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Massive Transfusion And Trauma And Obstetrics

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https://www.readbyqxmd.com/read/30044152/menstruation-related-disseminated-intravascular-coagulation-in-an-adenomyosis-patient-case-report-and-review-of-the-literature
#1
Alice Cernogoraz, Luigi Schiraldi, Deborah Bonazza, Giuseppe Ricci
Disseminated intravascular coagulation (DIC) is a high mortality coagulopathy that leads to simultaneous thrombotic and bleeding problems. It occurs as a complication in different disease as malignancies, obstetrical catastrophes, bacterial sepsis and traumas. We report on an extremely rare case of acute DIC in a patient with misdiagnosed adenomyosis and massive methrorragia which led to acute kidney failure. The patient was successfully treated with hysterectomy and blood product transfusions; however, a slight reduction of renal function persisted...
July 25, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29241907/a-systematic-review-of-massive-transfusion-protocol-in-obstetrics
#2
REVIEW
Hiroaki Tanaka, Shigetaka Matsunaga, Tomoyuki Yamashita, Toshiyuki Okutomi, Atsushi Sakurai, Akihiko Sekizawa, Junichi Hasegawa, Katsuo Terui, Yasutaka Miyake, Jun Murotsuki, Tomoaki Ikeda
Post-partum obstetric haemorrhage is a leading cause of mortality among Japanese women, generally treated with haemostatic measures followed by supplementary transfusion. Commonly used in the setting of severe trauma, massive transfusion protocols (MTPs), preparations of red blood cell concentrate (RBC) and fresh frozen plasma (FFP) with additional supplements, have proved effective in decreasing patient mortality following major obstetric bleeding events. Although promising, the optimal configuration of RBC and FFP utilized for obstetric bleeding needs to be verified...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28688890/any-changes-in-recent-massive-transfusion-practices-in-a-tertiary-level-institution
#3
Romi Sinha, David Roxby
BACKGROUND & OBJECTIVES: A previous review of transfusion practices in our institution between 1998 and 2008 showed a trend of high ratios of red cells (RC) to plasma (FFP) and platelets to RC towards the later years of review period. The aim of the study was to further evaluate transfusion practices in the form of blood product usage and outcomes following massive transfusion (MT) METHODS: All adult patients with critical bleeding who received a MT (defined as ≥10 units of RC in 24h) in 2008 and between January 2010 and December 2014 were identified...
August 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#4
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background  Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective  The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design  We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
July 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/26901542/epidemiology-of-massive-transfusion-a-binational-study-from-sweden-and-denmark
#5
Märit Halmin, Flaminia Chiesa, Senthil K Vasan, Agneta Wikman, Rut Norda, Klaus Rostgaard, Ole Birger Vesterager Pedersen, Christian Erikstrup, Kaspar René Nielsen, Kjell Titlestad, Henrik Ullum, Henrik Hjalgrim, Gustaf Edgren
OBJECTIVE: There is an increasing focus on massive transfusion, but there is a paucity of comprehensive descriptions of the massively transfused patients and their outcomes. The objective of this study is to describe the incidence rate of massive transfusion, patient characteristics, and the mortality of massively transfused patients. DESIGN: Descriptive cohort study. SETTING: Nationwide study with data from Sweden and Denmark. PATIENTS: The study was based on the Scandinavian Donations and Transfusions database, including all patients receiving 10 or more red cell concentrate transfusions in Sweden from 1987 and in Denmark from 1996...
March 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26683982/the-haematological-features-and-transfusion-management-of-women-who-required-massive-transfusion-for-major-obstetric-haemorrhage-in-the-uk-a-population-based-study
#6
MULTICENTER STUDY
Laura Green, Marian Knight, Frances Seeney, Cathy Hopkinson, Peter W Collins, Rachel E Collis, Nigel A B Simpson, Andrew Weeks, Simon J Stanworth
Understanding the coagulopathy of major-obstetric-haemorrhage (MOH) that leads to massive-transfusion (MT) is fundamental to improving outcomes. This study reports on the haematological features and transfusion management of women experiencing MT [defined as transfusion of ≥8 units of red blood cells (RBC) within 24 h of delivery]. One hundred and eighty-one cases [median (interquartile range; IQR) age 33 years (29-36)] were identified from all UK hospitals, using the UK Obstetric Surveillance System between July 2012 and June 2013...
