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https://www.readbyqxmd.com/read/29776919/behaviour-modification-interventions-to-optimise-red-blood-cell-transfusion-practices-a-systematic-review-and-meta-analysis
#1
Lesley J J Soril, Thomas W Noseworthy, Laura E Dowsett, Katherine Memedovich, Hannah M Holitzki, Diane L Lorenzetti, Henry Thomas Stelfox, David A Zygun, Fiona M Clement
OBJECTIVE: To assess the impact of behaviour modification interventions to promote restrictive red blood cell (RBC) transfusion practices. DESIGN: Systematic review and meta-analysis. SETTING, PARTICIPANTS, INTERVENTIONS: Seven electronic databases were searched to January 2018. Published randomised controlled trials (RCTs) or non-randomised studies examining an intervention to modify healthcare providers' RBC transfusion practice in any healthcare setting were included...
May 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/29776837/evaluation-of-massive-transfusion-protocol-practices-by-type-of-trauma-at-a-level-i-trauma-center
#2
Roshan Givergis, Swapna Munnangi, Katayoun Fayaz M Fomani, Anthony Boutin, Luis Carlos Zapata, Ld George Angus
PURPOSE: To evaluate massive transfusion protocol practices by trauma type at a level I trauma center. METHODS: A retrospective analysis was performed on a sample of 76 trauma patients with MTP activation between March 2010 and January 2015 at a regional trauma center. Patient demographics, transfusion practices, and clinical outcomes were compared by type of trauma sustained. RESULTS: Penetrating trauma patients who required MTP activation were significantly younger, had lower injury severity score (ISS), higher probability of survival (POS), decreased mortality, and higher Glasgow Coma scale (GCS) compared to blunt trauma patients...
April 18, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29773572/hemostatic-efficacy-of-pathogen-inactivated-versus-untreated-platelets-a-randomized-controlled-trial
#3
Pieter F van der Meer, Paula F Ypma, Nan van Geloven, Joost A van Hilten, Rinie J van Wordragen-Vlaswinkel, Okke Eissen, Jaap J Zwaginga, MIchael Trus, Erik A M Beckers, Peter Te Boekhorst, Alan Tinmouth, Yulia Lin, Cyrus Hsia, David Lee, Philip J Norris, Raymond P Goodrich, Anneke Brand, Tor Hervig, Nancy M Heddle, Johanna G van der Bom, Jean-Louis H Kerkhoffs
Pathogen inactivation of platelet concentrates reduces the risk of blood-borne infections. However, its effect on platelet function and hemostatic efficacy of transfusion is unclear. We conducted a randomized noninferiority trial comparing the efficacy of pathogen inactivated platelets using riboflavin and ultraviolet B illumination technology (intervention) compared to standard plasma-stored platelets (control) for the prevention of bleeding in patients with hematologic malignancies and thrombocytopenia. The primary outcome parameter was the proportion of transfusion treatment periods in which the patient had grade 2 or higher bleeding as defined by World Health Organization (WHO) criteria...
May 17, 2018: Blood
https://www.readbyqxmd.com/read/29773261/perioperative-transfusion-management-in-gastric-cancer-surgery-analysis-of-the-spanish-subset-of-the-eurecca-oesophago-gastric-cancer-registry
#4
Javier Osorio, Carlos Jericó, Coro Miranda, Elisenda Garsot, Alexis Luna, Mónica Miró, Maite Santamaría, Eva Artigau, Joaquín Rodríguez-Santiago, Sandra Castro, Josep Feliu, Aurora Aldeano, Carles Olona, Dulce Momblan, David Ruiz, Gonzalo Galofré, Inmaculada Pros, Xabier García-Albéniz, Miguel Lozano, Manuel Pera
INTRODUCTION: This study evaluated allogenic packed red blood cell (aPRBC) transfusion rates in patients undergoing resection for gastric cancer and the implementation of blood-saving protocols (BSP). METHODS: Retrospective study of all gastric cancer patients operated on with curative intent in Catalonia and Navarra (2011-2013) and included in the Spanish subset of the EURECCA Oesophago-Gastric Cancer Registry. Hospitals with BSP were defined as those with a preoperative haemoglobin (Hb) optimisation circuit associated with restrictive transfusion strategies...
