Análisis de reservas quirúrgicas de concentrados de glóbulos rojos en un hospital de oncologia

Autores/as

DOI:

https://doi.org/10.33448/rsd-v11i10.32935

Palabras clave:

Transfusión Sanguínea; Oncología Quirúrgica; Anemia; Anemia.

Resumen

La sangre juega un papel clave en el mantenimiento de la supervivencia del paciente durante los procedimientos quirúrgicos electivos. La transfusión de concentrados de glóbulos rojos es capaz de corregir rápidamente el estado anémico y mejorar la oxigenación, sin embargo, su realización se asocia con desenlaces adversos. En pacientes con cáncer, está relacionado con una peor supervivencia y un mayor riesgo de recurrencia. Así, buscamos analizar las reservas de concentrados de glóbulos rojos y evaluar el perfil de pacientes sometidos a cirugías electivas en un hospital oncológico. Fue un estudio observacional, descriptivo, con diseño transversal, con análisis de todas las formas de solicitud de concentrados de glóbulos rojos para reserva quirúrgica, con una muestra de 1386 solicitudes. Las mujeres y el grupo de edad entre 40 y 79 años fueron el público más transfundido con concentrados de glóbulos rojos, las cirugías fueron grandes, los sectores responsables de la mayor cantidad de transfusiones fueron la cirugía oncoabdominal y la oncoginecología, así como las patologías de estos sectores el cáncer de estómago y de cuello uterino; los procedimientos con exceso de compatibilidad fueron el tratamiento quirúrgico de la epilepsia, la traquelectomía, la arteriografía y la esplenectomía; la mayoría de los procedimientos tuvieron una tasa de pacientes transfundidos > 10% para los cuales es necesario reservar el componente sanguíneo. En el análisis del Maximal Blood Order Schedule, se observó que una amplia gama de procedimientos requiere dos unidades de concentrado de glóbulos rojos. Esto generó subsidios para incentivar el uso racional de la sangre en la institución de salud.

Citas

Acheson A. G, Brookes M. J, Spahn D. R. (2012). Effects of allogeneic red blood cell transfusions on clinical outcomes in patients undergoing colorectal cancer surgery: a systematic review and meta-analysis. Ann Surg. 256(2), 235–244.

Adegboye, M.; Kadir, D.M. (2018). Maximum surgical blood ordering schedule for common orthopedic surgical procedures in a tertiary hospital in North Central Nigeria. J Orthop Trauma Surg Rel Res. 13 (1).

American Cancer Society. (2019). Cancer facts & figures 2019. Atlanta: American Cancer Society.

Aquina, C., Blumberg, N., Becerra, A., Boscoe, F., Schymura, M., Noyes, K., Monson, J., & Fleming, F. (2017). Association among blood transfusion, sepsis, and decreased long-term survival after colon cancer resection. Annals of Surgery. 266(2), 311-317.

Baker, L.; Park, L.; Gilbert, R.; Ahn, H.; Martel, A.; Lenet, T.; Davis, A.; McIsaac, D.I.; Tinmouth, A.; Fergusson, D.A.; Martel, G. (2021). Intraoperative red blood cell transfusion decision-making: a systematic review of guidelines. Ann Surg. 274 (1), 86-96.

Barber, E. L., & Clarke-Pearson, D. L. (2017). Prevention of venous thromboembolism in gynecologic oncology surgery. Gynecologic Oncology. 144(2), 420–427.

Beal, E.W.; Tsung, A.; McAlearney, A.S.; Gregory, M.; Nyein, K.P.; Scrape, S.; Pawlik, T.M. (2021). Evaluation of red blood cell transfusion practice and knowledge among cancer surgeons. J Gastrintest Surg. 25 (11), 2928-2938.

Benson, C.S.; Shah, A.; Stanworth, S.J.; Frise, C.J.; Spiby, H.; Lax, S.J.; Murray, J. & Klein, A.A. (2021). The effect of iron deficiency and anaemia on women’s health. Anaesthesia. 76 (4), 84-95.

Blumberg N. (2005). Deleterious clinical effects of transfusion immunomodulation: proven beyond a reasonable doubt. Transfusion. 45(2), 33-39.

Cata, J. P., Owusu-Agyemang, P., Kapoor, R., & Lonnqvist, P.A. (2019). Impact of anesthetics, analgesics, and perioperative blood transfusion in pediatric cancer patients: A comprehensive review of the literature. Anesthesia & Analgesia. 129(6), 1653–1665.

Cobo, B.; Cruz, C. & Dick, P.C. (2021). Gender and racial inequalities in the access to and the use of Brazilian health services. Cien Saude Colet. 26 (90), 4021-4032.

Dömötör, H.; Varga, A.L.; Szödy, R.; Tóth, F. & Nardai, G. (2021). Institutinally adopted perioperative blood management program significantly decrease the transfusion rate of patients having primary hip replacement surgery. Adv Orthop. 30, 1-6.

