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hemostatic transfusion

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https://www.readbyqxmd.com/read/28687347/hestat-study-protocol-for-a-phase-ii-iii-randomized-placebo-controlled-single-blind-study-to-evaluate-the-new-hemostatic-agent-tt-173-in-total-knee-arthroplasty
#1
Aránzazu Gonzalez-Osuna, Sebastián Videla, Esther Cánovas, Gerard Urrútia, Santiago Rojas, Ramón López, Jesús Murat, Xavier Aguilera
BACKGROUND: Total knee arthroplasty is associated with postsurgical bleeding that often requires blood transfusion. Several hemostatic treatments have been evaluated with different degree of success. TT-173 is a topical hemostatic agent consisting in yeast derived vesicles containing recombinant tissue factor (rhFT) that activates the extrinsic pathway of coagulation. This trial sought to evaluate the efficacy and safety of TT-173 in total knee arthroplasty. METHODS/DESIGN: This is a phase II/III, sequential, simple blind, randomized, multicenter, placebo controlled and parallel clinical trial that will recruit 189 evaluable patients...
July 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28682954/acute-intracardiac-thrombosis-and-pulmonary-thromboembolism-after-cardiopulmonary-bypass-a-systematic-review-of-reported-cases
#2
Brittney Williams, Brody Wehman, Michael A Mazzeffi, Patrick Odonkor, Ryan L Harris, Zachary Kon, Kenichi A Tanaka
Intracardiac thrombosis (ICT) and pulmonary thromboembolism (PE) after cardiopulmonary bypass (CPB) are life-threatening events, but pathological mechanisms are not yet well defined. The aim of this review is to provide an update of case literature of a postbypass hypercoagulable state. Case commonalities among 48 ICT/PE events included congestive heart failure (50%), platelet transfusion (37.5%), CPB duration greater than 3 hours (37.5%), and aortic injury (27.1%). Preexisting thrombophilia was rarely reported, and 16...
July 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28681458/refined-methods-to-evaluate-the-in-vivo-hemostatic-function-and-viability-of-transfused-human-platelets-in-rabbit-models
#3
Naohide Watanabe, Masayuki Nogawa, Mariko Ishiguro, Hitomi Maruyama, Masayuki Shiba, Masahiro Satake, Koji Eto, Makoto Handa
BACKGROUND: To bridge the gap between in vitro function and clinical efficacy of platelet (PLT) transfusion products, reliable in vivo PLT functional assays for hemostasis and survival in animal models are required. However, there are no standardized methods for assessing the in vivo quality of transfused human PLTs. STUDY DESIGN AND METHODS: Plasma-depleted human PLT concentrates (PCs; Day 3, Day 5, Day 7, Day 10, and damaged) were transfused into busulfan-induced rabbits with thrombocytopenia with prolonged bleeding times 1 day after treatment with ethyl palmitate (EP) to block their reticuloendothelial systems...
July 5, 2017: Transfusion
https://www.readbyqxmd.com/read/28655456/reflections-on-multiple-strategies-to-reduce-transfusion-in-cancer-patients-a-joint-narrative
#4
REVIEW
Hadi Goubran, Jerard Seghatchian, Oksana Prokopchuk-Gauk, Julia Radosevic, Waleed Sabry, Nayyer Iqbal, Thierry Burnouf
Transfusion of red blood cells, platelets and plasma is widely used in the management of anemia and coagulopathy in cancer patients undergoing surgery, chemotherapy, and radiation. The decision to transfuse should not be made lightly as exposure to transfused blood, whether from an allogeneic or even autologous source, is not without risk and the long-term effect of blood transfusion on cancer outcomes remains questionable. Recognition of anemia associated with nutritional deficiency should be promptly corrected while avoiding the use of erythropoiesis stimulating agents...
June 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#5
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28647217/recognition-and-management-of-hemostatic-disorders-in-critically-ill-patients-needing-to-undergo-an-invasive-procedure
#6
REVIEW
Marcella C A Müller, Simon J Stanworth, Michiel Coppens, Nicole P Juffermans
Abnormal laboratory coagulation test results are frequently documented in critically ill patients, and these patients often also need to undergo invasive procedures. Clinicians have an understandable desire to minimize any perceived heightened risk of bleeding complications in those patients who require invasive procedures. In this setting, prophylactic administration of platelets or plasma is commonplace. This review explores the nature of these sequential statements and the degree to which these statements are supported by evidence...
