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https://www.readbyqxmd.com/read/29658485/hyperbaric-oxygen-therapy-its-use-in-medical-emergencies-and-its-development-in-hong-kong
#1
J Ks Leung, R Pk Lam
Hyperbaric oxygen therapy is widely accepted as life-saving treatment for decompression illness. Yet its use in acute carbon monoxide poisoning has remained controversial because of inconsistent findings in clinical trials. Hyperbaric oxygen therapy has an adjunctive role in managing gas gangrene, necrotising soft-tissue infection, and crush injury, as supported by case series. Several cases have been reported in the literature detailing the use of hyperbaric oxygen therapy in patients with severe anaemia in whom blood transfusion is not possible...
April 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29408897/rates-and-predictors-of-attrition-among-children-on-antiretroviral-therapy-in-ethiopia-a-prospective-cohort-study
#2
Mulatu Biru, Inger Hallström, Pia Lundqvist, Degu Jerene
INTRODUCTION: Attrition from antiretroviral therapy (ART) programmes is a critical challenge among children receiving care in resource-limited settings. Our objective was to determine the rates and predictors of attrition among children on ART in Ethiopia. METHODS: Between December 2014 and September 2016, we conducted a prospective cohort study in eight health facilities in Ethiopia. Eligibility criteria included age 3 months-14 years; being on ART for not more than a month...
2018: PloS One
https://www.readbyqxmd.com/read/29369437/best-practice-in-critical-care-anaemia-in-acute-and-critical-illness
#3
REVIEW
A B Docherty, A F Turgeon, T S Walsh
Anaemia is common in critical illness, and standard treatment is red blood cell (RBC) transfusion, typically using a restrictive transfusion threshold of 70 g L-1 . However, there are subgroups of patients in whom it is biologically plausible that a higher transfusion threshold may be beneficial, namely, acute sepsis, traumatic brain injury and coexisting cardiovascular disease. In this review article, we will discuss the pathophysiology of anaemia, as well as its prevalence and time course. We will explore the limitations of using haemoglobin concentration as a surrogate for oxygen delivery and the concept of the critical haemoglobin concentration...
April 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29297368/the-bloody-mess-of-red-blood-cell-transfusion
#4
REVIEW
Susilo Chandra, Hrishikesh Kulkarni, Martin Westphal
Red blood cell (RBC) transfusion might be life-saving in settings with acute blood loss, especially uncontrolled haemorrhagic shock. However, there appears to be a catch-22 situation reflected by the facts that preoperative anaemia represents an independent risk factor for postoperative morbidity and mortality, and that RBC transfusion might also contribute to adverse clinical outcomes. This dilemma is further complicated by the difficulty to define the "best" transfusion trigger and strategy. Since one size does obviously not fit all, a personalised approach is merited...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28841235/harms-of-off-label-erythropoiesis-stimulating-agents-for-critically-ill-people
#5
REVIEW
Bita Mesgarpour, Benedikt H Heidinger, Dominik Roth, Susanne Schmitz, Cathal D Walsh, Harald Herkner
BACKGROUND: Anaemia is a common problem experienced by critically-ill people. Treatment with erythropoiesis-stimulating agents (ESAs) has been used as a pharmacologic strategy when the blunted response of endogenous erythropoietin has been reported in critically-ill people. The use of ESAs becomes more important where adverse clinical outcomes of transfusing blood products is a limitation. However, this indication for ESAs is not licensed by regulatory authorities and is called off-label use...
August 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28782423/maternal-anaemia-after-delivery-prevalence-and-risk-factors
#6
Carola Medina Garrido, Jaime León, Adriana Romaní Vidal
The purpose of this study was to assess the prevalence of postpartum anaemia and determine the clinical risk factors for this condition to provide a viable alternative to postpartum haemoglobin measurement. In total, 1415 patients at Hospital Universitario del Tajo, Madrid, who underwent postpartum haemoglobin testing were included, and risk factors for having an Hb level <10 g/dl were determined. We found that 29% of the mothers were anaemic, and birth canal lacerations, caesarean delivery, episiotomy and South American origin were identified as the main risk factors for this condition...
