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Transfusion practices

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https://www.readbyqxmd.com/read/29470342/acog-practice-bulletin-no-192-management-of-alloimmunization-during-pregnancy
#1
(no author information available yet)
When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother. Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or "alloimmunization," may lead to various degrees of transplacental passage of these antibodies into the fetal circulation. Depending on the degree of antigenicity and the amount and type of antibodies involved, this transplacental passage may lead to hemolytic disease in the fetus and neonate...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29470338/acog-practice-bulletin-no-192-summary-management-of-alloimmunization-during-pregnancy
#2
(no author information available yet)
When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother. Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or "alloimmunization," may lead to various degrees of transplacental passage of these antibodies into the fetal circulation. Depending on the degree of antigenicity and the amount and type of antibodies involved, this transplacental passage may lead to hemolytic disease in the fetus and neonate...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29467101/ultrasound-screening-for-complications-in-twin-pregnancy
#3
Rosemary Townsend, Asma Khalil
In the decades since the introduction of ultrasound into routine obstetric practice, the advantages of ultrasound have moved beyond the simple ability to identify multiple pregnancies antenatally to the possibility of screening them for fetal anomalies, pre-eclampsia, preterm birth, and the complications specific to monochorionic pregnancies. Screening studies have often excluded twins because physiological differences impact on the validity and sensitivity of the screening tests in routine use in singletons, and therefore, the evidence of screening performance in multiple pregnancy lags behind the evidence from singleton pregnancies...
February 18, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29464966/trends-in-transfusion-rates-after-the-focus-trial
#4
David H Howard, John D Roback, David J Murphy
AIM: We estimate the impact of the FOCUS trial, which concluded that hip surgery patients with hemoglobin values above 8 g/dl do not benefit from routine transfusions, on transfusion rates. METHODS: We evaluated trends in transfusion rates using inpatient discharge data from four states. RESULTS: The transfusion rate was 5.2 percentage points lower in the fourth quarter of 2013 than it would have been had pre-FOCUS trends continued. Transfusion rates declined more in hospitals with a low end-of-life treatment intensity index, a general measure of treatment intensity...
February 21, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29460456/acute-haemolysis-dic-and-renal-failure-after-transfusion-of-uncross-matched-blood-during-trauma-resuscitation-illustrative-case-and-literature-review
#5
J Fiorellino, A L Elahie, T E Warkentin
AIMS/OBJECTIVES: The aims of this study were to report a patient with acute haemolytic transfusion reaction (HTR) after transfusing uncross-matched red blood cell (RBC) units and to identify the frequency of this complication. BACKGROUND: Uncross-matched RBC units are commonly transfused in emergencies, but the frequency of acute HTR is unknown. METHODS: We describe a male stabbing victim who received three units of uncross-matched RBC units complicated by acute intravascular HTR, disseminated intravascular coagulation (DIC) and renal failure...
February 19, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29460307/antibodies-to-human-platelet-antigens-form-a-significant-proportion-of-platelet-antibodies-detected-in-indian-patients-with-refractoriness-to-platelet-transfusions
#6
A S Abraham, M P Chacko, N A Fouzia, A Srivastava, D Daniel
BACKGROUND: The transfusion of platelets is an important therapeutic strategy in bleeding patients with thrombocytopenia. However, some chronically transfused patients fail to achieve the appropriate platelet count increment following transfusion due to the presence of platelet alloantibodies. OBJECTIVES: The aims of this research were to study the prevalence of platelet alloimmunisation and to characterise the platelet-reactive (PR) antibodies in haematology patients refractory to platelet transfusions in an Indian setting...
February 19, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29459342/hemoglobin-thresholds-and-red-blood-cell-transfusion-in-adult-patients-with-moderate-or-severe-traumatic-brain-injuries-a-retrospective-cohort-study
#7
Amélie Boutin, Lynne Moore, Robert S Green, Ryan Zarychanski, Mete Erdogan, François Lauzier, Shane English, Dean A Fergusson, Michael Butler, Lauralyn McIntyre, Michaël Chassé, Paule Lessard Bonaventure, Caroline Léger, Philippe Desjardins, Donald Griesdale, Jacques Lacroix, Alexis F Turgeon
PURPOSE: We aimed to evaluate the association between transfusion practices and clinical outcomes in patients with traumatic brain injury. MATERIAL AND METHODS: We conducted a retrospective cohort study of adult patients with moderate or severe traumatic brain injury admitted to the intensive care unit (ICU) of a level I trauma center between 2009 and 2013. The associations between hemoglobin (Hb) level, red blood cell (RBC) transfusion and clinical outcomes were estimated using robust Poisson models and proportional hazard models with time-dependent variables, adjusted for confounders...