Ecker,B.,Simmons,K.,Zaheer,S.,Poe,S.,Bartlett,E.,Drebin,J., Fraker, D., Kelz, R., Roses, R., & Karakousis, G. (2016). Blood transfusion in major abdominal surgery for malignant tumors: A trend analysis using the National Surgical Quality Improvement Program. JAMA Surgery.151(6), 518–525.

Ganz, T. & Nemeth, E. (2009). Iron sequestration and anemia of inflammation. Semin Hematol. 46(4):387–393.

Goel R, Patel EU, Cushing MM, et al. (2018). Association of perioperative red blood cell transfusions with venous thromboembolism in a North American Registry. JAMA Surg. 153, 826-833.

Gombtz, H.; Hofmann, A.; Rehak, P.; Kurz, J. (2011). Patient blood management (part 1) – patient – specific concept t reduce and avoid anemia, blood loss and transfusion. Anasthesiol intensivmed Notfallmed Schmerzther. 46 (6), 396-401.

Grandone, E.; Mastroianno, M.; De Laurenzo, A.; Di Mauro, L.; Carella, M.; Gosgoglione, F.; Cornacchia, D.; Angelis, G.; Tiscia, G.L.; Ostuni, A. & Margaglione, M. (2021). Mortality and clinical outcome of Italian patients undergoing orthopaedic surgery: effect of perioperative blood transfusion. Blood Transfus. 19 (4), 284-291.

Gross, I.; Trentino, K.M.; Andreescu, A.; Pierson, R.; Maietta, R.A. & farmer, S. (2016). Impact of a patient blood management program and an outpatient anemia management protocol on red cell’s transfusions in oncology inpatients and outpatients. Oncologist. 21 (3), 327-332.

Guzman, J.P.S.; Resurreccion, L.L. & Gepte, M.B.P. (2019). Use of Maximum Surgical Order schedule (MSBOS) among paediatric patients to optimize blood utilization. Ann Pediatr Surg. 15, 4.

Haghpanah, S.; Miladi, S.; Kasraian, L.; Zamani, A.; Gholami, M. (2021). Blood Transfusion practice in operating rooms in Nemazee hospital in Southern Iran. Arch Iran Med. 24 (2), 107-112.

Inamdar, M.B.; Hulikal, N.; Banoth, M.; Reddy, V.; Vijay, S.B.K. & Mangu, H.R. (2021). A prospective single centre study of preoperative blood ordering versus actual usage among patients undergoing elective curative oncological resections in a tertiary care hospital in India. Indian Journal of Surgical Oncology. 12 (13), 491-497.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Tipos de câncer. Rio de Jnaeiro: INCA, 2019. Disponivel em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2020-incidencia-de-cancer-no-brasil.pdf. Acesso em: 11 de julho de 2022.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil/ Instituto Nacional de Câncer José Alencar Gomes da Silva. – Rio de Janeiro: INCA, 2019.

Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC). (2014). Handbook of Transfusion Medicine. 5th edition. United Kingdom Blood Service.

Junior, P.B. (2017). Elaboração do manual de transfusão sanguínea do hospital das clínicas da faculdade de medicina de Botucatu – HCFMB para médicos [tese]. Botucatu: Universidade Estadual Paulista Julio de Mesquita Filho.

Knight, K., Wade, S., & Balducci, L. (2004). Prevalence and outcomes of anemia in cancer: A systematic review of the literature. The American Journal of Medicine. 116(7), 11-26.

Maia, A.E.S.; Grello, F.A.C.; Cunha, K.C. (2021). Perfil sociodemográfico e clínico de pacientes com câncer cadastrados no programa de visita domiciliar de um Hospital da Rede Pública. Revista Brasileira de Cancerologia. 67 (2), 1-9.

Martins, L.C.; Santos, F.T.S. & Correa, A.R.S. (2021). Influência do regionalismo amazônico como fator de risco para desenvolvimento de câncer gástrico. Enferm Bras. 20 (2), 130-142.

Moghaddamahmadi, M.; Khoshrang, H.; Khatami, S.S.; Marvasti, A.H.; Choshal, H.G.& Mehrkhah, S. (2021). Survey of Maximum Blood Ordering for surgery (MSBOS) in elective general surgery, neurosurgey and orthopedic surgery at the Poursina Hospital in Rasht, Iran, 2017. Hematol Transfus Cell Ther. 43 (4), 482-488.

Moura, L.L.; Codeço, C.T.; Luz, P.M. (2021). Coberura da vacina papilomavírus humano (HPV) no Brasil: heterogeneidade espacial e entre coortes etárias. Rev Bras Epidemiol. 24, 1-12.

Muñoz, M., Laso-Morales, M. J., Gómez-Ramírez, S., Cadellas, M., Núñez-Matas, M. J., & García-Erce, J. A. (2017). Pre-operative haemoglobin levels and iron status in a large multicentre cohort of patients undergoing major elective surgery. Anaesthesia, 72(7), 826–834.

