Discussion of Findings
Because most of the studies were comparison studies with exception of one Cross-sectional one-way study to analyze their data, the researchers used two sample t-test for comparison, Linear regression test to see the relation between hemoglobin and hematocrit, Chi square test for the predicted data results, Mann–Whitney U test to compare the difference of the dependent variable, Kruskal–Wallis-one way analysis of variance, Pearson Correlation test, fisher exact test and covariance analysis (ANCOVA) (Mukhopadhyay et al., 2010; Oto et al., 2012; Peruzzi et al., 1993; Rezende et al., 2010; Riessen et al., 2015; Thomas et al., 2009; Ullman et al., 2015). For inclusion criteria, the researcher’s chose critically ill patients admitted to ICU with or without arterial or central venous catheter line, and intubated patients for more than 24 hours. However, their limitation as well as their exclusion criteria was actively bleeding patients, hemoglobin less than 7g/dl on admission, patients with cancer, chronic kidney disease, chronic anemia, or hematological disorders as these would have been confounding variables (Mukhopadhyay et al., 2010; Peruzzi et al., 1993; Rezende et al., 2010; Riessen et al., 2015).
Most of the researchers compared the use of blood conserving apparatus in relation preserved H&H and decrease in transfusion requirement, and majority of them found the use of blood saving apparatus conserves H&H (Mukhopadhyay et al., 2010; Peruzzi et al.,
With a quantitative approach, a descriptive, prospective, cross-sectional method was used to collect data. Utilizing medical records from 51 patients hospitalized between February and April of 2013, data such as age, Braden Scale scores, comorbidities and length of stay were collected. Clinical data obtained was then organized in an Excel table and input into the statistical software, Epi Info, to be arranged for statistical analysis (Oliveira de Carvalho et al.,
Intravenous (IV) fluids were bolusing; however, when blood pressure was only obtainable manually and revealed that her blood pressure was 74/34, the decision was made to send the patient to the intensive care unit (ICU). There, coagulation studies revealed an elevated PT, PTT, D-dimer, and a decreased fibrinogen count. She received a peripherally inserted central catheter (PICC), a transfusion of two units of packed red blood cells (PRBCs), as well as cryoprecipitate therapy during her treatment in the ICU.
Further, the relationship between $PaO_{2}$ and survival to ICU discharge was investigated. A dataset spanning 10 years (March 2004 - December 2014) was utilised for this analysis.\\
1.Full blood counts: To assess the Hb for evidence of anemia, WBC for evidence of infection.
In a publication of the Stanford University School of Medicine, held an article entitled “Against the Flow—What’s Behind the Decline in Blood Transfusions?” The author of that article, Sarah C. P. Williams, stated: “Over the past decade, a growing body of research has revealed that in hospitals around the world, donated blood is used more often, and in larger quantities, than is needed to help patients—both in operating rooms and hospital
Lastly, in case of an emergency hemorrhagic episode science has advance to the point to decrease blood transfusions to the minimum with help of medications like:
Drueke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, et al. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med. 2006 Nov 16;355(20):2071-84.
