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https://www.readbyqxmd.com/read/28514773/a-feasibility-study-of-the-full-outpatient-conduction-of-hematopoietic-transplants-in-persons-with-multiple-sclerosis-employing-autologous-non-cryopreserved-peripheral-blood-stem-cells
#1
Guillermo J Ruiz-Argüelles, Andrés A León-Peña, Mónica León-González, Ana Karen Nuñez-Cortes, Juan Carlos Olivares-Gazca, Iván Murrieta-Alvarez, Jocelyn Vargas-Espinosa, Emilio Medina-Ceballos, Yahveth Cantero-Fortiz, Alejandro Ruiz-Argüelles, Manuel A Ruiz-Delgado, Rodrigo J Ruiz-Delgado, Guillermo Ruiz-Reyes, Manuel Priesca-Marín, Merari Starlight Torres-Priego, David Blumenkron-Marroquin, Guillermo J Ruiz-Delgado
BACKGROUND: With the goal of achieving immune system reset, autologous hematopoietic stem cell transplantations have been performed in patients with multiple sclerosis (MS). MATERIAL AND METHODS: Two hundred and eighty-six consecutive patients with MS were autografted in a single center using non-frozen peripheral blood stem cells (PBSCs), on an outpatient basis and conditioning with cyclophosphamide and rituximab. The protocol was registered in ClinicalTrials.gov identifier NCT02674217...
May 18, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/28514321/patient-blood-management-in-major-orthopedic-surgery-less-erythropoietin-and-more-iron
#2
Emmanuel Rineau, Alexandra Stoyanov, Emmanuel Samson, Laurent Hubert, Sigismond Lasocki
Erythropoietin (EPO) is proposed preoperatively to reduce blood transfusion in anemic patients (hemoglobin < 13 g/dL) scheduled for a major orthopedic surgery. New intravenous iron formulations allow infusion of higher doses, increasing EPO response. In that context, we evaluated in a before-after study (n = 62 and 65 patients for each period) a new EPO administration protocol (2 injections 4 and 3 weeks before surgery, and a third if hemoglobin <13 g/dL instead of <15 g/dL 2 weeks before surgery)...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28512085/self-reported-outcomes-and-adverse-events-after-medical-abortion-through-online-telemedicine-population-based-study-in-the-republic-of-ireland-and-northern-ireland
#3
Abigail R A Aiken, Irena Digol, James Trussell, Rebecca Gomperts
Objectives To assess self reported outcomes and adverse events after self sourced medical abortion through online telemedicine.Design Population based study.Setting Republic of Ireland and Northern Ireland, where abortion is unavailable through the formal healthcare system except in a few restricted circumstances.Population 1000 women who underwent self sourced medical abortion through Women on Web (WoW), an online telemedicine service, between 1 January 2010 and 31 December 2012.Main outcome measures Successful medical abortion: the proportion of women who reported ending their pregnancy without surgical intervention...
May 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28500653/blood-transfusion-in-the-surgical-treatment-of-adolescent-idiopathic-scoliosis-a-single-center-experience-of-patient-blood-management-in-210-cases
#4
Søren Ohrt-Nissen, Naeem Bukhari, Casper Dragsted, Martin Gehrchen, Pär I Johansson, Jesper Dirks, Jakob Stensballe, Benny Dahl
BACKGROUND: The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. STUDY DESIGN AND METHODS: Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28499679/aeromedical-ultrasound-the-evaluation-of-point-of-care-ultrasound-during-helicopter-transport
#5
Jeffrey G Yates, Denise Baylous
INTRODUCTION: This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. METHODS: This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#6
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28486322/evaluation-tool-for-assessing-a-newly-implemented-massive-transfusion-protocol
#7
(no author information available yet)
No abstract text is available yet for this article.
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28486321/evaluation-tool-for-assessing-a-newly-implemented-massive-transfusion-protocol
#8
Shannon Broxton, Regina Medeiros, Autumn Schumacher
Exsanguination requires massive blood product replacement and termination of the bleeding source to prevent hemorrhagic shock and death. Massive transfusion protocols (MTPs) are algorithms that allow the health care team to quickly stabilize the bleeding patient and guide blood product administration. However, no national MTP guidelines or a standardized evaluation tool exist for collecting and reporting MTP-related data. The purpose of this article is to describe an original MTP evaluation tool, how it was used, barriers encountered, and a framework for reporting the MTP evaluation data...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28486023/red-blood-cell-transfusion-guided-by-near-infrared-spectroscopy-in-neurocritically-ill-patients-with-moderate-or-severe-anaemia
#9
Santiago Ramón Leal-Noval, Victoria Arellano-Orden, Manuel Múñoz-Gómez, Aurelio Cayuela, Antonio Marín-Caballos, María D Rincón-Ferrari, Claudio García-Alfaro, Rosario Amaya-Villar, Manuel Casado-Méndez, Reginald Dusseck, Francisco Murillo-Cabezas
In neurocritically ill patients (NCPs), the use of hemoglobin level as the sole indicator for red blood cell transfusion (RBCT) can result in under- or over-transfusion. This randomised controlled trial was conducted to ascertain whether a transcranial oxygen saturation (rSO2) threshold, as measured by near-infrared spectroscopy, reduces RBCT requirements in anemic NCPs (closed traumatic brain injury, subarachnoid or intracerebral hemorrhage), compared to a hemoglobin threshold alone. Patients with hemoglobin 70-100 g/L received RBCTs to attain an rSO2 >60% (rSO2 arm) or to maintain hemoglobin between 85 and 100 g/L (hemoglobin arm)...
