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Record W4417041598 · doi:10.1182/hematology.2025000705

The untransfusable patient

2025· article· en· W4417041598 on OpenAlexaff
Kathryn E. Webert, Michelle P. Zeller

Bibliographic record

VenueHematology · 2025
Typearticle
Languageen
FieldMedicine
TopicBlood transfusion and management
Canadian institutionsHamilton Health SciencesMcMaster UniversityCanadian Blood Services
Fundersnot available
KeywordsBlood managementAnemiaBlood lossBlood transfusionTranexamic acidSurgical proceduresBlood product

Abstract

fetched live from OpenAlex

Red cell transfusions represent the main treatment of acute blood loss anemia; however, there are patients who are unable or refuse to receive blood products. Further, in all patients, it is essential to only transfuse when the benefits of transfusion outweigh the risks. In those patients who are unable to receive a blood transfusion, it is important to have a multidisciplinary treatment plan. Further, for those patients requiring surgery, it is important to consider the pre-, intra-, and postoperative periods. Many of the principles and strategies outlined in this article can be applied to patients across clinical contexts and are not exclusive to the surgical setting. Before any planned surgery or intervention, all patients should be screened for anemia at least 6 weeks prior to their anticipated surgical or delivery date. Anemia should be corrected, and the patient's bleeding history should be documented. Strategies to reduce blood loss intraoperatively should be discussed with the surgical and anesthetic team. A plan for emergency management of bleeding and treatment to reduce risk, both intraoperatively and postoperatively, should be developed. The patient's decisions about which, if any, blood products or fractions are acceptable should be documented. Intraoperatively, surgical and anesthetic techniques to minimize bleeding should be used along with appropriate medications. Postoperatively, considerations include the minimization of blood sampling, ongoing support of the patient's hemoglobin mass, and optimization of the physiologic tolerance of anemia. Options exist to allow for the safe and effective management of patients who refuse or are unable to receive blood transfusions. It is essential to have clear communication and documentation of the goals of therapy as well as acceptable interventions. The involvement of a multidisciplinary team to manage the patient is essential.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.913
Threshold uncertainty score0.129

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.005
GPT teacher head0.251
Teacher spread0.247 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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