February 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/26309583/investigation-of-the-current-situation-of-massive-blood-transfusion-in-different-surgical-departments-a-large-multicenter-study-in-china
#7
Yang Sun, Zhan-Kui Jin, Cui-Xiang Xu, Qian-Li Dang, Li-Jie Zhang, Hong-Nan Chen, Yao-Jun Song, Jiang-Cun Yang
OBJECTIVE: This study aims to learn about the current situation of surgical massive blood transfusion of different surgical departments in China's Tertiary hospitals, which could provide the basis for the formulation of guidelines on massive blood transfusion. METHOD: A multicenter retrospective research on the application status of blood constituents during massive blood transfusion was conducted and a comparative analyses of survival and length of hospitalization in patients from different departments (trauma, cardiac surgery, obstetric conditions, or other common surgeries), were performed...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26178308/a-national-common-massive-transfusion-protocol-mtp-is-a-feasible-and-advantageous-option-for-centralized-blood-services-and-hospitals
#8
J Chay, M Koh, H H Tan, J Ng, H J Ng, N Chia, P Kuperan, J Tan, E Lew, L K Tan, P L Koh, K A Desouza, S Bin Mohd Fathil, P M Kyaw, A L Ang
BACKGROUND: A common national MTP was jointly implemented in 2011 by the national blood service (Blood Services Group) and seven participating acute hospitals to provide rapid access to transfusion support for massively haemorrhaging patients treated in all acute care hospitals. METHODS: Through a systematic clinical workflow, blood components are transfused in a ratio of 1:1:1 (pRBC: whole blood-derived platelets: FFP), together with cryoprecipitate for fibrinogen replacement...
January 2016: Vox Sanguinis
https://www.readbyqxmd.com/read/25460838/center-of-excellence-for-placenta-accreta
#9
REVIEW
Robert M Silver, Karin A Fox, John R Barton, Alfred Z Abuhamad, Hyagriv Simhan, C Kevin Huls, Michael A Belfort, Jason D Wright
Placenta accreta spectrum is one of the most morbid conditions obstetricians will encounter. The incidence has dramatically increased in the last 20 years. The major contributing factor to this is believed to be the increase in the rate of cesarean delivery. Despite the increased incidence of placenta accreta, most obstetricians have personally managed only a small number of women with placenta accreta. The condition poses dramatic risk for massive hemorrhage and associated complication such as consumption coagulopathy, multisystem organ failure, and death...
May 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25329026/medical-advances-in-the-treatment-of-postpartum-hemorrhage
#10
REVIEW
Anne-Sophie Ducloy-Bouthors, Sophie Susen, Cynthia A Wong, Alex Butwick, Benoit Vallet, Evelyn Lockhart
Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. Recent advances in the management of severe bleeding for trauma patients may provide insight into PPH management, but must be applied with caution considering the significant differences between trauma and obstetric patients. In this review, we summarized evidence for current management strategies for patients with major obstetric hemorrhage, including (1) rapid laboratory assessment of coagulopathy, (2) early transfusion of plasma and high plasma-to-red blood cell transfusion ratios in massive PPH, and (3) use of tranexamic acid and fibrinogen concentrates in the setting of PPH complicated by coagulopathy...
November 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24335401/update-on-massive-transfusion
#11
REVIEW
H P Pham, B H Shaz
Massive haemorrhage requires massive transfusion (MT) to maintain adequate circulation and haemostasis. For optimal management of massively bleeding patients, regardless of aetiology (trauma, obstetrical, surgical), effective preparation and communication between transfusion and other laboratory services and clinical teams are essential. A well-defined MT protocol is a valuable tool to delineate how blood products are ordered, prepared, and delivered; determine laboratory algorithms to use as transfusion guidelines; and outline duties and facilitate communication between involved personnel...
December 2013: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/23905877/regional-anaesthesia-and-patients-with-abnormalities-of-coagulation-the-association-of-anaesthetists-of-great-britain-ireland-the-obstetric-anaesthetists-association-regional-anaesthesia-uk
#12
(no author information available yet)
Concise guidelines are presented that relate abnormalities of coagulation, whether the result of the administration of drugs or that of pathological processes, to the consequent haemorrhagic risks associated with neuraxial and peripheral nerve blocks. The advice presented is based on published guidelines and on the known properties of anticoagulant drugs. Four separate Tables address risks associated with anticoagulant drugs, neuraxial and peripheral nerve blocks, obstetric anaesthesia and special circumstances such as trauma, sepsis and massive transfusion...
September 2013: Anaesthesia
https://www.readbyqxmd.com/read/23450758/bull-gore-injury-of-the-vagina
#13
Maitri Raghavendra Kulkarni, Mahendra Gangadharaiah, Sunanda R Kulkarni
Although an obstetrically related trauma is the most common cause of the injuries to the female genital tract, non obstetric causes also lead to a significant number of vaginal and vulval injuries. We present 2 cases of vaginal injury, due to bull goring, one of which was associated with massive vulval haematoma. The 2 cases presented in a span of 2 months, in a rural medical college in South India. Both of them were managed surgically, following an initial haemodynamic resuscitation. They also required blood transfusions and an antibiotic prophylaxis...
January 2013: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/23223094/an-observational-study-of-the-fresh-frozen-plasma-red-blood-cell-ratio-in-postpartum-hemorrhage
#14
Pierre Pasquier, Etienne Gayat, Thibaut Rackelboom, Julien La Rosa, Abeer Tashkandi, Antoine Tesniere, Julie Ravinet, Jean-Louis Vincent, Vassilis Tsatsaris, Yves Ozier, François Goffinet, Alexandre Mignon
BACKGROUND: Postpartum hemorrhage is the leading cause of maternal death worldwide. Recent data from trauma patients and patients with hemorrhagic shock have suggested that an increased fresh frozen plasma:red blood cell (FFP:RBC) ratio may be of benefit in massive bleeding. We addressed this issue in cases of severe postpartum hemorrhage. METHODS: We reviewed data from all patients diagnosed with severe postpartum hemorrhage during a 4-year period (2006-2009). Patients who were treated with sulprostone and required transfusion within 6 hours of delivery were included in the study and were divided into 2 groups according to their response to sulprostone: bleeding controlled with sulprostone alone (sulprostone group) and bleeding requiring an additional advanced interventional procedure including arterial angiographic embolization and/or surgical procedures (arterial ligation, B-Lynch suture, or hysterectomy; intervention group)...
