scholarly journals Frequency of homologous blood transfusion in patients undergoing cleft lip and palate surgery

2010 ◽  
Vol 43 (01) ◽  
pp. 054-059
Author(s):  
Wasiu L. Adeyemo ◽  
Mobolanle O. Ogunlewe ◽  
Ibironke Desalu ◽  
Akinola L. Ladeinde ◽  
Titilope A. Adeyemo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Cleft Palate ◽  
Teaching Hospital ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Teaching ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
The Mean

ABSTRACT Aim: The study aims to determine the frequency of homologous blood transfusion in patientsundergoing cleft lip and palate surgery at the Lagos University Teaching Hospital, Nigeria. Setting and Design: A prospective study of transfusion rate in cleft surgery conducted at the Lagos University Teaching Hospital, Nigeria. Material and Methods: One hundred consecutive patients who required cleft lip and palate surgery were recruited into the study. Data collected included age, sex and weight of patients, type of cleft defects, type of surgery done, preoperative haematocrit, duration of surgery, amount of blood loss during surgery, the number of units of blood cross-matched and those used. Each patient was made to donate a unit of homologous blood prior to surgery. Results: There were 52 females and 48 males with a mean age of 64.4 ± 101.1 months (range, 3-420 months). The most common cleft defect was isolated cleft palate (45%) followed by unilateral cleft lip (28%). Cleft palate repair was the most common procedure (45%) followed by unilateral cleft lip repair (41%). The mean estimated blood loss was 95.8 ± 144.9 ml (range, 2-800ml). Ten (10%) patients (CL=2; CP=5, BCL=1; CLP=2) were transfused but only two of these were deemed appropriate based on percentage blood volume loss. The mean blood transfused was 131.5 ± 135.4ml (range, 35-500ml). Six (60%) of those transfused had a preoperative PCV of < 30%. Only 4.9% of patients who had unilateral cleft lip surgery were transfused as compared with 50% for CLP surgery, 11% for CP surgery, and 10% for bilateral cleft lip surgery. Conclusions: The frequency of blood transfusion in cleft lip and palate surgery was 10% with a cross-match: transfusion ratio of 10 and transfusion index of 0.1. A “type and screen” policy is advocated for cleft lip and palate surgery.

scholarly journals Frequency of homologous blood transfusion in patients undergoing cleft lip and palate surgery

2010 ◽  
Vol 43 (1) ◽  
pp. 54 ◽  
Author(s):  
WasiuL Adeyemo ◽  
MobolanleO Ogunlewe ◽  
Ibironke Desalu ◽  
AkinolaL Ladeinde ◽  
TitilopeA Adeyemo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Homologous Blood ◽  
Homologous Blood Transfusion

scholarly journals Decreasing the Blood Transfusion Rate in Elective Hip Replacement Surgery Using an Autologous Drainage System

2007 ◽  
Vol 89 (2) ◽  
pp. 136-139 ◽  
Author(s):  
SW Sturdee ◽  
DJ Beard ◽  
G Nandhara ◽  
SV Sonanis
Keyword(s):  
Blood Transfusion ◽  
Hip Replacement ◽  
Drainage System ◽  
Length Of Hospital Stay ◽  
Transfusion Rate ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Drain Group ◽  
The Mean ◽  
Arthroplasty Surgery

INTRODUCTION This is a prospective study looking at the effectiveness of autologous postoperative drains in primary uncemented total hip replacement (THR) surgery. PATIENTS AND METHODS A total of 86 patients were studied, with 43 using standard suction drains (normal drain group) and 43 using autologous drains (autologous drain group). RESULTS Thirty-seven units of homologous blood were transfused in the normal drain group and 5 units in the autologous drain group. The mean number of units of homologous blood transfused per patient was reduced from 0.86 to 0.12 (P < 0.01) with the use of autologous drains and the transfusion rate was reduced from 23% to 6% (P < 0.02). The mean length of hospital stay was also reduced by two nights (P < 0.05). There were no adverse effects from using the autologous system and it does reduce the need for a homologous blood transfusion. CONCLUSIONS The system is simple and easy to use and we have also found it to be cost effective. Previously, it has not been reported as being effective in hip arthroplasty surgery, unlike knee arthroplasty surgery. We would recommend using autologous postoperative drains in primary THR surgery.