May 9, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28476526/restrictive-transfusion-in-radical-cystectomy-is-safe
#10
Sumeet Syan-Bhanvadia, Siri Drangsholt, Swar Shah, Jie Cai, Gus Miranda, Hooman Djaladat, Siamak Daneshmand
INTRODUCTION AND OBJECTIVE: Perioperative blood transfusion (PBT) is commonplace in radical cystectomy (RC) and has been linked to poorer oncologic outcomes. Limiting PBT in this largely elderly and comorbid population has not been studied. Herein, we first investigate the safety of a restrictive transfusion protocol (RTP) in patients undergoing RC for urothelial carcinoma and then compare oncologic outcomes between patients who did and did not receive PBT. METHODS: Outcomes for 173 consecutive patients meeting inclusion criteria undergoing RC for urothelial carcinoma from April 2010 to June 2014 by a single surgeon employing RTP were analyzed from an institutional review board-approved, prospectively collected database...
May 2, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28466601/adult-extracorporeal-membrane-oxygenation-an-international-survey-of-transfusion-and-anticoagulation-techniques
#11
S A Esper, I J Welsby, K Subramaniam, W John Wallisch, J H Levy, J H Waters, D J Triulzi, J W A Hayanga, G J Schears
BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a method of life support for either isolated cardiac failure or respiratory failure, with or without cardiac failure. When used for hemodynamic support, the ECMO circuit presents a non-endothelialized, artificial surface to blood inciting an inflammatory response which activates haemostatic pathways. Anticoagulation may complicate a pre-existing coagulopathy and/or inadequate surgical hemostasis of varying severity...
May 3, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28460705/massive-transfusion-protocol-simulation-an-innovative-approach-to-team-training
#12
REVIEW
Allison Langston, Dayna Downing, Jennifer Packard, Marion Kopulos, Shelley Burcie, Kay Martin, Brennan Lewis
At a 72-bed pediatric facility, a multidisciplinary team approach was used to prepare for the expansion of services for patients requiring spinal fusion. This preparation included emergency response requiring massive transfusion, necessitating the need for a Massive Transfusion Protocol (MTP) process to be in place. Such instances are low volume/high risk, creating difficulty for staff to gain and maintain proficiency with the equipment and processes related to the MTP in a secure environment. The purpose of this article is to highlight the preparation and education put into place before receiving the first pediatric patient for spinal fusion...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460592/anticoagulation-and-transfusions-management-in-veno-venous-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-assessment-of-factors-associated-with-transfusion-requirements-and-mortality
#13
Gennaro Martucci, Giovanna Panarello, Giovanna Occhipinti, Veronica Ferrazza, Fabio Tuzzolino, Diego Bellavia, Filippo Sanfilippo, Cristina Santonocito, Alessandro Bertani, Patrizio Vitulo, Michele Pilato, Antonio Arcadipane
PURPOSE: We describe an approach for anticoagulation and transfusions in veno-venous-extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality. METHODS: Observational study on consecutive adults supported with VV-ECMO for acute respiratory distress syndrome (ARDS). We targeted an activated partial thromboplastin time of 40 to 50 seconds and a hematocrit of 24% to 30%. Univariate and multiple analyses were done to evaluate factors associated with transfusion requirements and the influence of increasing transfusions on mortality during ECMO...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28459771/feasibility-of-hip-fracture-surgery-using-a-no-transfusion-protocol-in-elderly-patients-a-propensity-score-matched-cohort-study
#14
Byung-Ho Yoon, Young Seung Ko, Suk-Hwan Jang, Jeong Ku Ha
OBJECTIVES: This study aimed To determine whether hip fracture surgery (HFS) without transfusion affects postoperative mortality and complications in elderly patients. DESIGN: Retrospective comparative study. PATIENTS: 314 patients aged ≥ 65 years of age who underwent HFS between May 2003 and December 2014. Patients were divided into two groups: those who consented to blood transfusion if needed and those who did not. One-to-one propensity score matching generated 50 matched pairs of patients...
