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Transfusion practices

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https://www.readbyqxmd.com/read/29664740/ce-a-review-of-current-practice-in-transfusion-therapy
#1
Margaret Carman, Jennifer Schieferle Uhlenbrock, Sara Marie McClintock
Preventing and recognizing complications, including TACO, TRALI, and TRIM. ABSTRACT: In the United States, roughly 4.5 million patients per year receive transfusions of various blood products. Despite the lifesaving benefits of transfusion therapy, it is an independent risk factor for infection, morbidity, and death in critically ill patients. It's important for nurses to understand the potential complications patients face when blood products are administered and to recognize that patients who have received blood products in the past remain at risk for delayed reactions, including immune compromise and infection...
April 16, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29664169/improving-quality-of-care-for-patients-with-iron-deficiency-anemia-presenting-to-the-emergency-department
#2
Fatima Khadadah, Jeannie Callum, Dominick Shelton, Yulia Lin
BACKGROUND: Patients presenting to the emergency department (ED) with iron deficiency anemia (IDA) are underrecognized, undertreated with iron, and overtransfused. A 3-month audit of red blood cell (RBC) transfusions at the Sunnybrook Health Sciences Centre ED in 2013 showed that only 53% of transfusions for IDA were appropriate. The aim of this quality improvement project was to increase the rate of appropriate transfusion to greater than 80%. STUDY DESIGN AND METHODS: Since November 2013, several quality improvement interventions have been implemented, including educational presentations, development of an algorithm on IDA management in the ED, and development of an ED IDA toolkit...
April 17, 2018: Transfusion
https://www.readbyqxmd.com/read/29661410/use-of-prothrombin-complex-concentrate-for-management-of-coagulopathy-after-cardiac-surgery-a-propensity-score-matched-comparison-to-plasma
#3
J Fitzgerald, M Lenihan, J Callum, S A McCluskey, C Srinivas, A van Rensburg, K Karkouti
BACKGROUND: An important cause of coagulopathy in cardiac surgery is impaired thrombin generation. While plasma is often used to correct this element of the coagulopathy, studies in vitro suggest that prothrombin complex concentrates (PCCs) might be more effective. Comparative data, however, are scant. METHODS: We compared the outcomes of those who received only plasma with those who received PCCs (with or without plasma) for management of coagulopathy in patients who underwent cardiac surgery with cardiopulmonary bypass at a single institution from 2012 to 2016...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661282/impact-of-fresh-frozen-plasma-transfusion-on-postoperative-inflammation-and-prognosis-of-colorectal-liver-metastases
#4
Yuichi Nakaseko, Koichiro Haruki, Hiroaki Shiba, Takashi Horiuchi, Nobuhiro Saito, Taro Sakamoto, Takeshi Gocho, Katsuhiko Yanaga
BACKGROUND: Blood transfusion has been reported to be associated with immunomodulation and poor oncologic outcomes in several malignancies. The aim of the study is to investigate the influence of the use of fresh frozen plasma (FFP) on long-term outcomes in patients with colorectal liver metastases (CRLM) after hepatic resection. MATERIALS AND METHODS: The study comprised 127 patients who had undergone first hepatic resection for CRLM between April 2000 and December 2013...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29660827/patient-blood-management-and-the-importance-of-the-transfusion-practitioner-role-to-embed-this-into-practice
#5
REVIEW
L Bielby, R L Moss
Patient blood management (PBM) is a widely established international initiative, with a multidisciplinary approach to reduce transfusion. The Transfusion Practitioner (TP) role is well embedded in the United Kingdom (UK) and Australia. The value of the TP in changing both culture and practice to implement an all-inclusive PBM approach to care will be discussed. The TP role was born from both a safety and haemovigilance culture, where the greatest identified risk to the patient undergoing a transfusion was human error...
April 16, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29659467/a-standard-push-pull-protocol-for-waste-free-sampling-in-the-pediatric-intensive-care-unit
#6
Clare McBride, Suzan Miller-Hoover, James A Proudfoot
Blood sampling is a major source of blood loss in the pediatric intensive care unit (PICU). Blood-sparing sampling techniques such as the push-pull method can significantly reduce sampling-related blood loss and protect patients from anemia and blood transfusions. The push-pull method is supported by research evidence for central venous catheter (CVC) sampling, but research protocols differ and not all CVCs and laboratory tests have been studied. A standard push-pull protocol for the PICU was developed, implemented, and evaluated in this evidence-based practice project...