scholarly journals Kajian faktor-faktor yang berhubungan dengan skor nasalance pada pasien celah palatum

2016 ◽  
Vol 45 (2) ◽  
pp. 131
Author(s):  
Duhita Yassi ◽  
Dini Widiarni ◽  
Tri Juda Airlangga ◽  
Lestaria Aryanti ◽  
Muchtarudin Mansyur
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Otitis Media With Effusion ◽  
Group Analysis ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Significant Difference ◽  
The Mean

Latar belakang: Celah bibir dan palatum merupakan kelainan proses pertumbuhan area orofasial yang menimbulkan permasalahan kompleks. Penelitian ini menitikberatkan permasalahanyang terkait dengan fungsi bicara. Tujuan: Penelitian ini melaporkan gambaran skor nasalance padacelah palatum, hubungan antara skor nasalance percontoh celah palatum dan tanpa celah palatum sertafaktor-faktor yang berhubungan dengan skor nasalance. Metode: Desain penelitian adalah comparativecross sectional. Pengambilan percontoh dilakukan dengan purposive sampling. Dilakukan wawancara,pengisian kuesioner, pemeriksaan THT, audiometri, timpanometri, nasoendoskopi, dan nasometri.Hasil: Didapatkan gambaran rerata skor nasalance percontoh celah palatum. Terdapat  perbedaanbermakna antara skor nasalance percontoh celah palatum dan tanpa celah palatum pada Uji Gajah danUji Hantu (p<0,001). Pada analisis multivariat secara keseluruhan faktor-faktor yang berhubungandengan skor nasalance (adenoid, otitis media efusi, serta gangguan pendengaran) dan keberadaancelah palatum berpengaruh secara signifikan terhadap skor nasalance untuk semua uji nasalance(p<0,05) pada pengujian terhadap kedua kelompok percontoh. Bila dilihat secara parsial faktor adenoidberpengaruh secara signifikan terhadap skor semua uji nasalance baik pada analisis kedua kelompokpercontoh maupun pada percontoh celah palatum saja. Kesimpulan: Rerata skor nasalance kelompokcelah palatum lebih tinggi daripada kelompok tanpa celah palatum. Didapatkan peran faktor yangberpengaruh terhadap skor nasalance, khususnya adenoid. Diperlukan penelitian lebih lanjut terhadappercontoh sesudah operasi sehingga bisa dijadikan sebagai evaluasi terhadap keberhasilan tindakan. Kata kunci: celah palatum, skor nasalance, tonsil, adenoid, otitis media efusi, gangguan pendengaran ABSTRACTBackground: Cleft lip and palate is an orofacial malformation and associated with many problems. This study concerned in speech problem in cleft palate patients. Purpose: This study reportednasalance score in cleft palate patients, the correlation between nasalance score in cleft palate and noncleft palate groups and also some factors related with nasalance score in cleft palate patients. Methods:The design of this study was comparative cross sectional, with purposive sampling. Data was collectedwith interview, questioner apllication, ENT examination, audiometry, tympanometry, nasoendoscopy,and nasometry. Results: The result of this study reported the mean of nasalance score in cleft palatepatients. There was significant difference in nasalance score between cleft palate and non cleft palatepatients in Uji Gajah and Uji Hantu (p>0,05). In multivariate analysis, in general the factors relatedwith nasalance score (adenoid, otitis media with effusion, and hearing loss) and cleft palate  itself weresignificantly correlated with nasalance score in all nasalance test (p<0,05) in both groups analysis butno signifficant correlation in cleft palate group analysis. Partially, adenoid  was significantly correlated in both group analysis and cleft palate group analysis. Conclusion: The mean of nasalance score incleft palate group was higher than non cleft group. Some factors in this study, especially adenoid had corelations with nasalance score. It needs further study to evaluate the nasalance score patients withcleft palate after surgery to compare the results. Keywords: cleft palate, nasalance score, tonsil, adenoid, otitis media with effusion, hearing disturbance

