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Platelet transfusion, mortality

Efrain Riveros-Perez, Amy C Hermesch, Linda A Barbour, Joy L Hawkins
Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem...
2018: International Journal of Women's Health
Kunal Tewari, Vishal Vishnu Tewari, Ritu Mehta
Background: Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional burden on hospitals, necessitating bolstering of services in the emergency department, laboratory with creation of additional dengue fever wards. Objectives: To study the clinical and hematological profile of dengue fever cases presenting to a hospital. Methods: Patients with fever and other signs of dengue with either positive NS1 antigen test or IgM or IgG antibody were included...
2018: Mediterranean Journal of Hematology and Infectious Diseases
Massimo Franchini, Carlo Mengoli, Mario Cruciani, Marco Marietta, Giuseppe Marano, Stefania Vaglio, Simonetta Pupella, Eva Veropalumbo, Francesca Masiello, Giancarlo M Liumbruno
BACKGROUND: Thrombelastography (TEG) and rotational thromboelastometry (ROTEM) are viscoelastic haemostatic assays (VHA) which exploit the elastic properties of clotting blood. The aim of this systematic review and meta-analysis was to evaluate the usefulness of these tests in bleeding patients outside the cardiac surgical setting. MATERIALS AND METHODS: We searched the Cochrane Library, MEDLINE, EMBASE and SCOPUS. We also searched clinical trial registries for ongoing and unpublished studies, and checked reference lists to identify additional studies...
February 26, 2018: Blood Transfusion, Trasfusione del Sangue
Chao He, Xiaojuan Liu, Wei Peng, Chuan Li, Tian-Fu Wen
BACKGROUND: Simultaneous splenectomy during liver transplantation (LT) is debated. The present meta-analysis assessed the efficacy and safety of splenectomy on the outcome of LT patients. METHODS: We searched PubMed, Embase, and Wanfang databases for relevant studies published until the date of July 15, 2017. Quality assessment of the included studies was performed using a modified Newcastle-Ottawa Scale judgment. The data were analyzed using RevMan5.3 software...
March 2018: Medicine (Baltimore)
Slavisa Ninkovic, Zoe McQuilten, Robert Gotmaker, Andrew E Newcomb, Merrole F Cole-Sinclair
BACKGROUND: Transfusion of platelets is common in cardiac surgery, and while there are guidelines for their use, there are concerns about potential risks. We aimed to assess the impact of platelet transfusion on mortality, thrombosis, and infection in this patient group. STUDY DESIGN AND METHODS: A retrospective cohort study of all patients at St Vincent's Hospital Melbourne who underwent a first cardiac surgery procedure from June 2001 to June 2014 was conducted...
March 7, 2018: Transfusion
Mahir Elder, Nimrod Blank, Amir Kaki, M Chadi Alraies, Cindy L Grines, Marvin Kajy, Reema Hasan, Tamam Mohamad, Theodore Schreiber
BACKGROUND: Right ventricular (RV) failure due to pulmonary embolism (PE) increases morbidity and mortality and contributes to prolonged hospital length of stay and higher costs of care. RV mechanical circulatory support (MCS) including Impella RP devices have been increasingly used in hemodynamically compromised PE patients who are refractory to intravascular volume expansion and inotropic therapy. However, effectiveness and safety of Impella RP, in hemodynamically unstable PE patients is unknown...
March 7, 2018: Journal of Interventional Cardiology
Hellen McKinnon Edwards
This thesis is comprised of three studies focusing on severe postpartum haemorrhage (PPH). PPH is a major cause of maternal morbidity and mortality worldwide. Risk factors include retained placenta, prolonged duration of the third stage of labour, previous caesarean section, and operative vaginal delivery. Occurrence and development of PPH are, however, unpredictable and can sometimes give rise to massive haemorrhage or even hysterectomy and maternal death. Severe haemorrhage can lead to coagulopathy causing further haemorrhage and requiring substitution with blood transfusions...
March 2018: Danish Medical Journal
Jessica Corean, Rami Al-Tigar, Theodore Pysher, Robert Blaylock, Ryan A Metcalf
Objectives: Transfusion-transmitted bacterial infection (TTBI) from platelet components is likely underrecognized and can be fatal. Twenty-four-hour prospective culture was felt to be insufficiently preventive after multiple TTBIs occurred and strategies to improve safety were sought. Methods: Two fatal and one severe TTBIs occurred from a split-apheresis platelet donation contaminated with Klebsiella pneumoniae. Improvement opportunities were identified and corrective and preventive action (CAPA) followed...
