Although the material damage from 2012's Hurricane Sandy may have been repaired, the storm left a lasting impact on cardiovascular health, according to new findings from Weill Cornell Medicine and New York University researchers.
The study, published Sept. 3 in JAMA Network Open, found that older adults living in flood-hit areas in New Jersey faced a 5% higher risk of heart disease for up to five years after Sandy’s landfall. This is one of the first studies to rigorously quantify long-term cardiovascular risks associated with flooding in older adults. Most studies focus ...