THE EFFECT OF BLOOD TRANSFUSION ON IMMUNE FUNCTION Since homologous blood is never given to normal volunteers, the effect of blood transfusion on immune function in normal man is unknown. In patients who receive homologous blood, changes in immune response are evaluated in the context of the disease for which the blood is given and extrapolated to the effect of blood in the absence of disease. Changes in immunity consistently following transfusion for a variety of diseases can be assumed to be due to the transfusion and not to the diseases. Changes in immune function following transfusion with autologous blood or washed/filtered homologous blood can be compared to patients who are receiving routinely prepared homologous blood. The blood is given within the context of a surgical procedure as a consequence of operative blood loss which is due to trauma and trauma itself is associated with changes in immune function. In Vitro Lymphocyte Responsiveness Generally, inhibition of lymphocyte response to a given antigen or mitogen measured by incorporation of tritiated thymidine is accompanied by inhibition of response to all antigens and mitogens. Surgery, anesthesia, blood loss and blood transfusion cause lymphocyte suppression in clinical studies. Isolating the effect of homologous blood transfusion from the surgery, anesthesia and blood loss is not easy. In vitro lymphocyte responses decline in proportion to the magnitude of the procedure and in proportion to the amount of blood lost. Certain anesthetic agents, notably ether and cyclopropane, are associated with more profound suppression of immune function than halothane and nitrous oxide, for example (1). Patients with malignancies have low lymphocyte responses and declines with surgery are more precipitous than for patients without malignancies. Operated patients who receive homologus blood have declines in lymphocyte responsiveness compared to untransfused patients undergoing the same procedure. Thorough well-controlled studies have also observed the opposite, causing Munster et al. to comment that continued investigation " into the effect of PHA and ConA on post-traumatic lymphocyte transformation in many laboratories has produced no conclusive and repeatable pattern." (2) Prolonged depression in in vitro lymphocyte responsiveness is noted within hours of surgery and recovers over the next several days. The inhibition is due to both intrinsic and extrinsic factors since lymphocyte responsiveness can be partially restored by testing in plasma from normal blood donors. Homologous blood transfusion adds to the depressed state of the lymphocytes, but may cause stimulation in unoperated patients. The in vivo counterpart of in vitro testing of lymphocytes is delayed cutaneous hypersensitivity to antigens. Delayed Cutaneous Hypersensitivity There exists a correlation between in vivo and in vitro lymphocyte testing and preoperative evaluation of in vivo lymphocyte function is predictive of postoperative infection and subsequent course after surgery. Anergy is associated with low serum albumin and reduced polymophonuclear neutrophil chemotaxis. Patients with gastrointestinal bleeding, recipients of homologous blood, are often anergic (3). Sepsis following surgery for gastrointestinal bleeding is more common, hospital stay longer, and mortality higher in anergic patients. Patients who are initially anergic and remain anergic usually die.

1995 ◽  
pp. 292-292
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Immune Function ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Cutaneous Hypersensitivity ◽  
Lymphocyte Responses ◽  
Delayed Cutaneous Hypersensitivity

Occurrence of Cleft Lip and Palate in the Faroe Islands and Greenland from 1950 to 1999

2003 ◽  
Vol 40 (4) ◽  
pp. 426-430 ◽  
Author(s):  
Linda P. Jakobsen ◽  
Kirsten Mølsted ◽  
Kaare Christensen
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Genetic Factors ◽  
Cleft Lip And Palate ◽  
Faroe Islands ◽  
Hearing Disorders ◽  
Live Births ◽  
Time Period ◽  
The Mean ◽  
Isolated Cleft Palate