February 15, 2018: American Journal of Clinical Pathology
Tomaz Crochemore, Thiago Domingos Corrêa, Marcus D Lance, Cristina Solomon, Ary Serpa Neto, João Carlos de Campos Guerra, Priscila Scolmeister Lellis, Livia Muller Bernz, Natalia Nunes, Cassio Massashi Mancio, Ana Paula Hitomi Yokoyama, Eliézer Silva
BACKGROUND: Transfusion therapy is associated with increased morbidity, mortality and costs. Conventional coagulation tests (CCT) are weak bleeding predictors, poorly reflecting coagulation in vivo. Thromboelastometry (ROTEM) provides early identification of coagulation disorders and can guide transfusion therapy by goals, reducing blood components transfusion. OBJECTIVE: The aim of this study is to describe coagulation profile of critically ill patients using ROTEM and evaluate the association between CCT and thromboelastometry...
2018: PloS One
Yuanjia Zhu, Andrew J Toth, Ashley M Lowry, Eugene H Blackstone, Brian T Hill, Stephanie L Mick
BACKGROUND: Surgical outcomes of patients with chronic lymphocytic leukemia (CLL) undergoing cardiac surgery are limited. Our objectives were to investigate hospital morbidity and mortality after open cardiac surgery in CLL versus non-CLL patients. METHODS: From May 1995 to May 2015, 157 patients with CLL and 55,917 without and older than 47 years underwent elective cardiac surgery at Cleveland Clinic. By Rai criteria, 79 CLL patients (56%) were low risk (class 0), 13 (9...
February 15, 2018: Annals of Thoracic Surgery
Urmil Pandya, Alexander Malik, Michael Messina, Abdul-Rahman Albeiruti, Chance Spalding
Reversal of antiplatelet therapy with platelet transfusion in traumatic intracranial hemorrhage remains controversial. Several studies have examined this topic but few have investigated whether the timing of transfusion affects outcomes. Patients admitted to a level 1 trauma center from 1/1/14 to 3/31/16 with traumatic intracranial hemorrhage taking pre-injury antiplatelet therapy were retrospectively analyzed. Patients on concurrent pre-injury anticoagulant therapy were excluded. Per institutional guideline, patients on pre-injury clopidogrel received 2 doses of platelets while patients on pre-injury aspirin received 1 dose of platelets...
February 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Carlito Lagman, John P Sheppard, Prasanth Romiyo, Thien Nguyen, Giyarpuram N Prashant, Daniel T Nagasawa, Linda M Liau, Isaac Yang
The objectives of this study are to identify risk factors for and to evaluate clinical outcomes of platelet transfusion in glioblastoma surgery. The medical records of adult patients who underwent craniotomy for glioblastoma resection at a single academic medical center were retrospectively reviewed. We stratified patients into 2 groups: those who were transfused at least 1 unit of platelets intraoperatively or postoperatively (no more than 7 days after surgery), and those who were not transfused with platelets...
February 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Wei Zheng, Kang-Mei Zhao, Li-Hui Luo, Yang Yu, Sheng-Mei Zhu
Background: Although many previous studies have confirmed that perioperative blood transfusion is associated with poor outcomes after liver transplantation (LT), few studies described the influence of single-donor platelet apheresis transfusion in living donor LT (LDLT). This study aimed to assess the effect of blood products on outcomes for LDLT recipients, focusing on apheresis platelets. Methods: This retrospective study included 126 recipients who underwent their first adult-to-adult LDLT...
February 20, 2018: Chinese Medical Journal
DaShawn A Hickman, Christa L Pawlowski, Andrew Shevitz, Norman F Luc, Ann Kim, Aditya Girish, Joyann Marks, Simi Ganjoo, Stephanie Huang, Edward Niedoba, Ujjal D S Sekhon, Michael Sun, Mitchell Dyer, Matthew D Neal, Vikram S Kashyap, Anirban Sen Gupta
Traumatic non-compressible hemorrhage is a leading cause of civilian and military mortality and its treatment requires massive transfusion of blood components, especially platelets. However, in austere civilian and battlefield locations, access to platelets is highly challenging due to limited supply and portability, high risk of bacterial contamination and short shelf-life. To resolve this, we have developed an I.V.-administrable 'synthetic platelet' nanoconstruct (SynthoPlate), that can mimic and amplify body's natural hemostatic mechanisms specifically at the bleeding site while maintaining systemic safety...
