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https://www.readbyqxmd.com/read/28640786/a-standardized-approach-for-transfusion-medicine-support-in-patients-with-morbidly-adherent-placenta
#1
Anil K Panigrahi, Amanda Yeaton-Massey, Sara Bakhtary, Jennifer Andrews, Deirdre J Lyell, Alexander J Butwick, Lawrence Tim Goodnough
BACKGROUND: The incidence of placenta accreta (PA) has increased from 0.8 to 3.0 in 1000 pregnancies, driven by increased rates of cesarean deliveries (32.2% in 2014) of births in the United States. The average blood loss for a delivery complicated by PA ranges from 2000 to 5000 mL, frequently requiring substantial transfusion medicine support. We report our own institutional multidisciplinary approach for managing such patients, along with transfusion medicine outcomes, in this setting over a 5-year period...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28635130/prothrombin-complex-concentrate-for-emergent-reversal-of-warfarin-an-international-survey-of-hospital-protocols
#2
J Gorlin, S Kinney, M K Fung, A Tinmouth
For emergent warfarin reversal, four-factor prothrombin complex concentrates (4FPCCs) are recommended by many international guidelines. We surveyed international clinical sites including members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative. Most sites have emergent warfarin reversal protocols (53% use PCC, 25% use PCC+ plasma and 2% use plasma alone); however, variation between adjusted dosing and fixed dosing was observed.
June 21, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28630094/type-i-ifn-is-necessary-and-sufficient-for-inflammation-induced-red-blood-cell-alloimmunization-in-mice
#3
David R Gibb, Jingchun Liu, Prabitha Natarajan, Manjula Santhanakrishnan, David J Madrid, Stephanie C Eisenbarth, James C Zimring, Akiko Iwasaki, Jeanne E Hendrickson
During RBC transfusion, production of alloantibodies against RBC non-ABO Ags can cause hemolytic transfusion reactions and limit availability of compatible blood products, resulting in anemia-associated morbidity and mortality. Multiple studies have established that certain inflammatory disorders and inflammatory stimuli promote alloimmune responses to RBC Ags. However, the molecular mechanisms underlying these findings are poorly understood. Type I IFNs (IFN-α/β) are induced in inflammatory conditions associated with increased alloimmunization...
June 19, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28626367/towards-the-manufacture-of-megakaryocytes-and-platelets-for-clinical-application
#4
REVIEW
Anja Baigger, Rainer Blasczyk, Constanca Figueiredo
Platelet transfusions are used in standard clinical practice to prevent hemorrhage in patients suffering from thrombocytopenia or platelet dysfunctions. Recently, a constant rise on the demand of platelets for transfusion has been registered. This may be associated with several factors including demographic changes, population aging as well as incidence and prevalence of hematological diseases. In addition, platelet-regenerative properties have been started to be exploited in different areas such as tissue remodeling and anti-cancer therapies...
June 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28626365/emergence-of-cd43-expressing-hematopoietic-progenitors-from-human-induced-pluripotent-stem-cells
#5
Katharina U Kessel, Anika Bluemke, Hans R Schöler, Holm Zaehres, Peter Schlenke, Isabel Dorn
BACKGROUND: The ex vivo generation of human hematopoietic stem cells (HSCs) with long-term repopulating capacity and multi-lineage differentiation potential represents the holy grail of hematopoiesis research. In principle, human induced pluripotent stem cells (hiPSCs) provide the tool for both studying molecular mechanisms of hematopoietic development and the ex vivo production of 'true' HSCs for transplantation purposes and lineage-specific cells, e.g. red blood cells, for transfusion purposes...
