losartan-potassium and Rectal-Diseases

To find out whether recombinant human erythropoietin (r-HuEPO) given perioperatively has any effect on haemostatic activity in patients undergoing elective colorectal resection.. A placebo-controlled double-blind study.. Odense university hospital, Denmark.. 24 patients undergoing elective colorectal resection, 13 of whom were given r-HuEPO (Eprex) and 11 placebo.. Concentrations of haemoglobin, tissue-type plasminogen activator and plasminogen activator inhibitor-1; activated partial thromboplastin time; prothrombin time; platelet and reticulocyte counts; blood loss; and transfusions.. There was no significant change in fibrinolytic activity, prothrombin time, or activated prothrombin time in the treatment group. Platelet counts differed slightly but not significantly, being higher in the r-HuEPO group. There was a significant increase in reticulocyte counts in the r-HuEPO group.. R-HuEPO given perioperatively significantly increased erythropoiesis in patients undergoing elective colorectal operations but had no influence on haemostatic activity.

Topics: Aged; Aged, 80 and over; Colonic Diseases; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Elective Surgical Procedures; Erythrocyte Count; Erythropoietin; Female; Hemostasis; Hemostatic Techniques; Humans; Male; Middle Aged; Platelet Count; Postoperative Care; Preoperative Care; Prognosis; Recombinant Proteins; Rectal Diseases; Reticulocytes

Blood transfusion is associated with higher postoperative complication. With the availability of autologous blood and erythropoietin, it would be advantageous to identify patients who are at higher risk for requiring blood transfusion. Our aim is to identify possible predictive factors for perioperative blood transfusion in patients undergoing colorectal resection. We examined 206 patients who underwent colorectal resections.. We analyzed factors including preoperative hematocrit, age, history of radiation, type of resection, operative blood loss, additional surgical procedure, surgery duration, and comorbidity.. Forty-one patients (19.9%) received perioperative blood transfusion. Twenty patients (55.6%) with preoperative hematocrit less than 30 received transfusion (p<0.0001). Twenty-one patients (12.4%) with preoperative hematocrit greater than 30 received perioperative blood transfusion. Thirty-three patients (17.9%) under 65 years received transfusion. Eight patients (36.4%) more than the age of 65 received transfusion (p=0.05). Ten patients (16.1%) without any comorbidity received transfusion, whereas ten patients (15.1%) with one comorbidity, ten patients (22.2%) with two comorbidities, and 11 patients (33.3%) with greater than three comorbidities received blood transfusion (p=0.07). In the multivariate analysis, relative risk of perioperative blood transfusion was 3.63 for patients with preoperative hematocrit less than 30 (p<0.0001), 1.26 for patients more than the age of 65 (p=0.49), and 1.07 for each comorbidity (p=0.62). Patients with higher number of comorbidities and age greater than 65 tend to have lower preoperative hematocrit than other patients.. Hematocrit less than 30 is an independent risk factor for requiring perioperative blood transfusion, and patients with hematocrit less than 30 should be considered for autologous blood transfusion and erythropoietin.

Topics: Adult; Aged; Blood Loss, Surgical; Blood Transfusion; Colon; Colonic Diseases; Erythropoietin; Female; Hematinics; Hematocrit; Humans; Male; Middle Aged; Patient Selection; Perioperative Care; Rectal Diseases; Rectum; Retrospective Studies; Risk Assessment; Risk Factors

Topics: Adult; Anemia, Hypochromic; Arthroplasty, Replacement, Hip; Chronic Disease; Colitis; Drug Therapy, Combination; Epoetin Alfa; Erythropoietin; Ferric Compounds; Folic Acid; Humans; Intestinal Polyps; Leucovorin; Malabsorption Syndromes; Male; Methotrexate; Osteoarthritis, Hip; Preoperative Care; Recombinant Proteins; Rectal Diseases; Remission Induction; Spondylitis, Ankylosing; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency