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Red Cell Transfusion ARDS

Alexander Beyer, Ryan Rees, Christopher Palmer, Brian T Wessman, Brian M Fuller
BACKGROUND: Blood product transfusion occurs in a significant percentage of intensive care unit (ICU) patients. Pulmonary complications, such as acute respiratory distress syndrome (ARDS), occurring in the setting of transfusion, are associated with increased morbidity and mortality. Contrary to the ICU setting, there is little evidence describing the epidemiology of transfusion in the emergency department (ED) or its potential impact on outcome. The objectives of this study were to: (1) characterize transfusion practices in the ED with respect to patient characteristics and pre-transfusion laboratory values; and (2) investigate the effect of ED blood product transfusion on the incidence of pulmonary complications after admission...
December 2017: International Journal of Emergency Medicine
Mei-Fang Chen, Liang-Wan Chen, Hua Cao, Yong Lin
BACKGROUND: To explore the risk factors for and the prognosis of postoperative acute respiratory distress syndrome (ARDS) in patients with Stanford type A aortic dissection (AD). METHODS: This retrospective nested case-control study included 527 Stanford type A AD patients who were divided into ARDS groups and non-ARDS groups. The clinical features of the groups were examined. RESULTS: The fifty-nine patients in the ARDS group exhibited extended durations of cardiopulmonary bypass (CPB) (P=0...
October 2016: Journal of Thoracic Disease
Michael Zubrow, Nadir Yehya
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Michael C Sklar, Eric Sy, Laurance Lequier, Eddy Fan, Hussein D Kanji
BACKGROUND: The optimal anticoagulation strategy for venovenous extracorporeal membrane oxygenation (VV-ECMO) is not known. OBJECTIVES: To evaluate the safety of anticoagulation strategies and monitoring during VV-ECMO for respiratory failure. DATA SOURCES: We conducted a systematic review to evaluate the association between anticoagulation strategies during VV-ECMO and prespecified outcomes, including major bleeding episodes, thrombotic events, and in-hospital mortality...
December 2016: Annals of the American Thoracic Society
Jacquelyn E M Grev, Marketa Stanclova, Marc A Ellsworth, Christopher E Colby
Objective The objective of this study was to determine whether packed red blood cell (pRBC) transfusions in extremely low birth weight (ELBW) infants were associated with acute respiratory decompensation (ARD). Study Design Retrospective chart review of ELBW infant pRBC transfusions analyzed for meeting ARD criteria during the 6 hours post-pRBC transfusion was compared with the pretransfusion baseline period. A control period subdivided into similar pre- and postintervals was also assessed for each infant...
January 2017: American Journal of Perinatology
Nils Wagner, Annahita Akbarpour, Katharina Mörs, Maika Voth, Philipp Störmann, Birgit Auner, Mark Lehnert, Ingo Marzi, Borna Relja
BACKGROUND: The effect of alcohol consumption on inflammatory state and outcome in brain-injured patients remains controversial. We analyzed the influence of positive blood alcohol concentration (BAC) on inflammatory changes, inhospital complications, and mortality in traumatic brain injury (TBI) patients. PATIENTS AND METHODS: Patients with an Injury Severity Score (ISS) at least 16 and Abbreviated Injury Scale of head (AIS-head) at least 3 were included upon arrival in the emergency room and grouped according to positive BAC (>0...
September 2016: Shock
Patrick L Bosarge, Lauren Allen Raff, Gerald McGwin, Shannon L Carroll, Scott C Bellot, Enrique Diaz-Guzman, Jeffrey D Kerby
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in the trauma population has been reported to have a mortality benefit in patients with severe refractory hypoxic respiratory failure. This study compares the early initiation of ECMO for the management of severe adult respiratory distress syndrome (ARDS) versus a historical control immediately preceding the use of ECMO for trauma patients. METHODS: A retrospective study was conducted at a single verified Level I trauma center...
August 2016: Journal of Trauma and Acute Care Surgery
B Relja, J Menke, N Wagner, B Auner, M Voth, C Nau, I Marzi
BACKGROUND: The influence of alcohol on the outcome after major trauma remains controversial. In several recent studies, alcohol has been associated with neuroprotective effects in head injuries, while others reported negative or no effects on survival and/or the in-hospital stay in major trauma patients (TP). The purpose of this study was to examine the relationship of alcohol with injury characteristics and outcome as well as to analyze possible anti-inflammatory properties in major TP...
March 2016: Injury
Henk Schonewille, Áine Honohan, Leo M G van der Watering, Francisca Hudig, Peter A Te Boekhorst, Ankie W M M Koopman-van Gemert, Anneke Brand
BACKGROUND: Most incidentally transfused patients receive only ABO-D-compatible transfusions and antibodies are formed in up to 8%. The effect of extended (c, C, E, K, Fy(a) , Jk(a) , and S antigens) matched (EM) and ABO-D-matched red blood cell (RBC) transfusions on the incidence of new clinically relevant RBC antibody formation after a first elective transfusion event in surgical patients was studied. STUDY DESIGN AND METHODS: A multicenter randomized trial was performed in nontransfused patients who were scheduled to experience a single elective transfusion event of maximal 4 RBC units...
February 2016: Transfusion
Krstina Doklestić, Branislav Stefanović, Pavle Gregorić, Nenad Ivančević, Zlatibor Lončar, Bojan Jovanović, Vesna Bumbaširević, Vasilije Jeremić, Sanja Tomanović Vujadinović, Branislava Stefanović, Nataša Milić, Aleksandar Karamarković
BACKGROUND: Severe liver injury in trauma patients still accounts for significant morbidity and mortality. Operative techniques in liver trauma are some of the most challenging. They include the broad and complex area, from damage control to liver resection. MATERIAL AND METHOD: This is a retrospective study of 121 trauma patients with hepatic trauma American Association for Surgery of Trauma (AAST) grade III-V who have undergone surgery. Indications for surgery include refractory hypotension not responding to resuscitation due to uncontrolled hemorrhage from liver trauma; massive hemoperitonem on Focused assessment by ultrasound for trauma (FAST) and/or Diagnostic peritoneal lavage (DPL) as well as Multislice Computed Tomography (MSCT) findings of the severe liver injury and major vascular injuries with active bleeding...
2015: World Journal of Emergency Surgery: WJES
Nicola Curry, Amber Raja, James Beavis, Simon Stanworth, Paul Harrison
BACKGROUND: Microvesicles (MV) have been implicated in the development of thrombotic disease, such as acute respiratory distress syndrome (ARDS) and multiple organ failure (MOF). Trauma patients are at increased risk of late thrombotic events, particularly those who receive a major transfusion. The aims of this study were: (a) to determine whether there were increased numbers of pro-coagulant MV following injury; (b) to determine their cellular origin; and (c) to explore the effects of MV with clinical outcomes; in particular red cell transfusion requirements and death...
2014: Journal of Extracellular Vesicles
Christian Weingart, Matthias Lubnow, Alois Philipp, Thomas Bein, Daniele Camboni, Thomas Müller
Clinical data on anticoagulation needs of modern extracorporeal membrane oxygenation (ECMO) and its impact on coagulation are scarce. Therefore, we analyzed coagulation-related parameters, need for transfusion, and management of anticoagulation in adult patients with severe acute respiratory failure during treatment with either pumpless interventional lung assist (iLA) or veno-venous ECMO (vv-ECMO). Sixty-three patients treated with iLA and 192 patients treated with vv-ECMO at Regensburg University Hospital between January 2005 and May 2011 were analyzed...
September 2015: Artificial Organs
Ilya Kagan, Jonathan Cohen, Michael Stein, Itai Bendavid, Dana Pinsker, Veronica Silva, Miriam Theilla, Ronit Anbar, Shaul Lev, Milana Grinev, Pierre Singer
BACKGROUND: Severe injury triggers a complex systemic immune response which may result in significant respiratory compromise, including the development of acute respiratory distress syndrome (ARDS). No randomized clinical trial has assessed the role of nutritional interventions to limit respiratory complications. METHODS: This was a single-center, prospective, randomized, comparative, double-blind, controlled study of patients with severe trauma requiring mechanical ventilation...
March 2015: Intensive Care Medicine
Pearl Toy, Peter Bacchetti, Barbara Grimes, Ognjen Gajic, Edward L Murphy, Jeffrey L Winters, Michael A Gropper, Rolf D Hubmayr, Michael A Matthay, Gregory Wilson, Monique Koenigsberg, Deanna C Lee, Nora V Hirschler, Clifford A Lowell, Randy M Schuller, Manish J Gandhi, Philip J Norris, David C Mair, Rosa Sanchez Rosen, Mark R Looney
BACKGROUND: Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. STUDY DESIGN AND METHODS: In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota)...