June 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28611888/efficacy-and-safety-of-tranexamic-acid-in-prehospital-traumatic-hemorrhagic-shock-outcomes-of-the-cal-pat-study
#6
Michael M Neeki, Fanglong Dong, Jake Toy, Reza Vaezazizi, Joe Powell, Nina Jabourian, Alex Jabourian, David Wong, Richard Vara, Kathryn Seiler, Troy W Pennington, Joe Powell, Chris Yoshida-McMath, Shanna Kissel, Katharine Schulz-Costello, Jamish Mistry, Matthew S Surrusco, Karen R O'Bosky, Daved Van Stralen, Daniel Ludi, Karl Sporer, Peter Benson, Eugene Kwong, Richard Pitts, John T Culhane, Rodney Borger
INTRODUCTION: The California Prehospital Antifibrinolytic Therapy (Cal-PAT) study seeks to assess the safety and impact on patient mortality of tranexamic acid (TXA) administration in cases of trauma-induced hemorrhagic shock. The current study further aimed to assess the feasibility of prehospital TXA administration by paramedics within the framework of North American emergency medicine standards and protocols. METHODS: This is an ongoing multi-centered, prospective, observational cohort study with a retrospective chart-review comparison...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28610884/outcomes-for-low-risk-surgical-aortic-valve-replacement-a-benchmark-for-aortic-valve-technology
#7
Lily E Johnston, Emily A Downs, Robert B Hawkins, Mohammed A Quader, Alan M Speir, Jeffrey B Rich, Ravi K Ghanta, Leora T Yarboro, Gorav Ailawadi
BACKGROUND: Two large, randomized trials are underway evaluating transcatheter aortic valve replacement (AVR) against conventional surgical AVR. We analyzed contemporary, real-world outcomes of surgical AVR in low-risk patients to provide a practical benchmark of outcomes and cost for evaluating current and future transapical AVR technology. METHODS: From 2010 to 2015, 2,505 isolated AVR operations were performed for severe aortic stenosis at 18 statewide cardiac institutions...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28605004/preoperative-optimisation-of-anaemia-for-primary-total-hip-arthroplasty-a-systematic-review
#8
Dinesh P Alexander, Nicholas Frew
BACKGROUND: The 2009 NHS Blood and Transplant national comparative audit on blood use following primary total hip arthroplasty (THR) highlighted that preoperative anaemia was common and undertreated. They recommended that hospitals have a written policy for treating anaemia preoperatively. In our centre, we found that preoperative optimisation of anaemia, significantly reduced blood transfusion rate to <5%. The 2015 national audit showed that even though 48% of patients received tranexamic acid, 85% of patients required transfusion...
June 7, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28602891/manufacture-of-autologous-cd34-selected-grafts-in-the-niaid-sponsored-halt-ms-and-scot-multicenter-clinical-trials-for-autoimmune-diseases
#9
Carolyn A Keever-Taylor, Shelly Heimfeld, Kaitlyn C Steinmiller, Richard A Nash, Keith M Sullivan, Christine W Czarniecki, Tomeka C Granderson, Julia S Goldstein, Linda M Griffith
To ensure comparable grafts for autologous HCT in NIAID-sponsored IND protocols for multiple sclerosis (HALT-MS) and systemic sclerosis (SCOT), a DMF approach to control manufacture was implemented, including a common Master Production Batch Record, and site-specific SOPs with "Critical Elements". We assessed comparability of flow cytometry and controlled rate cryopreservation among sites, and stability of cryopreserved grafts, using hematopoietic progenitor cells (HPC) from healthy donors. Auto-CD34+HPC graft specifications included ≥70% viable CD34+ cells before cryopreservation...
June 5, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28596671/autologous-blood-transfusion-as-a-life-saving-measure-for-a-trauma-patient-with-fracture-femur-and-drug-induced-hemolytic-anemia-a-case-report
#10
Sumit Vishwakarma, Rahul Chaurasia, Arulselvi Subramanian, Vivek Trikha, Kabita Chatterjee
A positive direct antiglobulin test has been reported in 1:1000 to 1:14,000 blood donors and 1-15 % of hospital patients. Drugs may cause a positive direct antiglobulin test result and/or immune-mediated haemolysis with an incidence of approximately 1 in a 1 million population. Our aim is to highlight the importance of following strict transfusion protocols and management insight in a direct antiglobulin test positive patient showing incompatibility with multiple units possibly due to drug induced immune haemolytic anaemia (DIIHA)...