Objective To describe the occurrence of cleft lip with or without cleft palate (CL/P) and isolated cleft palate (CP) in the Faroe Islands and Greenland over a 50-year time period that has included substantial changes in lifestyle. Design A prevalence study based on patient records obtained from the Institute of Speech and Hearing Disorders in Copenhagen, Denmark, at which the treatment of patients with CP and CL/P from Greenland, the Faroe Islands, and Denmark is coordinated. Participants All live-born children in the Faroe Islands, Greenland, and Denmark with CL/P or CP born in the period 1950 to 1999 (Faroe Islands and Greenland) and 1950 to 1987 (Denmark). Results and Conclusion The mean prevalence of CL/P in the Faroe Islands and Greenland during the period 1950 to 1999 was 1.0 and 0.6 per 1000 live births, respectively. This is significantly lower than the mean prevalence of 1.4 (p < .05 and p < .001) per 1000 live births found in Denmark. The mean prevalence of CP in the Faroe Islands and Greenland was 1.5 and 1.1 per 1000 live births, respectively, which is significantly higher than the Danish prevalence of 0.5 per 1000 live births (p < .001 in both tests). There was no clear time trend in the prevalence, indicating that genetic factors or timetable environmental factors play a dominating role in the etiology of CL/P and CP in the Faroe Islands and Greenland.

scholarly journals Haemodilution for Major Vascular Surgery — Using 3.5% Polygeline (Haemaccel)

1982 ◽  
Vol 10 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Michael J. Davies ◽  
Keith D. Cronin ◽  
Charles Domaingue
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Vascular Surgery ◽  
Operative Blood Loss ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
Blood Replacement ◽  
Transfusion Requirements ◽  
Major Vascular Surgery

Intra-operative haemodilution and autotransfusion was carried out in 32 patients having major vascular surgery. The intra-operative blood loss and peri-operative blood replacement was compared with that in 25 patients having similar surgery in whom haemodilution was considered to be contraindicated. Both groups of patients had similar mean intra-operative blood loss measured but homologous blood transfusion requirements were significantly different; 2.6 units (SD 1.9) in the haemodiluted patients compared with 6.0 units (SD 3.5) in the non-diluted patients. There was no mortality in the haemodiluted patients nor was any morbidity attributed to the procedure. Polygeline (haemaccel) was used as the diluent and proved satisfactory for this purpose.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

Acute Isovolaemic Haemodilution: The Best Option for Autologous Blood Transfusion in Africa?

1995 ◽  
Vol 25 (4) ◽  
pp. 152-155 ◽  
Author(s):  
Zacharia A Berege ◽  
Bart Jacobs ◽  
Michael R Matasha ◽  
Frank Mpelumbe ◽  
Ernestini Kimaro
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Autologous Blood ◽  
Autologous Blood Transfusion ◽  
Total Blood Volume ◽  
East African ◽  
Homologous Blood ◽  
Total Blood ◽  
Induction Of Anaesthesia ◽  
Donated Blood

The purpose of this study was to identify the best method of autologous blood transfusion to be applied in an East African hospital. One hundred and nine consecutive patients for whom major blood loss was anticipated were enrolled. Seventeen patients donated 1 unit of blood 3 days preoperatively and 92 underwent acute isovolaemic haemodilution prior to induction of anaesthesia. For the haemodiluted patients a 2:1 ratio of sterile pryogen-free saline to collected blood was used. One of the 16 patients from whom 2 units were withdrawn by haemodilution experienced hypovolaemia which was rapidly restored by additional transfusion of colloid. Of the patients who donated blood preoperatively only 23.5% were autotransfused compared to 98.9% of the haemodiluted patients. Of the latter 23.9% (22) had an intraoperative blood loss exceeding 15% of their total blood volume and 7.6% (7) lost more than 25%. Only one received homologous blood in addition. For hospitals with limited blood bank facilities and regular cancellation of surgery, the use of acute isovolaemic haemodilution is recommended. A 3:1 ratio of saline to blood is now advised when 1 unit is withdrawn and a part replacement with crystalloid when 2 units are collected.

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