May 14, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29768691/detection-of-hepatitis-b-virus-dna-among-chronic-and-potential-occult-hbv-patients-in-resource-limited-settings-by-loop-mediated-isothermal-amplification-assay
#5
Arifa Akram, S M Rashedul Islam, Saif Ullah Munshi, Shahina Tabassum
Transmission of Hepatitis B Virus (HBV) usually occurs due to the transfusion of blood or blood products from chronic HBV (CHB) or occult HBV infected (OBI) patients. Besides serological tests e.g. HBsAg and anti-HBc (total), detection of HBV-DNA is necessary for the diagnosis of OBI patients. Different nucleic acid tests (NATs) including real-time-Polymerase Chain Reaction (qPCR) are used for the detect HBV-DNA. The NATs are expensive and require technical expertise which are barriers to introducing them in resource-limited settings...
May 16, 2018: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29761839/effects-of-plasma-transfusions-on-antithrombin-levels-after-paediatric-liver-transplantation
#6
D Arni, B E Wildhaber, V McLin, P C Rimensberger, M Ansari, P Fontana, O Karam
BACKGROUND AND OBJECTIVES: Thrombotic complications affect 3-10% of patients after liver transplantation (LT), leading to potentially life-threatening complications. In the days following LT, antithrombin (AT) is decreased longer than pro-coagulant factors, thus favouring a pro-thrombotic profile. Plasma transfusions are given empirically in some centres to correct AT levels following LT. We assessed the effect of plasma transfusion on AT levels after paediatric LT. MATERIALS AND METHODS: Prospective single-centre observational study in 20 consecutive paediatric LT recipients over a 24-month period...
May 15, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29761515/association-of-perioperative-transfusion-with-survival-and-recurrence-after-resection-of-gallbladder-cancer-a-10-institution-study-from-the-us-extrahepatic-biliary-malignancy-consortium
#7
Alexandra G Lopez-Aguiar, Cecilia G Ethun, Mia R McInnis, Timothy M Pawlik, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley A Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles R Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza W Beal, Ioannis Hatzaras, Rivfka Shenoy, Kenneth Cardona, Shishir K Maithel
BACKGROUND AND OBJECTIVES: Perioperative blood transfusion is associated with poor outcomes in several malignancies. Its effect in gallbladder cancer (GBC) is unknown. METHODS: All patients with GBC who underwent curative-intent resection at 10-institutions from 2000 to 2015 were included. The effect of blood transfusion on overall survival (OS) and recurrence-free (RFS) was evaluated. RESULTS: Of 262 patients with curative-intent resection for GBC, 61 patients (23%) received blood transfusions...
May 14, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29751949/platelet-storage-lesions-what-more-do-we-know-now
#8
REVIEW
Monica Suet Ying Ng, John-Paul Tung, John Francis Fraser
Platelet concentrate (PC) transfusions are a lifesaving adjunct to control and prevent bleeding in cancer, hematologic, surgical, and trauma patients. Platelet concentrate availability and safety are limited by the development of platelet storage lesions (PSLs) and risk of bacterial contamination. Platelet storage lesions are a series of biochemical, structural, and functional changes that occur from blood collection to transfusion. Understanding of PSLs is key for devising interventions that prolong PC shelf life to improve PC access and wastage...
April 17, 2018: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29750321/improved-outcomes-of-enhanced-recovery-after-surgery-eras-protocol-for-radical-cystectomy-with-addition-of-a-multidisciplinary-care-process-in-a-us-comprehensive-cancer-care-center
#9
Sephalie Y Patel, Rosemarie E Garcia Getting, Brandon Alford, Karim Hussein, Braydon J Schaible, David Boulware, Jae K Lee, Scott M Gilbert, Julio M Powsang, Wade J Sexton, Philippe E Spiess, Michael A Poch
INTRODUCTION: Although enhanced recovery after surgery (ERAS) components include both anesthesia and surgical care processes, it is unclear whether a multidisciplinary approach to implementing ERAS care processes improves clinical outcomes. The addition of multidisciplinary care with anesthesiology-related components to an existing ERAS protocol for radical cystectomy at a US comprehensive cancer center provided an opportunity to compare short- and long-term outcomes. METHODS: We retrospectively compared the outcomes of 116 consecutive patients who underwent cystectomy after implementation of a multidisciplinary ERAS protocol with those of a historical control group of 143 consecutive patients who had been treated with a surgical ERAS protocol...
