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https://www.readbyqxmd.com/read/29151812/prophylactic-platelet-transfusions-prior-to-surgery-for-people-with-a-low-platelet-count
#1
Lise J Estcourt, Reem Malouf, Carolyn Doree, Marialena Trivella, Sally Hopewell, Janet Birchall
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the clinical effectiveness and safety of prophylactic platelet transfusions prior to surgery for people with a low platelet count or platelet dysfunction (inherited or acquired).
2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29151811/prophylactic-plasma-transfusion-for-patients-undergoing-non-cardiac-surgery
#2
Jonathan Huber, Simon J Stanworth, Carolyn Doree, Marialena Trivella, Susan J Brunskill, Sally Hopewell, Kirstin L Wilkinson, Lise J Estcourt
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the clinical effectiveness and safety of prophylactic plasma transfusion for people with confirmed or presumed coagulopathy requiring non-cardiac surgery.
August 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29142987/prospective-study-of-routine-heparin-avoidance-hemodialysis-in-a-tertiary-acute-care-inpatient-practice
#3
Sami Safadi, Robert C Albright, John J Dillon, Amy W Williams, Fares Alahdab, Julie K Brown, Amanda L Severson, Walter K Kremers, Mary Ann Ryan, Marie C Hogan
Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015). Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29127739/renal-haemodynamics-and-oxygenation-during-and-after-cardiac-surgery-and-cardiopulmonary-bypass
#4
REVIEW
Roger G Evans, Yugeesh R Lankadeva, Andrew D Cochrane, Bruno Marino, Naoya Iguchi, Michael Z L Zhu, Sally G Hood, Julian A Smith, Rinaldo Bellomo, Bruce S Gardiner, Chang-Joon Lee, David W Smith, Clive N May
Acute kidney injury (AKI) is a common complication following cardiac surgery performed on cardiopulmonary bypass (CPB) and has important implications for prognosis. The aetiology of cardiac surgery-associated AKI is complex, but renal hypoxia, particularly in the medulla, is thought to play at least some role. There is strong evidence from studies in experimental animals, clinical observations and computational models, that medullary ischaemia and hypoxia occurs during CPB. There are no validated methods to monitor or improve renal oxygenation during CPB, and thus possibly decrease the risk of AKI...
November 11, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/29123874/early-administration-of-fibrinogen-concentrates-improves-the-short-term-outcomes-of-severe-pelvic-fracture-patients
#5
Koichi Inokuchi, Makoto Sawano, Koji Yamamoto, Atsushi Yamaguchi, Satoru Sugiyama
Aim: Hemorrhage from pelvic fracture is a major cause of mortality after blunt trauma. Several studies have suggested that early fibrinogen supplementation improves outcomes of traumatic hemorrhage. Thus, we revised our massive transfusion protocol (MTP) in April 2013 to include early off-label administration of fibrinogen concentrate. The objective of this study was to evaluate the impact of the revision on the short-term outcomes of pelvic fracture patients. Methods: This was a single-center, retrospective, cohort study...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29120972/comparison-of-anti-xa-and-activated-partial-thromboplastin-time-monitoring-for-heparin-dosing-in-vascular-surgery-patients-a-single-center-retrospective-study
#6
Elsie Rizk, Allison D Wilson, Michelle U Murillo, David R Putney, Bcps-Aq Cardiology
BACKGROUND: Vascular surgery patients often require anticoagulation with intravenous unfractionated heparin monitored via anti-Xa levels or the activated partial thromboplastin time (aPTT). This study compares the two monitoring strategies in terms of major bleeding events in the vascular surgery population. METHODS: This was a single center, retrospective study that included patients treated with a pharmacy-managed heparin protocol monitored by either anti-Xa or aPTT after vascular surgery...
November 8, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29105189/cyclophosphamide-induced-tolerance-in-kidney-transplantation-avoids-long-term-immunosuppressive-therapy
#7
REVIEW
Ario Takeuchi, Koji Kato, Koichi Akashi, Masatoshi Eto
There has recently been remarkable progress in immunosuppressive agents, such as tacrolimus and cyclosporine. Therefore, the rate of organ establishment has improved in transplantation. However, immunosuppressive agents generally suppress the function of T cells. Thus, opportunistic infections, such as cytomegalovirus infection, are still a major problem in kidney transplantation. Induction of specific tolerance to avoid immunosuppressive drug therapy after kidney transplantation is considered as the ultimate goal of transplantation...