June 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28591652/fetal-therapy-model-of-myelomeningocele-with-three-dimensional-skin-using-amniotic-fluid-cell-derived-induced-pluripotent-stem-cells
#11
Kazuhiro Kajiwara, Tomohiro Tanemoto, Seiji Wada, Jurii Karibe, Norimasa Ihara, Yu Ikemoto, Tomoyuki Kawasaki, Yoshie Oishi, Osamu Samura, Kohji Okamura, Shuji Takada, Hidenori Akutsu, Haruhiko Sago, Aikou Okamoto, Akihiro Umezawa
Myelomeningocele (MMC) is a congenital disease without genetic abnormalities. Neurological symptoms are irreversibly impaired after birth, and no effective treatment has been reported to date. Only surgical repairs have been reported so far. In this study, we performed antenatal treatment of MMC with an artificial skin using induced pluripotent stem cells (iPSCs) generated from a patient with Down syndrome (AF-T21-iPSCs) and twin-twin transfusion syndrome (AF-TTTS-iPSCs) to a rat model. We manufactured three-dimensional skin with epidermis generated from keratinocytes derived from AF-T21-iPSCs and AF-TTTS-iPSCs and dermis of human fibroblasts and collagen type I...
June 6, 2017: Stem Cell Reports
https://www.readbyqxmd.com/read/28590380/surgical-treatment-for-hemophilic-pseudotumor-twenty-three-cases-with-an-average-follow-up-of-5-years
#12
Jiliang Zhai, Xisheng Weng, Baozhong Zhang, Yong Liu, Peng Gao, Yan-Yan Bian
BACKGROUND: Hemophilic pseudotumor (HPT) is a rare disease with many challenges. Only a few reports on surgical treatment for HPT have been published. METHODS: The cases of 23 patients with HPT who had surgical treatment from July 1996 to December 2014 were retrospectively reviewed. Demographic data, blood loss and transfusion during surgery, outcomes, and complications after surgery were analyzed. RESULTS: Eleven patients underwent HPT resection; 4 underwent HPT excision, allograft transplantation, and absorbable screw fixation; 3 had HPT resection and metallic internal fixation; 2 had HPT resection, autogenous fibular grafting, and absorbable screw fixation; 2 underwent curettage and bone-grafting; and 1 patient received above-the-knee amputation...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28590357/rotem-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#13
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood (WB) by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28582301/reducing-postoperative-bleeding-after-craniosynostosis-repair-utilizing-a-low-dose-transexamic-acid-infusion-protocol
#14
Jennifer K Hansen, Anna M Lydick, Matthew M Wyatt, Brian T Andrews
BACKGROUND: Craniosynostosis surgery is associated with large volume blood loss and the need for blood transfusion. Recently, the use of tranexamic acid (TXA) has been demonstrated to be helpful in reducing perioperative blood loss in many pediatric procedures. This study used a low-dose pharmacokinetic TXA dosing protocol and assessed its ability to limit perioperative blood loss for craniosynostosis repairs. METHODS: A retrospective chart review was conducted of pediatric craniosynostosis surgeries performed at our institution between September 2011 and December 2014...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28578542/citrate-versus-heparin-anticoagulation-in-continuous-renal-replacement-therapy-in-small-children
#15
Paulien A M A Raymakers-Janssen, Marc Lilien, Ingrid A van Kessel, Esther S Veldhoen, Roelie M Wösten-van Asperen, Josephus P J van Gestel
BACKGROUND: Citrate is preferred over heparin as an anticoagulant in adult continuous renal replacement therapy (CRRT). However, its potential adverse effects and data on use in CRRT in infants and toddlers is limited. We conducted a prospective study on using citrate in CRRT in critically ill small children. METHODS: Children who underwent CRRT with the smallest filter in our PICU between November 2011 and November 2016 were included. Both heparin and citrate were applied according to a strict protocol...