January 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28772331/-pre-operative-evaluation-of-patients-undergoing-total-joint-arthroplasty-what-is-essential
#7
Holger Haas, Christian D Weber
Background A thorough pre-operative evaluation is required prior to total joint arthroplasty (TJA). The objective of screening is to identify patient- and procedure-related risk constellations. Pre-operative diagnostic measures are vital in order to anticipate, reduce or even eliminate threats to patient safety. Furthermore, the clinical and radiographical workup may confirm the indication and type of surgical procedure, but this is not the subject of this article. Objective An overview of the current literature on pre-operative diagnostic principles is presented...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28625299/managing-major-obstetric-haemorrhage-pharmacotherapy-and-transfusion
#8
REVIEW
Rachel Collis, Emilia Guasch
Major obstetric haemorrhage is a leading cause of maternal mortality. A prescriptive approach to early recognition and management is critical to improving outcomes. Uterine atony is the primary cause of post-partum haemorrhage. First-line prevention and treatment include the administration of uterine tonic agents; other conservative measures include uterine cavity tamponade and uterine compression sutures. Interventional radiology procedures have been used for both prophylaxis and treatment, but a hysterectomy may be necessary if conservative measures fail...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28596707/red-cell-distribution-width-rdw-as-a-biomarker-for-respiratory-failure-in-a-pediatric-icu
#9
Tom Schepens, Jozef J De Dooy, Walter Verbrugghe, Philippe G Jorens
BACKGROUND: The red cell distribution width (RDW) is a widely available, inexpensive, and highly reproducible test that reflects the range of the red cell sizes. Any process that releases reticulocytes in the circulation will result in an increase in RDW. Elevated RDW values are linked to worsened pulmonary function in the adult population. We performed a retrospective cohort study to describe the association between RDW and respiratory failure in critically ill children in a in a pediatric intensive care unit (PICU) in a tertiary university hospital...
2017: Journal of Inflammation
https://www.readbyqxmd.com/read/28407219/multiple-micronutrient-supplementation-for-women-during-pregnancy
#10
REVIEW
Batool A Haider, Zulfiqar A Bhutta
BACKGROUND: Multiple-micronutrient (MMN) deficiencies often coexist among women of reproductive age in low- to middle-income countries. They are exacerbated in pregnancy due to the increased demands, leading to potentially adverse effects on the mother and developing fetus. Though supplementation with MMNs has been recommended earlier because of the evidence of impact on pregnancy outcomes, a consensus is yet to be reached regarding the replacement of iron and folic acid supplementation with MMNs...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28185119/biallelic-brca2-mutations-in-two-black-south-african-children-with-fanconi-anaemia
#11
Candice Feben, Careni Spencer, Anneline Lochan, Nakita Laing, Karen Fieggen, Engela Honey, Tasha Wainstein, Amanda Krause
Fanconi anaemia (FA) is a genotypically and phenotypically heterogeneous genetic condition, characterized cytogenetically by chromosomal instability and breakage secondary to impaired DNA repair mechanisms. Affected individuals typically manifest growth restriction and congenital physical abnormalities and most progress to hematological disease including bone marrow aplasia. A rare genetic subtype of FA (FA-D1) is caused by biallelic mutations in the BRCA2 gene. Affected individuals manifest severe congenital anomalies and significant pigmentary changes and are additionally at risk for early onset leukemia and certain solid organ malignancies, including Wilms tumors and brain tumors...
July 2017: Familial Cancer
https://www.readbyqxmd.com/read/28057694/nutrition-modification-aimed-at-enhancing-dietary-iron-and-folic-acid-intake-an-application-of-health-belief-model-in-practice
#12
Marzieh Araban, Khadije Baharzadeh, Mahmood Karimy
Background: The amount of calories and nutrients required for woman increase during pregnancy and Intake adequate amounts of nutrients is essential for the health of mother and foetal. This study was designed to investigate the effect of nutrition education based on the Health Belief Model (HBM) on calories, iron and folic acid intake for pregnant women. Methods: This quasi-experimental study was performed on 76 pregnant women referring to four urban health centres of Khuzestan at 2015...
April 1, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/27927658/aneurysmal-subarachnoid-hemorrhage-red-blood-cell-transfusion-and-outcome-sahara-a-pilot-randomised-controlled-trial-protocol
#13
RANDOMIZED CONTROLLED TRIAL
Shane W English, D Fergusson, M Chassé, A F Turgeon, F Lauzier, D Griesdale, A Algird, A Kramer, A Tinmouth, C Lum, J Sinclair, S Marshall, D Dowlatshahi, A Boutin, G Pagliarello, L A McIntyre
INTRODUCTION: Anaemia is common in aneurysmal subarachnoid haemorrhage (aSAH) and is a potential critical modifiable factor affecting secondary injury. Despite physiological evidence and management guidelines that support maintaining a higher haemoglobin level in patients with aSAH, current practice is one of a more restrictive approach to transfusion. The goal of this multicentre pilot trial is to determine the feasibility of successfully conducting a red blood cell (RBC) transfusion trial in adult patients with acute aSAH and anaemia (Hb ≤100 g/L), comparing a liberal transfusion strategy (Hb ≤100 g/L) with a restrictive strategy (Hb ≤80 g/L) on the combined rate of death and severe disability at 12 months...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#14
RANDOMIZED CONTROLLED TRIAL
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27686346/intravenous-iron-or-placebo-for-anaemia-in-intensive-care-the-ironman-multicentre-randomized-blinded-trial-a-randomized-trial-of-iv-iron-in-critical-illness
#15
RANDOMIZED CONTROLLED TRIAL
Edward Litton, Stuart Baker, Wendy N Erber, Shannon Farmer, Janet Ferrier, Craig French, Joel Gummer, David Hawkins, Alisa Higgins, Axel Hofmann, Bart De Keulenaer, Julie McMorrow, John K Olynyk, Toby Richards, Simon Towler, Robert Trengove, Steve Webb
PURPOSE: Both anaemia and allogenic red blood cell transfusion are common and potentially harmful in patients admitted to the intensive care unit. Whilst intravenous iron may decrease anaemia and RBC transfusion requirement, the safety and efficacy of administering iron intravenously to critically ill patients is uncertain. METHODS: The multicentre, randomized, placebo-controlled, blinded Intravenous Iron or Placebo for Anaemia in Intensive Care (IRONMAN) study was designed to test the hypothesis that, in anaemic critically ill patients admitted to the intensive care unit, early administration of intravenous iron, compared with placebo, reduces allogeneic red blood cell transfusion during hospital stay and increases the haemoglobin level at the time of hospital discharge...