January 2013: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/22643264/outcomes-after-massive-transfusion-in-nontrauma-patients-in-the-era-of-damage-control-resuscitation
#15
COMPARATIVE STUDY
Bryan C Morse, Christopher J Dente, Erica I Hodgman, Beth H Shaz, Anne Winkler, Jeffrey M Nicholas, Amy D Wyrzykowski, Grace S Rozycki, David V Feliciano
There are little data regarding the use of massive transfusion protocols (MTP) outside of the trauma setting. This study compares the use of an MTP between trauma and non-trauma (NT) patients. Data were collected for trauma and NT patients from the prospectively maintained MTP database at a Level I trauma center over a 4-year period. Massive transfusion was defined as ≥ 10 units packed red blood cells (PRBCs) in a 24-hour period. Of 439 MTP activations, 37 (8%) were NT patients (64% male; mean age = 51 years, initial base deficit = -10...
June 2012: American Surgeon
https://www.readbyqxmd.com/read/22510859/prohemostatic-interventions-in-obstetric-hemorrhage
#16
REVIEW
Marie-Pierre Bonnet, Olga Basso
Obstetric hemorrhage is a major cause of maternal morbidity and mortality. Pregnancy is associated with substantial hemostatic changes, resulting in a relatively hypercoagulable state. Acquired coagulopathy can, however, develop rapidly in severe obstetric hemorrhage. Therefore, prohemostatic treatments based on high fresh frozen plasma and red blood cell (FFP:RBC) ratio transfusion and procoagulant agents (fibrinogen concentrates, recombinant activated factor VII, and tranexamic acid) are crucial aspects of management...
April 2012: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/22381112/acute-renal-failure-induced-by-disseminated-intravascular-coagulopathy-in-a-patient-with-adenomyosis
#17
Heon Jong Yoo, Dong Suk Chang, Ki Hwan Lee
Disseminated intravascular coagulation is most frequently associated with obstetric catastrophes, metastatic malignancy, massive trauma and bacterial sepsis, but relatively rarely related to benign tumors. We report on disseminated intravascular coagulopathy in a patient with significant adenomyosis and menometrorrhagia. An extremely rare case, disseminated intravascular coagulopathy developed in this benign case and was successfully treated with a hysterectomy and blood product transfusions.
March 2012: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/22119633/transfusion-practice-in-major-obstetric-haemorrhage-lessons-from-trauma
#18
I Saule, N Hawkins
The management of massive haemorrhage with blood products is changing as evidence arrives from civilian and military trauma. Rapid early replacement of coagulation factors and platelets is now becoming central to improving outcome, usually given in higher ratios with respect to red cell units than previously recommended and using empiric transfusion based on clinical rather than laboratory parameters. The management of three cases of major obstetric haemorrhage based on these principles is presented. Packed red blood cells, fresh frozen plasma, platelets and cryoprecipitate were transfused in the ratios 5:2:2:1, 4...
January 2012: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/21675158/massive-postpartum-hemorrhage-recombinant-factor-viia-use-is-safe-but-not-effective
#19
Michael Kalina, Glen Tinkoff, Gerard Fulda
OBJECTIVE: Postpartum hemorrhage is a leading cause of maternal mortality. Massive transfusion in obstetric patients is rare. Recombinant Factor VIIa (rFVIIa) use in trauma patients with massive transfusion is efficacious. Our goal was to evaluate the safety and efficacy of rFVIIa use in obstetric patients with massive postpartum hemorrhage (MPH). METHODS: Patients records with MPH from 2003 to 2006 were reviewed. Data collected were demographics, APACHE II scores, International Normalized Ratio (INR), fibrinogen level, blood product administration, rates of pulmonary embolism (PE), deep vein thrombosis (DVT), myocardial infarction (MI), hysterectomy, and mortality...
April 2011: Delaware Medical Journal
https://www.readbyqxmd.com/read/21668737/obstetric-hemorrhage
#20
REVIEW
C McLintock, A H James
An obstetric hemorrhage may occur before or after delivery, but more than 80% of cases occur postpartum. Worldwide, a massive obstetric hemorrhage, resulting from the failure of normal obstetrical, surgical and/or systemic hemostasis, is responsible for 25% of the estimated 358,000 maternal deaths each year. Most women will not have identifiable risk factors. Nonetheless, primary prevention of a postpartum hemorrhage (PPH) begins with an assessment of identifiable risk factors. Women identified as being at high risk of a PPH should be delivered in a center with access to adequately trained staff and an onsite blood bank...
August 2011: Journal of Thrombosis and Haemostasis: JTH
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