May 10, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29746314/impact-of-anticoagulation-and-circuit-technology-on-complications-during-extracorporeal-membrane-oxygenation
#10
Robert A Niebler, Hinah Parker, George M Hoffman
The objective of this study is to evaluate the impact a change in anticoagulation protocol and circuit technology had on bleeding and thrombotic complications in patients supported on extracorporeal membrane oxygenation (ECMO). A retrospective review at a tertiary, academic pediatric intensive care unit was undertaken. The anticoagulation protocol changed from targeting an activated clotting time (ACT) to anti-Xa level. Significant changes in the ECMO circuit were undertaken concurrently. One-hundred and fifty-two ECMO runs in 129 patients in the ACT target group were compared with 122 ECMO runs in 101 patients in the anti-Xa target group...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29743075/clinical-grade-generation-of-peptide-stimulated-cmv-ebv-specific-t-cells-from-g-csf-mobilized-stem-cell-grafts
#11
Regina Gary, Michael Aigner, Stephanie Moi, Stefanie Schaffer, Anja Gottmann, Stefanie Maas, Robert Zimmermann, Jürgen Zingsem, Julian Strobel, Andreas Mackensen, Josef Mautner, Andreas Moosmann, Armin Gerbitz
BACKGROUND: A major complication after allogeneic hematopoietic stem cell transplantation (aSCT) is the reactivation of herpesviruses such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Both viruses cause significant mortality and compromise quality of life after aSCT. Preventive transfer of virus-specific T cells can suppress reactivation by re-establishing functional antiviral immune responses in immunocompromised hosts. METHODS: We have developed a good manufacturing practice protocol to generate CMV/EBV-peptide-stimulated T cells from leukapheresis products of G-CSF mobilized and non-mobilized donors...
May 9, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29740442/stability-of-chimerism-in-non-obese-diabetic-mice-achieved-by-rapid-t-cell-depletion-is-associated-with-high-levels-of-donor-cells-very-early-after-transplant
#12
Jiaxin Lin, William F N Chan, Louis Boon, Colin C Anderson
Stable mixed hematopoietic chimerism is a robust method for inducing donor-specific tolerance with the potential to prevent rejection of donor islets in recipients with autoimmune type-1 diabetes. However, with reduced intensity conditioning, fully allogeneic chimerism in a tolerance resistant autoimmune-prone non-obese diabetic (NOD) recipient has rarely been successful. In this setting, successful multilineage chimerism has required either partial major histocompatability complex matching, mega doses of bone marrow, or conditioning approaches that are not currently clinically feasible...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29732562/irradiation-and-prolonged-storage-of-red-cells-are-associated-with-increased-adverse-events
#13
J Chen, E Biller, M Losos, J Li, D Hamad, L Blower, M Grevenow, J Oakley
BACKGROUND: Red blood cell (RBC) transfusion is associated with the most transfusion-related adverse events (AE). Recent clinical studies showed no significant difference in transfusion-associated mortality between fresh and older RBCs. However, the impact of storage duration as well as irradiation on nonfatal yet much more common complications has not been fully investigated. MATERIALS/METHODS: In this retrospective study of RBC transfusion-associated AEs, a total of 188,562 units of leucocyte-reduced RBCs were transfused in approximately 5·5 years...
May 6, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29728151/development-and-validation-of-a-pre-hospital-red-flag-alert-for-activation-of-intra-hospital-haemorrhage-control-response-in-blunt-trauma
#14
Sophie Rym Hamada, Anne Rosa, Tobias Gauss, Jean-Philippe Desclefs, Mathieu Raux, Anatole Harrois, Arnaud Follin, Fabrice Cook, Mathieu Boutonnet, Arie Attias, Sylvain Ausset, Mathieu Boutonnet, Gilles Dhonneur, Jacques Duranteau, Olivier Langeron, Catherine Paugam-Burtz, Romain Pirracchio, Guillaume de St Maurice, Bernard Vigué, Alexandra Rouquette, Jacques Duranteau
BACKGROUND: Haemorrhagic shock is the leading cause of early preventable death in severe trauma. Delayed treatment is a recognized prognostic factor that can be prevented by efficient organization of care. This study aimed to develop and validate Red Flag, a binary alert identifying blunt trauma patients with high risk of severe haemorrhage (SH), to be used by the pre-hospital trauma team in order to trigger an adequate intra-hospital standardized haemorrhage control response: massive transfusion protocol and/or immediate haemostatic procedures...
May 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29726824/advances-in-the-management-of-pediatric-septic-shock-old-questions-new-answers
#15
Javed Ismail, M Jayashree
Septic shock in children is associated with high mortality, especially in developing countries. Management includes early recognition, timely antibiotics, aggressive fluid resuscitation, and appropriate vasoactive therapy, to achieve the therapeutic end points. The evidence at each step in management has evolved over the past decade with a paradigm shift in emphasis from a 'protocolized care' to an 'individualized physiology-based care'. This shift mirrors the general trend one observes in critical care with respect to various treatment modalities i...