November 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27681259/iron-supplementation-to-treat-anaemia-in-adult-critical-care-patients-a-systematic-review-and-meta-analysis
#16
Akshay Shah, Noémi B Roy, Stuart McKechnie, Carolyn Doree, Sheila A Fisher, Simon J Stanworth
BACKGROUND: Anaemia affects 60-80 % of patients admitted to intensive care units (ICUs). Allogeneic red blood cell (RBC) transfusions remain the mainstay of treatment for anaemia but are associated with risks and are costly. Our objective was to assess the efficacy and safety of iron supplementation by any route, in anaemic patients in adult ICUs. METHODS: Electronic databases (CENTRAL, MEDLINE, EMBASE) were searched through March 2016 for randomized controlled trials (RCT)s comparing iron by any route with placebo/no iron...
September 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27516193/could-the-erythrocyte-indices-or-serum-ferritin-predict-the-therapeutic-response-to-a-trial-with-oral-iron-during-pregnancy-results-from-the-accuracy-study-for-maternal-anaemia-diagnosis-ama
#17
Cristiane Campello Bresani Salvi, Maria Cynthia Braga, José Natal Figueirôa, Malaquias Batista Filho
BACKGROUND: Treatment of maternal iron-deficiency anaemia can reduce risks of prematurity and low birth weight; hence a reliable diagnosis of maternal iron needs is critical. However, erythrocyte indices and serum ferritin have shown a weak correlation with iron status during pregnancy. This study verified the accuracy of those tests to predict the responsiveness to a therapeutic test with oral iron as reference standard for iron deficiency in pregnant women. METHODS: A prospective diagnostic study phase 3 was conducted in a single prenatal care center in Northeast Brazil...
August 12, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27476492/the-effect-of-blood-transfusion-on-central-venous-oxygen-saturation-in-critically-ill-patients-admitted-to-a-neurointensive-care-unit
#18
R M Surve, R Muthuchellappan, G S U Rao, M Philip
BACKGROUND: Literature suggests poorer outcomes during anaemia as well as following red blood cell transfusion (BT) in brain injured patients. Recently, central venous oxygen saturation (ScvO2 ) has been proposed as a physiological trigger to guide red BT. In this study, we looked at ScvO2 changes following BT in patients admitted to a neurointensive care unit (NICU). STUDY DESIGN: In this prospective, observational study, adult, acutely ill neurological patients of >18 years were recruited...
October 2016: Transfusion Medicine
https://www.readbyqxmd.com/read/26951090/anaemia-is-not-a-risk-factor-for-progression-of-acute-kidney-injury-a-retrospective-analysis
#19
Jonah Powell-Tuck, Siobhan Crichton, Mario Raimundo, Luigi Camporota, Duncan Wyncoll, Marlies Ostermann
BACKGROUND: In hospitalised patients, anaemia increases the risk of developing acute kidney injury (AKI). Our aim was to determine whether anaemia also has an impact on the risk of progression from early AKI to more severe AKI in critically ill patients. METHODS: We retrospectively analysed the data of patients admitted to the adult intensive care unit between 2007 and 2009 who had AKI I as per the AKI Network classification, and who had undergone haemodynamic monitoring within 12 h of AKI I...
March 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26734254/management-of-anaemia-and-blood-transfusion-in-critical-care-implementing-national-guidelines-in-icu
#20
Sethina Watson, Kate Kendrick
Anaemia in intensive care is common, with approximately 50% of patients receiving a red cell transfusion. Recognised complications from transfusion include 'transfusion associated lung injury', infection, and organ failure progression. Most cohort studies show a positive relationship between red cell transfusion and adverse outcomes. In 2012, the British Committee for Standards in Haematology issued guidelines for red cell (RBC) transfusion in critical care. They recommend a haemoglobin transfusion trigger of below 70 g/dL unless the patient is bleeding, has acute sepsis, neurological injury, or an acute coronary syndrome...
2014: BMJ Quality Improvement Reports
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