January 31, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29455308/fluid-therapy-and-outcome-a-prospective-observational-study-in-65-german-intensive-care-units-between-2010-and-2011
#8
Christian Ertmer, Bernhard Zwißler, Hugo Van Aken, Michael Christ, Fabian Spöhr, Axel Schneider, Robert Deisz, Matthias Jacob
BACKGROUND: Outcome data on fluid therapy in critically ill patients from randomised controlled trials may be different from data obtained by observational studies under "real-life" conditions. We conducted this prospective, observational study to investigate current practice of fluid therapy (crystalloids and colloids) and associated outcomes in 65 German intensive care units (ICUs). In total, 4545 adult patients who underwent intravenous fluid therapy were included. The main outcome measures were 90-day mortality, ICU mortality and acute kidney injury (AKI)...
February 17, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29452838/external-quality-control-program-in-screening-for-infectious-diseases-at-blood-banks-in-mexico
#9
J Manuel Bello-López, Cristina Castañeda-García, Celerino Muñoz-Estrada, Antonio José Machorro-Peréz
INTRODUCTION: Quality control for the detection of infectious markers in blood banks is a necessary activity to ensure the accuracy of donor screening results. Considering that in Mexico blood safety is one of the goals of the National Action Programs, it is essential to evaluate banks through an External Quality Control Program. OBJECTIVE: To analyze one of the evaluations that showed the greatest participation (2014-2/lot46) of banks in the Mexican Republic in the detection of transfusion-transmitted diseases...
January 11, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29446461/a-method-for-red-blood-cell-biotinylation-in-a-closed-system
#10
Djuna Z de Back, Richard Vlaar, Boukje Beuger, Brunette Daal, Johan Lagerberg, Alexander P J Vlaar, Dirk de Korte, Marian van Kraaij, Robin van Bruggen
BACKGROUND: Several circumstances require the accurate measurement of red blood cell (RBC) survival and clearance, such as determination of posttransfusion recovery of stored RBCs to investigate the effect of new additive solutions. To this end, biotin as a marker of RBCs to track donor RBCs in the blood of the recipient has been used in many studies. However, so far only experimental, nonvalidated, biotin-labeled red cell concentrates (RCCs) are transfused. The goal of this study was to produce a standardized biotin-labeled RCC product in a fast, simple, and sterile manner that can be used for clinical research and for the evaluation of new blood products according to Good Practice Guidelines (GPG) for blood establishments...
February 15, 2018: Transfusion
https://www.readbyqxmd.com/read/29442472/safe-transfusion-of-blood-components
#11
Alister Jones
Administering the wrong blood component to the wrong patient can have serious clinical consequences, including death. Patients have a right to safe clinical practice in line with nurses' professional standards and code of conduct, and other healthcare regulatory frameworks. Transfusion of blood components is no exception to this; therefore, it is important for healthcare organisations to have policies in place to support healthcare practitioners in ensuring patient safety throughout the transfusion process...
February 14, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29441123/circulation-first-the-time-has-come-to-question-the-sequencing-of-care-in-the-abcs-of-trauma-an-american-association-for-the-surgery-of-trauma-multicenter-trial
#12
Paula Ferrada, Rachael A Callcut, David J Skarupa, Therese M Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M Nygaard, Martin A Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith, Forrest O Moore, Irene Tabas, Joseph Dubose
Background: The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence. Methods: This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29441026/hemodynamic-functionality-of-transfused-red-blood-cells-in-the-microcirculation-of-blood-recipients
#13
REVIEW
Gregory Barshtein, Dan Arbell, Saul Yedgar
The primary goal of red blood cell (RBC) transfusion is to supply oxygen to tissues and organs. However, due to a growing number of studies that have reported negative transfusion outcomes, including reduced blood perfusion, there is rising concern about the risks in blood transfusion. RBC are characterized by unique flow-affecting properties, specifically adherence to blood vessel wall endothelium, cell deformability, and self-aggregability, which define their hemodynamic functionality (HF), namely their potential to affect blood circulation...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29439814/teaching-operative-cardiac-surgery-in-the-era-of-increasing-patient-complexity-can-it-still-be-done
#14
George Tolis, Philip J Spencer, Jordan P Bloom, Serguei Melnitchouk, David A D'Alessandro, Mauricio A Villavicencio, Thoralf M Sundt
OBJECTIVE: Teaching the next generation operative cardiac surgery while maintaining the highest level of patient care is an ever-increasing challenge given the growing proportion of patients with multiple comorbidities, the loss of more straightforward cases to percutaneous interventions, and the pressure of public reporting. No study to date has compared the outcomes of similar cases performed entirely ("skin-to-skin") by the resident with those performed entirely by the staff to confirm the safety of this practice...