February 15, 2018: Scientific Reports
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
Guilherme Piovezani Ramos, Moritz Binder, Paul Hampel, Manuel Bonfim Braga Neto, Dharma Sunjaya, Badr Al Bawardy, Barham K Abu Dayyeh, Navtej S Buttar, David H Bruining, Nayantara Coelho-Prabhu, Mark V Larson, Louis M Wong Kee Song, Elizabeth Rajan
BACKGROUND AND AIMS: Gastrointestinal bleeding (GIB) in the setting of thrombocytopenia raises concerns about endoscopic procedure risk. We aimed to assess the safety and outcomes of endoscopy for overt GIB in the setting of severe thrombocytopenia in liver cirrhosis (LC) and non-liver cirrhosis (NLC). METHODS: Retrospective study on inpatients who underwent endoscopy within 24-hours of presentation for overt GIB with a platelet count (PC) of 20 to <50 x 103/mL...
February 1, 2018: Gastrointestinal Endoscopy
Thomas J Cusack, J Ricardo Carhuapoma, Wendy C Ziai
PURPOSE OF REVIEW: Spontaneous intraparenchymal hemorrhage (IPH) is a prominent challenge faced globally by neurosurgeons, neurologists, and intensivists. Over the past few decades, basic and clinical research efforts have been undertaken with the goal of delineating biologically and evidence-based practices aimed at decreasing mortality and optimizing the likelihood of meaningful functional outcome for patients afflicted with this devastating condition. Here, the authors review the medical and surgical approaches available for the treatment of spontaneous intraparenchymal hemorrhage, identifying areas of recent progress and ongoing research to delineate the scope and scale of IPH as it is currently understood and treated...
February 3, 2018: Current Treatment Options in Neurology
C Aubron, R K Kandane-Rathnayake, N Andrianopoulos, A Westbrook, S Engelbrecht, I Ozolins, M Bailey, L Murray, D J Cooper, E M Wood, Z K McQuilten
BACKGROUND AND OBJECTIVES: The timing of blood administration in critically ill patients is first driven by patients' needs. This study aimed to define the epidemiology and significance of overnight transfusion in critically ill patients. MATERIALS AND METHODS: This is a post hoc analysis of a prospective multicentre observational study including 874 critically ill patients receiving red blood cells, platelets, fresh frozen plasma (FFP) or cryoprecipitate. Characteristics of patients receiving blood only during the day (8 am up until 8 pm) were compared to those receiving blood only overnight (8 pm up until 8 am)...
February 2, 2018: Vox Sanguinis
Senaka Rajapakse, Nipun Lakshitha de Silva, Praveen Weeratunga, Chaturaka Rodrigo, Sumadhya Deepika Fernando
The global incidence of dengue has increased sevenfold between 1990 and 2013. Despite a low case fatality rate (<1%), during epidemics, due to the large number of people affected, overall mortality rates can be significant. The risk of clinically significant bleeding in dengue is unpredictable and often contributes to an adverse outcome. This systematic review focuses on the evidence for prophylactic and therapeutic interventions for bleeding in dengue infection. PubMed, CINAHL, Cochrane Library, Embase and Google Scholar were searched for randomized, quasi-randomized and non-randomized, prospective or retrospective studies that had a control group alongside an intervention aimed at stopping or preventing bleeding in dengue infection...
January 29, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Marcel Baschin, Sixten Selleng, Astrid Hummel, Stephan Diedrich, Henry W Schroeder, Thomas Kohlmann, Antje Westphal, Andreas Greinacher, Thomas Thiele
BACKGROUND: Patients receiving antiplatelet therapy (APT) have an increased risk of perioperative bleeding and cardiac adverse events (CAE). Preoperative platelet transfusions may reduce the bleeding risk but may also increase the risk of CAE, particularly coronary thrombosis in patients after recent stent implantation. OBJECTIVES: To analyse the incidence of perioperative CAE and bleeding in patients undergoing non-cardiac surgery using a standardized management of transfusing two platelet concentrates pre-operatively and restart of APT within 24-72 hours after surgery...
January 31, 2018: Journal of Thrombosis and Haemostasis: JTH
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