Nery, C.V.S. (2018). A elaboração de um protocolo de reserva de Concentrado de Hemácias para cirurgias eletivas realizadas em um hospital público do Distrito Federal como ferramenta para otimização do uso racional do sangue [tese]. Ribeirão Preto: Universidade de São Paulo.

Pereira Filho, J.L.; Araújo, A.W.M.S.; Ribeiro, E.F.L.; Arouche, R.; Lopes, P.H.P.; Buna, S.S.S.; Bonfim, B.F.; Anunciação, R.K.L.; Costa, J.C.G.; Costa, W.F.N. & et al. (2021). Rastreamento do câncer do colo do útero na cidade de Belém, Estado do Pará, Brasil. Research, Society and Development. 10 (16), 1-11.

Petrelli, F.; Ghidini, M.; Ghidini, A.; Sgroi, G.; Vavassori, I.; Petrò, D.; Cabiddu, M. Aiolfi, A. et al. (2021). Red blood cell transfusions and the survival in patients with cancer undergoing curative surgery: a systematic reviem and meta-analysis. Surg today. 51 (10), 1535-1557.

Rohde JM, Dimcheff DE, Blumberg N et al. (2014). Health care-associated infection after red blood cell transfusion: A systematic review and meta-analysis. JAMA. 311, 1317–1326.

Saringcarinkul, A. & Chuasuwan, S. Maximum surgical blood order schedule for elective neurosurgery in a University Teaching Hospital in Northern Thailand. (2018). Asian J Neurosurg. 13, 329-335.

Shah, S., Spinella, P., & Muszynski, J. (2017). Immunologic effects of trauma and transfusion. Journal of Trauma and Acute Care Surgery, 82 (6S), 50-56.

Shander,A.; Javidroozi, M.; Ozawa, S.et al. (2011). What is really dangerous: anaemia or transfusion? Br J Anaesth. 107 (1), 41-59.

Shander, a.; Hardy, J.F.; Ozawa, S.; Farmer, S.L.; Hofmann, A.; Frank, S.M.; Kor, D.J.; Faraoni, D. & Freedman, J. (2022). A global definition of patient blood management. Anesth Analg.

Stephens, J.; Tano, R. (2021). Hemoglobin matters: Perioperative blood management for oncology patients. Can Oncol Nurs J. 31(4), 399-404.

Tamini, N.; Deghi, G.; Gianotti, L.; Braga, M.; Nespoli, L. (2021). Colon câncer surgery: does preoperative blood transfusion influence short-term postoperative outcomes?. J Invest Surg. 34 (9), 974-978.

Ural, K.G.; Volpi-Abadie, J.; Owen, G.; Gilly, G.; Egger, A.L.; Scuderi-Porter, H. (2016). Tailoring the blood ordering process for cardiac surgical cases using an institution-specific version of the maximum surgical blood order schedule. Semin Cardiothorac Vasc Anesth. 20 (1), 93-99.

Vetter, T.R.; Adhami, L.F.; Porterfield, J.R.J. et al. (2014). Perceptions about blood transfusion: a survey of surgical patients and their anesthesiologists and surgeons. Anesth Analg. 118, 1301–1308.

Vibhute, M.; Kamath, S.K.; Shetty, A. (2000). Blood utilisation in elective general surgery cases: requirements, ordering and transfusion practices. J Postgrad Med. 46, 1–9.

Xiao H, Quan H, Pan S, et al. (2018) Impact of peri-operative blood transfusion on post-operative infections after radical gastrectomy for gastric cancer: a propensity score matching analysis focusing on the timing, amount of transfusion and role of leukocyte depletion. J Cancer Res Clin Oncol.144, 1143-1154.

Xu, X.; Zhang, Y.; Gan, J.; Ye, X., Yu, X. & Huang, Y. Association between perioperative allogenic red blood cell transfusion and infection after clean-contaminated surgery: a retrospective cohort study. (2021). British Journal of Anaesthesia. 127 (3), 405-414.

Wu, H., Tai, Y., Lin, S., Chan, M., Chen, H., & Chang. K. (2018). The impact of blood transfusion on recurrence and mortality following colorectal cancer resection: A propensity score analysis of 4,030 patients. Scientific Reports, 8, 13345.

Publicado

01/08/2022

Cómo citar

SIQUEIRA, V. de S.; SAVINO NETO, S.; SANTOS, V. R. C. dos; MENDONÇA, X. M. F. D. Análisis de reservas quirúrgicas de concentrados de glóbulos rojos en un hospital de oncologia. Research, Society and Development, [S. l.], v. 11, n. 10, p. e317111032935, 2022. DOI: 10.33448/rsd-v11i10.32935. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32935. Acesso em: 17 jul. 2024.

Número

Sección

Ciencias de la salud