June 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28577064/no-benefit-of-autologous-transfusion-drains-in-total-knee-arthroplasty
#16
Christoph Schnurr, Ioannis Giannakopoulos, Dariusch Arbab, Jens Dargel, Johannes Beckmann, Peer Eysel
PURPOSE AND HYPOTHESIS: Autologous blood transfusion drains are commonly used to reduce allogeneic blood transfusion rate after total knee arthroplasty. There is conflicting evidence as to whether autologous transfusion drains (ABT drains) were effective when restrictive transfusion triggers were used. The aim of our study was to ascertain where, as a part of a blood management protocol, autologous blood transfusion drains reduce the allogeneic blood transfusion rate after total knee arthroplasty...
June 2, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28576754/stroke-avoidance-for-children-in-rep%C3%A3%C2%BAblica-dominicana-sacred-protocol-for-a-prospective-study-of-stroke-risk-and-hydroxyurea-treatment-in-sickle-cell-anemia
#17
Neelum D Jeste, Luisanna M Sánchez, Gabriela S Urcuyo, Melissa E Bergés, Judy P Luden, Susan E Stuber, Teresa S Latham, Rafael Mena, Rosa M Nieves, Russell E Ware
BACKGROUND: In the Dominican Republic, where the burden of sickle cell anemia (SCA) is high, many children lack access to routine screening and preventative care. Children with SCA are at risk for stroke, an event that leads to significant morbidity and mortality. In the United States, screening via transcranial Doppler (TCD) identifies children with SCA at highest stroke risk, allowing early intervention with blood transfusions. The need for indefinite transfusions for primary stroke prevention limits their practicality in limited-resource countries...
June 2, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28576250/patient-safety-in-burn-care-application-of-evidence-based-medicine-to-improve-outcomes
#18
REVIEW
Elizabeth L Dale, Charles Scott Hultman
This article reviews 5 areas in burn care that increasingly use evidence-based medicine to optimize quality and safety: resuscitation protocols, transfusion practices, vascular access, venous thromboembolic prophylaxis, and rational use of antibiotics.
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28552297/comparison-between-2-strategies-of-fluid-management-on-blood-loss-and-transfusion-requirements-during-liver-transplantation
#19
Nirmeen A Fayed, Khaled A Yassen, Ayat R Abdulla
OBJECTIVE: To compare the effects of low central venous pressure (LCVP) and transesophageal Doppler (TED)-guided fluid management on blood loss and blood transfusion during liver transplantation (LTx). DESIGN: Retrospective study. SETTING: Single institution, university hospital. PARTICIPANTS: Adult recipients of LTx. INTERVENTIONS: Two groups: control (LCVP G), n=45 with CVP maintained 40% lower than the preoperative value during the preanhepatic phase...
February 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28549445/fibrinogen-early-in-severe-trauma-study-feisty-study-protocol-for-a-randomised-controlled-trial
#20
James Winearls, Martin Wullschleger, Elizabeth Wake, Catherine Hurn, Jeremy Furyk, Glenn Ryan, Melita Trout, James Walsham, Anthony Holley, Jeremy Cohen, Megan Shuttleworth, Wayne Dyer, Gerben Keijzers, John F Fraser, Jeffrey Presneill, Don Campbell
BACKGROUND: Haemorrhage is a leading cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage. Early fibrinogen replacement is recommended by several international trauma guidelines using either fibrinogen concentrate (FC) or cryoprecipitate (Cryo). There is limited evidence to support one product over the other with widespread geographic and institutional variation in practice. This pilot trial is the first randomised controlled trial comparing FC to Cryo in traumatic haemorrhage...
May 26, 2017: Trials
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