April 25, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28459423/multivariate-analysis-of-blood-transfusion-rates-after-shoulder-arthroplasty
#15
Joseph J King, Matthew R Patrick, Ryan E Schnetzer, Kevin W Farmer, Aimee M Struk, Cyndi Garvan, Thomas W Wright
A retrospective review was performed of all shoulder arthroplasties with patients grouped on the basis of transfusion protocol time period. Group 1 had transfusions if postoperative hematocrit was <30. Group 2 had transfusions based on symptomatic anemia. Bivariate analysis of transfusion factors and multivariate analysis of significant bivariate factors were performed. Protocol change decreased transfusion rates from 16% (group 1, 153 arthroplasties) to 8% (group 2, 149 arthroplasties). Reverse shoulder arthroplasty (RTSA) transfusion rate decreased dramatically (from 24% to 5%)...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28457980/reversal-of-trauma-induced-coagulopathy-using-first-line-coagulation-factor-concentrates-or-fresh-frozen-plasma-retic-a-single-centre-parallel-group-open-label-randomised-trial
#16
Petra Innerhofer, Dietmar Fries, Markus Mittermayr, Nicole Innerhofer, Daniel von Langen, Tobias Hell, Gottfried Gruber, Stefan Schmid, Barbara Friesenecker, Ingo H Lorenz, Mathias Ströhle, Verena Rastner, Susanne Trübsbach, Helmut Raab, Benedikt Treml, Dieter Wally, Benjamin Treichl, Agnes Mayer, Christof Kranewitter, Elgar Oswald
BACKGROUND: Effective treatment of trauma-induced coagulopathy is important; however, the optimal therapy is still not known. We aimed to compare the efficacy of first-line therapy using fresh frozen plasma (FFP) or coagulation factor concentrates (CFC) for the reversal of trauma-induced coagulopathy, the arising transfusion requirements, and consequently the development of multiple organ failure. METHODS: This single-centre, parallel-group, open-label, randomised trial was done at the Level 1 Trauma Center in Innsbruck Medical University Hospital (Innsbruck, Austria)...
April 27, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28453219/clinical-methods-of-cryopreservation-for-donor-lymphocyte-infusions-vary-in-their-ability-to-preserve-functional-t-cell-subpopulations
#17
D Nicole Worsham, Jo-Anna Reems, Zbigniew M Szczepiorkowski, David H McKenna, Thomas Leemhuis, Aby J Mathew, Jose A Cancelas
BACKGROUND: Cryopreserved donor lymphocyte infusion (DLI) products are manufactured and administered to treat relapse after allogeneic hematopoietic stem cell transplantation. Reported clinical responses to DLIs vary broadly, even within the same group of patients. While there is an implicit recognition of the fact that different manufacturing protocols may have specific effects on different cell types, cryopreservation protocols are frequently derived from our experience in the cryopreservation of stem cell products and do not account for the heterogeneous functional nature of DLI T-cell populations...
April 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28452886/platelet-transfusions-reduce-fibrinolysis-but-do-not-restore-platelet-function-during-trauma-hemorrhage
#18
Paul Vulliamy, Scarlett Gillespie, Lewis S Gall, Laura Green, Karim Brohi, Ross A Davenport
INTRODUCTION: Platelets play a critical role in hemostasis with aberrant function implicated in trauma-induced coagulopathy. However, the impact of massive transfusion protocols on platelet function during trauma hemorrhage is unknown. The aim of this study was to characterize the effects of platelet transfusion on platelet aggregation and fibrinolytic markers during hemostatic resuscitation. METHODS: Trauma patients enrolled into the prospective Activation of Coagulation and Inflammation in Trauma (ACIT) study between January 2008 and November 2015 who received at least four units of packed red blood cells (PRBCs) were included...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452877/incompatible-type-a-plasma-transfusion-in-patients-requiring-massive-transfusion-protocol-outcomes-of-an-east-multicenter-study
#19
W Tait Stevens, Bryan C Morse, Andrew Bernard, Dan Davenport, Valerie G Sams, Michael Goodman, Russell Dumire, Matt Carrick, Patrick McCarthy, James R Stubbs, Timothy Pritts, Christopher J Dente, Xian Luo-Owen, Jason Gregory, David Turay, Dina Gomaa, Juan C Quispe, Caitlin A Fitzgerald, Nadeem Haddad, Asad Choudhry, Jose Quesada, Martin D Zielinski
With a relative shortage of type AB plasma, many centers have converted to type A plasma for resuscitation of patients whose blood type is unknown. The goal of this study is to determine outcomes for trauma patients who received incompatible plasma transfusions as part of a massive transfusion protocol (MTP). METHODS: As part of an EAST multi-institutional trial, registry and blood bank data were collected from 8 trauma centers for trauma patients (age ≥ 15 years) receiving emergency release plasma transfusions as part of MTPs from January 2012 - August 2016...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452870/every-minute-counts-time-to-delivery-of-initial-massive-transfusion-cooler-and-its-impact-on-mortality
#20
David E Meyer, Laura A Vincent, Erin E Fox, Terence O'Keeffe, Kenji Inaba, Eileen Bulger, John B Holcomb, Bryan A Cotton
BACKGROUND: ACS-TQIP Best Practices recommends initial massive transfusion (MT) cooler delivery within 15 minutes of protocol activation, with a goal of 10 minutes. The current study sought to examine the impact of timing of first cooler delivery on patient outcomes. METHODS: Patients predicted to receive MT at 12 level-1 trauma centers were randomized to two separate transfusion ratios as described in the PROPPR trial. ABC score or clinician gestalt prediction of MT was used to randomize patients and call for initial study cooler...
April 27, 2017: Journal of Trauma and Acute Care Surgery
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