Utilizing the five points mentioned would transition the information from the systematic review into practice. The review would identify as an evidence summary in the model, producing a more manageable quantity of information. It can then be translated as it is combined with clinical expertise and tailored to the clinical setting. The setting that would benefit the most from this change would be those in the critical care setting, as septic patients are in a critical state and are monitored closely. Having strong supporting evidence will make a substantial argument to change practices. Utilizing the data, combined with clinical expertise and experience, supports the changes needed to provide the most up to date, evidence based care. Clinical expertise regarding sepsis benefits the healthcare team in acknowledging other clinical data that could be used to determine fluid volume status, straying away from depending on central venous pressure. The goal would be to transition from using central venous pressure as a reliable indicator of fluid volume status to utilizing noninvasive cardiac output monitoring, when possible, and other clinical indicators. Another change would involve discrediting the validity of central venous pressure as a volume status indicator to clinicians. Mark, Monnet, and Teboul (2007) noted that 90% of intensivists use central venous pressure
These tests also help nurses and physicians to see the fluctuations that take place from time of admission. The patient came in with low RBC’s which may be caused by her chronic kidney failure. Erythropoietin is excreted by the kidneys to gather more red blood cells. When the kidneys are not functioning, this may inhibit the excretion of erythropoietin, causing a low red blood cell count. She also came in with low hemoglobin levels which indicates anemia which also goes hand in hand with her low red blood cell count because hemoglobin is a protein located within red blood cells that carries oxygen from the lungs to the body and tissues. E.M. lastly appeared to have low hematocrit levels this again, is associated with the patient's anemia this is the proportion of blood that contains red blood cells, and in this patient's case is very
The Book of Blood by HP Newquist is about bloods uses now and in the past as far as ancient Egypt. HP Newquist explains how blood letting was very popular and very ineffective, but more often than not the person got better because losing blood made them tired and sleep helps concentrate the body’s attention on the illness. Early blood transfers also were not very successful because the scientists back then couldn’t tell the difference between O, A, B, AB blood types and therefore mixing different blood types. We now know that blood letting will not help the body get better, but people do donate their blood to help others who are in need of blood to survive, which now doctors can successfully transfer and identify blood types.
In the study of Verani, McCracken, Arvelo, Estevez, Lopez, Reyes, Moir, Bernart, Moscoso, Gray, Olsen and Lindblade (2013), a total of 8,914 hospitalized patients
Create categories for the “Hemoglobin” variable responses with different cutoffs used medically. The “bed_net_days” variable responses can also be categorized if it is clinically, biologically or epidemiologically applicable for this study.
A hematocrit and hemoglobin value can provide with an indirect measurement for levels of RBC’s in the blood and how much hemoglobin there is in the blood. My patients Hct was 29.3L on 10/25 which is higher than a few days prior which was 24.5L but lower than admit day 10/17 32.3L. A low level of RBC’s can indicate anemia or hemorrhage but not immediately after, not until the blood volume is replaced with fluids (Pagana et. al. 2014). However, in her case low levels of H&H are also a consequence of hemodialysis. The patients Hgb was 9.1L on 10/25 but 10.5L on admit 10/17 her lowest being 10/21 at 7.9L. This value can also indicate anemia due to decrease of RBC’s which is also an indicator of the rapid blood loss through hemodialysis or through
This paper was written in conjunction with a pamphlet to inform those not directly involved the medical field of their options when it comes to blood and blood products at a level that they can understand. First this paper will explore the common types of blood transfusions that use red blood cells, plasma, platelets, and cryoprecipitate along with their reasons for being administered. Next it will be discussed how the blood transfusion process actually occurs; from donating and screening in blood banks right up until the blood is being transfused. Last of all, the more common possible risks and side effects of receiving a blood transfusion will be described such as reactions and infections.
The average adult has approximately five liters of blood coursing through the vessel and delivering essential element. Without blood, the human body would stop working. Blood is fluid of life and health for each individual body. Every single drop of blood contains millions of red blood cells which functions as transporting oxygen to all parts of the body. If there are scarce, it will disrupt blood circulation of the body gradually. This phenomenon usually arises during severe blood injury. At this moment, blood transfusion is the best way to overcome this kind of case. Thanks to an Arabic scholar, Ibn Al-Nafis who discovered in 1260 AD on minor circulation of blood in the body which then lead to idea of blood transfusion. (1) Nevertheless, the blood supply is still on demand. According to statistics in America Red Cross, more than 41,000 blood donations are needed every day for variety of purposes. (2) Maintaining blood supply remains arduous till now. Hence, in order to attract people to donate blood, some arguments are evolved whether payment or other reward should be done to increase the blood sources.(3) Therefore, the outcome of this argument is a new type of blood donation is produced which known as paid blood donation. This kind of donor contradicts to volunteer blood donor. Paid blood donor defines as a person who receives incentives for their contribution of blood. Jay Pennington voices out that nothing is free in the life. This statement initiates his article