February 10, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29438816/the-effect-of-tranexamic-acid-in-unilateral-and-bilateral-total-knee-arthroplasty-in-the-south-asian-population-a-retrospective-cohort-study
#15
Syed Hamza Mufarrih, Azeem Tariq Malik, Nada Qaisar Qureshi, Riaz Hussain Lakdawala, Umar Rabbani, Arif Ali, Shahryar Noordin
INTRODUCTION: Together with evidence of higher bleeding tendencies, the vulnerability of the South Asian population to anemia secondary to a higher prevalence of hemoglobinopathies and micronutrient deficiencies merits further exploration of the effects of tranexamic acid on this population. Additionally, limited access to self-care facilities and certain sociocultural beliefs and practices may not be conducive to a speedy recovery from surgical complications. The aim of this study is to investigate the effects of intraoperative administration of tranexamic acid during total knee arthroplasty when considering the South Asian population...
February 10, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29435899/do-drains-contribute-to-pancreatic-fistulae-analysis-of-over-5000-pancreatectomy-patients
#16
R El Khoury, C Kabir, V K Maker, M Banulescu, M Wasserman, A V Maker
INTRODUCTION: Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was associated with fistula formation. METHODS: Demographic, perioperative, and patient outcome data were captured from the most recent annual NSQIP pancreatic demonstration project database, including components of the fistula risk score...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29434048/hospital-end-of-life-care-in-haematological-malignancies
#17
Yvan Beaussant, Etienne Daguindau, Adrien Chauchet, Philippe Rochigneux, Christophe Tournigand, Régis Aubry, Lucas Morin
OBJECTIVE: To investigate patterns of care during the last months of life of hospitalised patients who died from different haematological malignancies. METHODS: Nationwide register-based study, including all hospitalised adults ≥20 years who died from haematological malignancies in France in 2010-2013. Outcomes included use of invasive cancer treatments and referral to palliative care. Percentages are adjusted for sex and age using direct standardisation. RESULTS: Of 46 629 inpatients who died with haematological malignancies, 24...
February 6, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29422156/expert-consensus-to-weight-an-adherence-score-for-audit-and-feedback-of-practices-that-prevent-necrotizing-enterocolitis-in-very-low-birth-weight-infants
#18
Sheila M Gephart, Christina Wyles, Jennifer Canvasser
OBJECTIVE: Necrotizing enterocolitis (NEC) is a catastrophic abdominal complication threatening the life of premature infants, but adoption of prevention and early recognition practices differs as do NEC rates in Neonatal Intensive Care Units (NICUs). The purpose of this research was to validate and weight an evidence-based adherence score (aka NEC-Zero Adherence Score) to prevent and foster timely recognition of NEC. STUDY DESIGN: An electronic Delphi (e-Delphi) approach was used to identify consensus...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29415351/considerations-for-pre-transfusion-immunohaematology-testing-in-patients-receiving-the-anti-cd38-monoclonal-antibody-daratumumab-for-the-treatment-of-multiple-myeloma
#19
Hang Quach, Simon Benson, Helen Haysom, Anne-Marie Wilkes, Nicole Zacher, Merrole Cole-Sinclair, Henry Miles Prince, Peter Mollee, Andrew Spencer, Phoebe Joy Ho, Simon J Harrison, Cindy Lee, Bradley Augustson, James Daly
In recent years, the anti-CD38 monoclonal antibody daratumumab (Darzalex; Janssen-Cilag Pty Ltd) has been shown to be highly efficacious in relapsed and refractory multiple myeloma, with the final results of treatment in newly diagnosed patients awaited. Despite awareness of the potential interference of daratumumab in pre-transfusion immunohaematology testing during phase I and II clinical studies, there was a degree of unpreparedness in the community upon the introduction of this drug into the clinics, particularly the impact that it has on the operational processes in hospital transfusion laboratories and timely issue of red blood cells (RBCs)...
February 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29406799/management-of-pediatric-urolithiasis-using-a-combination-of-laparoscopic-lithotomy-and-pyeloscopy
#20
Sergio Landa-Juárez, Bárbara M Rivera-Pereira, Ana M Castillo-Fernández
BACKGROUND: Minimally invasive procedures have become the standard option for treatment of urinary stones; the use of more invasive techniques is not a common practice currently. This emergent technology is not always available and laparoscopy is the alternative option. There are few reports of laparoscopic management for urinary lithiasis in pediatric patients. This study is about the use of laparoscopic surgery combined with pyeloscopy as a feasible first-line treatment for pediatric urolithiasis in renal and proximal ureteral locations...
February 6, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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