November 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29102095/resource-utilization-after-snakebite-severity-score-implementation%C3%A2-into-treatment-algorithm-of-crotaline-bite
#8
Amanda L Fowler, Darrel W Hughes, Mark T Muir, Elizabeth M VanWert, Conrado D Gamboa, John G Myers
BACKGROUND: Crotaline envenomation clinical manifestations vary considerably among patients. Current recommendations for treatment with Crotalidae polyvalent immune Fab require assessment of envenomation control. Determining control of envenomation, particularly when patients are evaluated by different providers in separate clinical settings, can be difficult. OBJECTIVE: To determine if a difference in total vials of Crotalidae antivenin therapy exists between pre-protocol and post-Snakebite Severity Score (SSS) protocol...
October 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29099347/the-morbidity-pattern-of-children-with-sickle-cell-disorders-admitted-to-the-queen-elizabeth-hospital-barbados-2009-2013
#9
D Grannum, Paula M Lashley
A retrospective study was conducted by examining all the medical files of all the children with sickle cell anaemia (Hb SS) admitted from 1 January 2009 to 31 December 2013. A total of 220 admission notes (59 patients aged 5 months-16 years) were analysed. Of these, 53.2% were boys; 85.8% of the patients had Hb SS. The most common reason for admission was vaso-occlusive crisis. Blood transfusions were used in 39.7% of admissions There were no deaths during the study period. We note the number of sickle cell-related admissions and morbidity has increased, along with an increase in the number of blood transfusions...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/29089726/the-use-of-idarucizumab-for-dabigatran-reversal-in-clinical-practice-a-case-series
#10
Pavel Goriacko, Vicken Yaghdjian, Issam Koleilat, Mark Sinnett, Harshal Shukla
PURPOSE: To describe the use of idarucizumab (Praxbind, Boehringer Ingelheim) in routine clinical practice at a large urban academic medical center. SUMMARY: Seven total doses of idarucizumab were administered to six unique patients from October 31, 2015, to October 31, 2016. The reversal agent was used in conjunction with local bleeding control measures, blood product transfusions, and acid-suppressive therapy. In 86% of cases, idarucizumab administration resulted in a successful cessation of bleeding by clinical assessment...
November 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29076249/expanding-access-to-transfusion-medicine-and-improving-practice-guidelines-patient-blood-management-protocols-and-products
#11
EDITORIAL
D J Roberts
No abstract text is available yet for this article.
October 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29076098/good-manufacturing-practice-gmp-translation-of-advanced-cellular-therapeutics-lessons-for-the-manufacture-of-erythrocytes-as-medicinal-products
#12
Neil W A McGowan, John D M Campbell, Joanne C Mountford
Blood transfusion is a mainstay of modern medical practice. In many parts of the world the use of this life-saving therapy is hampered by issues of supply and the potential for transfusion transmitted infections. Accordingly, there are many studies seeking to find an alternative to donated red blood cells (RBCs) for transfusion, including large-scale production from adult and pluripotent stem cells, or erythroid cell lines. Translating basic studies, using any cell lineage, into protocols that are suitable for the generation of cellular therapies requires a wide range of biological and regulatory procedures to be put in place...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29072372/misoprostol-treatment-vs-expectant-management-in-early-non-viable-pregnancy-in-women-with-vaginal-bleeding-a-pragmatic-randomized-controlled-trial
#13
A Fernlund, L Jokubkiene, P Sladkevicius, L Valentin
OBJECTIVES: To compare vaginal misoprostol treatment with expectant management in early non-viable pregnancies with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days. METHODS: Parallel randomized controlled, open label, trial conducted in Skåne university hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown-rump length <33mm) and vaginal bleeding were randomly allocated to either expectant management or single dose 800μg of misoprostol vaginally...
October 26, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29055003/anti-cd20-antibody-prevents-red-blood-cell-alloimmunization-in-a-mouse-model
#14
Rahma Elayeb, Marie Tamagne, Marion Pinheiro, Julie Ripa, Rachid Djoudi, Philippe Bierling, France Pirenne, Benoît Vingert
Alloimmunization against RBCs can cause life-threatening delayed hemolytic transfusion reactions. Anti-CD20 Ab has recently been used to prevent alloimmunization. However, its effects remain unclear, particularly in lymphoid organs. We investigated the impact of murine anti-CD20 Ab in the blood and spleen. We assessed protocols for preventing primary alloimmunization and for abolishing established alloimmunization. Prophylactic protocols prevented alloimmunization. However, anti-CD20 treatment could only limit the further amplification of established alloimmunization...