April 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29724898/how-i-safely-transfuse-patients-with-sickle-cell-disease-and-manage-delayed-hemolytic-transfusion-reactions
#16
France Pirenne, Karina Yazdanbakhsh
Transfusions can be a life-saving treatment for patients with sickle cell disease (SCD). However, availability of matched units can be limiting due to distinctive blood group polymorphisms in patients of African descent. Development of antibodies against the transfused red blood cells (RBCs), resulting in delayed hemolytic transfusion reactions (DHTRs), can be life-threatening and pose unique challenges for this population with regard to treatment strategies and transfusion management protocols. In cases where the transfused cells as well as patient's own RBCs are destroyed, diagnosis of DHTR can be difficult because symptoms may mimic vaso-occlusive crisis, and frequently antibodies are undetectable...
May 3, 2018: Blood
https://www.readbyqxmd.com/read/29724141/major-obstetric-haemorrhage-of-2000-ml-or-greater-a-clinical-audit
#17
J O'Sullivan, R Mansfield, R Talbot, A E Cairns
Haemorrhage remains a leading cause of maternal death. We conducted an audit to identify strategies to improve the management at our local NHS Trust. A data collection form was based on our local guideline. A coded database search was conducted for all deliveries where the estimated blood loss was ≥2000 ml (from June 1 2015 to December 31 2015), returning 68 search results (13.7/1000 births). Fifty-six records were included. Poor compliance (<75%) was seen in some key areas including the major obstetric haemorrhage (MOH) call activation (52%), the presence of an anaesthetic consultant (63%) and tranexamic acid administration (46%)...
May 4, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29722305/young-blood-products-emerging-treatment-for-alzheimer-s-disease
#18
REVIEW
Rita Khoury, Elias Ghossoub
Alzheimer's disease is the most common neurodegenerative disorder and no disease-modifying treatment is currently available. Research has shown that while brain neurogenesis continues in adult life, it declines with age. Using parabiosis, plasma transfusions and direct administration of neural growth factors, animal studies have demonstrated the positive impact of exposure to young blood products on neurogenesis and synaptic plasticity in an aging brain. The hippocampus and the sub-ventricular zones were identified as the main regions affected...
April 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29720245/human-platelet-lysate-in-mesenchymal-stromal-cell-expansion-according-to-a-gmp-grade-protocol-a-cell-factory-experience
#19
Valentina Becherucci, Luisa Piccini, Serena Casamassima, Silvia Bisin, Valentina Gori, Francesca Gentile, Riccardo Ceccantini, Elena De Rienzo, Barbara Bindi, Paola Pavan, Vanessa Cunial, Elisa Allegro, Stefano Ermini, Francesca Brugnolo, Giuseppe Astori, Franco Bambi
BACKGROUND: The use of platelet lysate (PL) for the ex-vivo expansion of mesenchymal stromal/stem cells (MSCs) was initially proposed by Doucet et al. in 2005, as an alternative to animal serum. Moreover, regulatory authorities discourage the use of fetal bovine serum (FBS) or other animal derivatives, to avoid risk of zoonoses and xenogeneic immune reactions. Even if many studies investigated PL composition, there still are some open issues related to its use in ex-vivo MSC expansion, especially according to good manufacturing practice (GMP) grade protocols...
May 2, 2018: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29716640/tranexamic-acid-versus-placebo-to-prevent-blood-transfusion-during-radical-cystectomy-for-bladder-cancer-tact-study-protocol-for-a-randomized-controlled-trial
#20
Rodney H Breau, Luke T Lavallée, Sonya Cnossen, Kelsey Witiuk, Ilias Cagiannos, Franco Momoli, Gregory Bryson, Salmaan Kanji, Christopher Morash, Alexis Turgeon, Ryan Zarychanski, Ranjeeta Mallick, Greg Knoll, Dean A Fergusson
BACKGROUND: Radical cystectomy for bladder cancer is associated with a high risk of needing red blood cell transfusion. Tranexamic acid reduces blood loss during cardiac and orthopedic surgery, but no study has yet evaluated tranexamic acid use during cystectomy. METHODS: A randomized, double-blind (surgeon-, anesthesiologist-, patient-, data-monitor-blinded), placebo-controlled trial of tranexamic acid during cystectomy was initiated in June 2013. Prior to incision, the intervention arm participants receive a 10 mg/kg loading dose of intravenously administered tranexamic acid, followed by a 5 mg/kg/h maintenance infusion...
May 2, 2018: Trials
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