May 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#7
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29649026/evidence-review-conducted-for-the-agency-for-healthcare-research-and-quality-safety-program-for-improving-surgical-care-and-recovery-focus-on-anesthesiology-for-colorectal-surgery
#8
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Michael C Grant, Christopher L Wu
The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29630059/model-surgical-training-skills-acquisition-in-fetoscopic-laser-photocoagulation-of-monochorionic-diamniotic-twin-placenta-using-realistic-simulators
#9
Tuangsit Wataganara, Arundhati Gosavi, Katika Nawapun, Pradip D Vijayakumar, Nisarat Phithakwatchara, Mahesh Choolani, Lin Lin Su, Arijit Biswas, Citra N Z Mattar
Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome (TTTS), but is technically challenging and can lead to significant complications. Acquiring and maintaining the necessary surgical skills require consistent practice, a critical caseload, and time. Training on realistic surgical simulators can potentially shorten this steep learning curve and enables several proceduralists to acquire procedure-specific skills simultaneously...
March 21, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29630007/optimizing-blood-transfusion-practices-through-bundled-intervention-implementation-in-patients-with-gynecologic-cancer-undergoing-laparotomy
#10
Sumer K Wallace, Jessica W Halverson, Christopher J Jankowski, Stephanie R DeJong, Amy L Weaver, Megan R Weinhold, Bijan J Borah, James P Moriarty, William A Cliby, Daryl J Kor, Andrew A Higgins, Hilary A Otto, Sean C Dowdy, Jamie N Bakkum-Gamez
OBJECTIVE: To examine blood transfusion practices and develop a standardized bundle of interventions to address the high rate of perioperative red blood cell transfusion among patients with ovarian and endometrial cancer. METHODS: This was a retrospective cohort study. Our primary aim was to determine whether an implemented bundled intervention was associated with a reduction in perioperative red blood cell transfusions among cases of laparotomy for cancer. Secondary aims included comparing perioperative demographic, surgical, complication, and cost data...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29625873/-lower-uterine-segment-trial-a-pragmatic-open-multicenter-randomized-trial
#11
P Rozenberg, P Deruelle, M-V Sénat, R Desbrière, N Winer, E Simon, Y Ville, G Kayem, I Boutron
BACKGROUND: The data from literature show that trial of labor and elective repeat cesarean delivery after a prior cesarean delivery both present significant risks and benefits, and these risks and benefits differ for the woman and her fetus. The benefits to the woman can be at the expense of her fetus and vice-versa. This uncertainty is compounded by the scarcity of high-level evidence that preclude accurate quantification of the risks and benefits that could help provide a fair counseling about a trial of labor and elective repeat cesarean delivery...
April 4, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29624679/metabolic-effect-of-alkaline-additives-and-guanosine-gluconate-in-storage-solutions-for-red-blood-cells
#12
Angelo D'Alessandro, Julie A Reisz, Rachel Culp-Hill, Herbert Korsten, Robin van Bruggen, Dirk de Korte
BACKGROUND: Over a century of advancements in the field of additive solutions for red blood cell (RBC) storage has made transfusion therapy a safe and effective practice for millions of recipients worldwide. Still, storage in the blood bank results in the progressive accumulation of metabolic alterations, a phenomenon that is mitigated by storage in novel storage additives, such as alkaline additive solutions. While novel alkaline additive formulations have been proposed, no metabolomics characterization has been performed to date...
April 6, 2018: Transfusion
https://www.readbyqxmd.com/read/29624677/logistical-and-safety-implications-of-temperature-based-acceptance-of-returned-red-blood-cell-units
#13
Robert A DeSimone, Michael D Nowak, Dian T Lo, Kathleen M Crowley, Priscilla Parra, Melissa M Cushing, Yen-Michael S Hsu
BACKGROUND: AABB requires that red blood cells (RBCs) are maintained at 1 to 10°C during transport. Historically, blood banks used the 30-minute rule for returned RBCs transported outside of validated containers. The implications of this policy have not been previously reported in a real-life hospital setting. STUDY DESIGN AND METHODS: A 2-year, retrospective review of RBC units returned outside of qualified containers was conducted. During the first year, the 30-minute rule was used to accept RBCs back into inventory...