October 20, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#15
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29023857/preceding-haemorrhagic-shock-as-a-detrimental-risk-factor-for-respiratory-distress-after-excessive-allogeneic-blood-transfusion
#16
R Masuda, T Iijima, R Kondo, Y Itoda, M Matsuhashi, S Hashimoto, T Kohira, N Kobayashi, H Okazaki
BACKGROUND AND OBJECTIVES: Whether transfusion-associated circulatory overload arises as a simple result of over-transfusion or requires another trigger remains unclear. Here, we examined whether respiratory distress could be reproduced by massive transfusion alone in an animal model. MATERIALS AND METHODS: A total of 20 anaesthetized swine were equipped with monitors. Allogeneic blood was obtained from 10 donor swine. A 4-stage loading protocol with each stage equivalent to 25% of the blood volume (BV) in the recipient swine was then used to infuse crystalloid (CR), hydroxyethyl starch (HES) or allogeneic blood (TR) (n = 5 each)...
October 11, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29021846/the-influence-of-residual-apixaban-on-bleeding-complications-during-and-after-catheter-ablation-of-atrial-fibrillation
#17
Yutaro Mukai, Kyoichi Wada, Koji Miyamoto, Kazuki Nakagita, Mai Fujimoto, Kouichi Hosomi, Takeshi Kuwahara, Mitsutaka Takada, Kengo Kusano, Akira Oita
BACKGROUND: The periprocedural protocol for atrial fibrillation (AF) ablation commonly includes anticoagulation therapy. Apixaban, a direct oral anticoagulant, is currently approved for clinical use; however, little is known about the effects of residual apixaban concentration on bleeding complications during/after AF ablation. Therefore, we measured residual apixaban concentration by using mass spectrometry and examined the anticoagulant's residual effects on bleeding complications. METHODS: Fifty-eight patients (Mean age of 64...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29017806/implementation-of-a-bundled-protocol-significantly-reduces-risk-of-spinal-cord-ischemia-after-branched-or-fenestrated-endovascular-aortic-repair
#18
Salvatore T Scali, Moses Kim, Paul Kubilis, Robert J Feezor, Kristina A Giles, Brittney Miller, Javairiah Fatima, Thomas S Huber, Scott A Berceli, Martin Back, Adam W Beck
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication after branched or fenestrated endovascular aortic repair (B/FEVAR) for thoracoabdominal aortic disease. The purpose of this analysis was to describe the impact of a bundled clinical care protocol designed to reduce the risk of SCI in this population of patients. METHODS: A bundled SCI prevention protocol including cerebrospinal fluid drainage, blood pressure parameters, transfusion goals, and pharmacologic adjuncts (steroids, naloxone) was initiated in May 2015...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29017765/accuracy-of-shock-index-versus-abc-score-to-predict-need-for-massive-transfusion-in-trauma-patients
#19
Rebecca Schroll, David Swift, Danielle Tatum, Stuart Couch, Jiselle B Heaney, Monica Llado-Farrulla, Shana Zucker, Frances Gill, Griffin Brown, Nicholas Buffin, Juan Duchesne
BACKGROUND: Various scoring systems have been developed to predict need for massive transfusion in traumatically injured patients. Assessments of Blood Consumption (ABC) score and Shock Index (SI) have been shown to be reliable predictors for Massive Transfusion Protocol (MTP) activation. However, no study has directly compared these two scoring systems to determine which is a better predictor for MTP activation. The primary objective was to determine whether ABC or SI better predicted the need for MTP in adult trauma patients with severe hemorrhage...
September 15, 2017: Injury
https://www.readbyqxmd.com/read/28987395/abciximab-heparin-therapy-for-left-ventricular-assist-device-implantation-in-patients-with-heparin-induced-thrombocytopenia
#20
Chia-Ling Lee, Paolo C Colombo, Andrew Eisenberger, David Diuguid, Douglas L Jennings, Jiho Han, Michael P Salna, Koji Takeda, Paul A Kurlansky, Melana Yuzefpolskaya, Arthur R Garan, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Optimal anticoagulation strategy remains uncertain in patients with heparin-induced thrombocytopenia (HIT) and undergoing left ventricular assist device (LVAD) implantation. We describe our protocol of abciximab and heparin in these patients. METHODS: Our protocol is to administer abciximab, 0.25 mg/kg loading dose, followed by continuous infusion of 0.125 μg · kg(-1) · min(-1) throughout cardiopulmonary bypass. Full-dose heparin is then given with subsequent additional doses to maintain an activated clotting time of 400 seconds or longer...
October 4, 2017: Annals of Thoracic Surgery
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