May 2015: Transfusion
J-A Dusacre, B Pons, P Piednoir, J-F Soubirou, G Thiery
We report the case of an 8-year-old sickle cell anemia child admitted for acute respiratory failure complicating acute chest syndrome. Because of threatening respiratory failure, tracheal intubation was performed immediately after ICU admission. The patient met the criteria for ARDS with a PaO2/FiO2 ratio of 94mmHg. An exchange transfusion was performed immediately after admission. HbS fraction failed from 69 % to 30 %. Fluid resuscitation with crystalloids and continuous norepinephrine infusion was needed because of arterial hypotension...
December 2014: Annales Françaises D'anesthèsie et de Rèanimation
Maria T Voelker, Thilo Busch, Sven Bercker, Falk Fichtner, Udo X Kaisers, Sven Laudi
Recommendations concerning the management of hemoglobin levels and hematocrit in patients on extracorporeal membrane oxygenation (ECMO) still advise maintenance of a normal hematocrit. In contrast, current transfusion guidelines for critically ill patients support restrictive transfusion practice. We report on a series of patients receiving venovenous ECMO (vvECMO) for acute respiratory distress syndrome (ARDS) treated according to the restrictive transfusion regimen recommended for critically ill patients...
April 2015: Artificial Organs
Danielle Y Qing, David Conegliano, Michael G S Shashaty, Jeongyun Seo, John P Reilly, G Scott Worthen, Dongeun Huh, Nuala J Meyer, Nilam S Mangalmurti
RATIONALE: Red blood cell (RBC) transfusions are associated with increased risk of acute respiratory distress syndrome (ARDS) in the critically ill, yet the mechanisms for enhanced susceptibility to ARDS conferred by RBC transfusions remain unknown. OBJECTIVES: To determine the mechanisms of lung endothelial cell (EC) High Mobility Group Box 1 (HMGB1) release following exposure to RBCs and to determine whether RBC transfusion increases susceptibility to lung inflammation in vivo through release of the danger signal HMGB1...
December 1, 2014: American Journal of Respiratory and Critical Care Medicine
John P Sharpe, Louis J Magnotti, Martin A Croce, Elena M Paulus, Thomas J Schroeppel, Timothy C Fabian, Jordan A Weinberg
BACKGROUND: Current direction in trauma resuscitation includes emphasis on minimizing crystalloid, along with early transfusion of blood products. Although evidence suggests that higher crystalloid volume during the first 24 hours is associated with negative outcomes, the effect of crystalloid administration during initial resuscitation remains unclear. The purpose of this study was to evaluate the impact of the ratio of crystalloid to packed red blood cells (C/PRBCs) infused during initial emergency department resuscitation on pulmonary morbidity and mortality...
December 2014: Journal of Trauma and Acute Care Surgery
Martin D Zielinski, Jason J Schrager, Pamela Johnson, James R Stubbs, Stephanie Polites, Scott P Zietlow, Donald H Jenkins, Bryce R H Robinson
INTRODUCTION: Group AB plasma, the traditional universal donor plasma product, is a limited resource. We compared outcomes of Group A plasma transfusion in comparison to AB. METHODS: Analysis of blunt-injured patients who received emergency release plasma from was performed. Multivariable logistic regression was utilized to identify associations with morbidity and mortality. RESULTS: There were 191 patients; 115 Group A and 76 Group AB. No differences were seen in age, sex, plasma transfusions, uncrossmatched red blood cells (RBCs), and Glasgow Coma Scale (GCS)...
February 2015: Clinical and Translational Science
Sunil V Patel, Biniam Kidane, Michelle Klingel, Neil Parry
INTRODUCTION: A previous meta-analysis has found an association between red blood cell (RBC) transfusions and mortality in critically ill patients, but no review has focused on the trauma population only. OBJECTIVES: To determine the association between RBC transfusion and mortality in the trauma population, with secondary outcomes of multiorgan failure (MOF) and acute respiratory distress syndrome (ARDS) or acute lung injury (ALI). DATA SOURCES: EMBASE (1947-2012) and MEDLINE (1946-2012)...
October 2014: Injury
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