April 6, 2018: Transfusion
https://www.readbyqxmd.com/read/29624594/a-systematic-scoping-review-on-the-consequences-of-stress-related-hyperglycaemia
#14
Elena Olariu, Nicholas Pooley, Aurélie Danel, Montserrat Miret, Jean-Charles Preiser
BACKGROUND: Stress-related hyperglycaemia (SHG) is commonly seen in acutely ill patients and has been associated with poor outcomes in many studies performed in different acute care settings. We aimed to review the available evidence describing the associations between SHG and different outcomes in acutely ill patients admitted to an ICU. Study designs, populations, and outcome measures used in observational studies were analysed. METHODS: We conducted a systematic scoping review of observational studies following the Joanna Briggs methodology...
2018: PloS One
https://www.readbyqxmd.com/read/29619936/intravenous-iron-treatment-in-the-puerperium
#15
Charlotte Holm
Iron deficiency and anaemia in the puerperium are associated with several important clinical consequences, most prominently physical fatigue. Current treatment practice with oral iron supplementation is associated with gastrointestinal side-effects and subsequent poor compliance. Red blood cell transfusion is also widely used to treat severe postpartum anaemia, though accumulating evidence questions its risk-benefit ratio. Intravenous iron has in previous studies been associated with fast improvement of haemoglobin and iron biochemical markers in the treatment of postpartum anaemia, but there is a lack of studies on patient reported outcomes...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29608319/warm-autoadsorption-using-zzap
#16
Farai M Tsimba-Chitsva, Amy Caballero, Becky Svatora
The masking of clinically significant alloantibodies by warm autoantibodies presents challenges in pretransfusion testing. The adoption of transfusion practices such as the issuing of "least incompatible" red blood cells (RBCs) without a complete antibody workup is potentially unsafe for patients. Several autoadsorption methods can be used to remove autoantibody reactivity. ZZAP treatment of autologous RBCs is an efficient way to prepare the cells for autoadsorption. Autoadsorbed serum or plasma can then be used to remove autoantibody reactivity and identify clinically significant alloantibodies...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29607593/massive-transfusions-for-critical-bleeding-is-everything-old-new-again
#17
REVIEW
A W J Flint, Z K McQuilten, E M Wood
Massive transfusion or major haemorrhage protocols have been widely adopted in the treatment of critically bleeding patients. Following evidence that higher ratios of transfused plasma and platelets to red blood cells may offer survival benefits in military trauma patients, these ratios are now commonly incorporated into massive transfusion protocols. They more closely resemble the effects of whole blood transfusion, which in the second half of last century was largely replaced by individual blood component transfusion based on laboratory-guided indicators...
April 1, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29607473/emergency-blood-transfusion-in-children-in-a-tertiary-hospital-in-nigeria-indications-frequency-and-outcome
#18
B I Abhulimhen-Iyoha, Y T Israel-Aina
BACKGROUND: Blood transfusion is a life-saving procedure in paediatric practice. It is important in replacing blood volume in cases of haemorrhage or providing specific blood components as required. However, the procedure carries some risks and complications. The decision to transfuse, frequency of transfusion and the availability of safe blood and blood products are essential determinants of the success of the procedure. Hence, knowledge of the indications and rate of transfusion is important to ensure that blood for transfusion is safe and made available as at when due...
January 2018: West African Journal of Medicine
https://www.readbyqxmd.com/read/29606603/surgical-management-of-hepatocellular-carcinoma-within-and-beyond-bclc-indications-in-a-middle-volume-center
#19
M Garancini, S Nespoli, F Romano, F Uggeri, L Degrate, S Okolicsanyi, L Gianotti
AIM OF THE STUDY: Current criteria for hepatic resection in patients with hepatocellular carcinoma (HCC) according to Barcellona Clinic Liver Cancer (BCLC) classification is debated. Actually, patients with multinodular or large HCC>5cm are excluded from surgical treatment following the algorithm, but several studies from referral centers showed that such patients may benefit from surgical resection in the clinical practice. The aim of this study was to compare short- and long-term outcomes after liver resection for HCC in stage 0/A or B in a middle volume center...
March 29, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29606583/cost-analysis-of-enhanced-recovery-after-surgery-in-microvascular-breast-reconstruction
#20
Christine Oh, James Moriarty, Bijan J Borah, Kristin C Mara, William S Harmsen, Michel Saint-Cyr, Valerie Lemaine
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways have been shown in multiple surgical specialties to decrease hospital length of stay (LOS) after surgery. ERAS in breast reconstruction has been found to decrease hospital LOS and inpatient opioid use. ERAS protocols can facilitate a patient's recovery and can potentially increase the quality of care while decreasing costs. METHODS: A standardized ERAS pathway was developed through multidisciplinary collaboration...
March 2, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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