June 15, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28614427/a-new-era-of-thromboelastometry
#7
Tomaz Crochemore, Felipe Maia de Toledo Piza, Roseny Dos Reis Rodrigues, João Carlos de Campos Guerra, Leonardo José Rolim Ferraz, Thiago Domingos Corrêa
Severe hemorrhage with necessity of allogeneic blood transfusion is common complication in intensive care unit and is associated with increased morbidity and mortality. Prompt recognition and treatment of bleeding causes becomes essential for the effective control of hemorrhage, rationalizing the use of allogeneic blood components, and in this way, preventing an occurrence of their potential adverse effects. Conventional coagulation tests such as prothrombin time and activated partial thromboplastin time present limitations in predicting bleeding and guiding transfusion therapy in critically ill patients...
June 12, 2017: Einstein
https://www.readbyqxmd.com/read/28611528/preoperative-detection-and-localization-of-small-bowel-hemangioma-two-case-reports
#8
Nobuhisa Takase, Keisuke Fukui, Takafumi Tani, Tohru Nishimura, Tomohiro Tanaka, Naoki Harada, Kimihiko Ueno, Manabu Takamatsu, Akihiko Nishizawa, Akiharu Okamura, Kunihiko Kaneda
Among the various diagnostic modalities for small bowel hemangioma, video capsule endoscopy (VCE) and double-balloon enteroscopy (DBE) can be recommended as part of the work-up in patients with obscure gastrointestinal bleeding (OGIB). DBE is superior to VCE in the accuracy of diagnosis and therapeutic potential, while in most cases total enteroscopy cannot be achieved through only the antegrade or retrograde DBE procedures. As treatment for small bowel bleeding, especially spout bleeding, localization of the lesion for the decision of DBE insertion facilitates early treatment, such as endoscopic hemostatic clipping, allowing patients to avoid useless transfusion and the worsening of their disease into life-threatening status...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28590357/rotem-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#9
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/28549672/rotational-thromboelastometry-predicts-increased-bleeding-after-off-pump-coronary-bypass-surgery
#10
Sarah Soh, Young-Lan Kwak, Jong-Wook Song, Kyung-Jong Yoo, Hee-Jung Kim, Jae-Kwang Shim
BACKGROUND: We aimed to investigate the ability of rotational thromboelastometry (ROTEM) thresholds for coagulopathy to predict increased perioperative blood loss in off-pump coronary artery bypass graft surgery (OPCABG) and its association with transfusion requirement. METHODS: The data of 303 patients undergoing OPCABG were retrospectively analyzed. Perioperative blood loss and transfusion requirement were compared according to the presence of abnormal ROTEM thresholds, which were tested after anesthesia induction and heparin reversal...
May 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28541859/emergency-cholecystectomy-for-patients-on-antiplatelet-therapy
#11
Keiichi Akahoshi, Takanori Ochiai, Ayumi Takaoka, Takuya Kitamura, Daisuke Ban, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe
The use of antiplatelet therapy (APT) and/or anticoagulant therapy (ACT) continues to increase due to the aging population. Because the management of patients with acute cholecystitis receiving APT/ACT is still unclear, surgeons are sometimes faced with the difficult decision to delay surgery. We aimed to analyze characteristics and surgical risks of patients who underwent emergency cholecystectomy for acute cholecystitis without discontinuing APT. We conducted a retrospective review of 113 patients between 2006 and 2014...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28537975/reduced-requirement-for-prothrombin-complex-concentrate-for-the-restoration-of-thrombin-generation-in-plasma-from-liver-transplant-recipients
#12
Ezeldeen Abuelkasem, Shaheer Hasan, Michael A Mazzeffi, Raymond M Planinsic, Tetsuro Sakai, Kenichi A Tanaka
BACKGROUND: Plasma transfusion remains the mainstay hemostatic therapy during liver transplantation (LT) in most countries. However, a large volume is required for plasma to achieve clinically relevant factor increases. Prothrombin complex concentrate (PCC) is a low-volume alternative to plasma in warfarin reversal, but its efficacy has not been well studied in LT. METHODS: Blood samples were collected from 28 LT patients at baseline (T0) and 30 minutes after graft reperfusion (T1)...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28509781/correction-of-severe-coagulopathy-and-hyperfibrinolysis-by-tranexamic-acid-and-recombinant-factor-viia-in-a-cirrhotic-patient-after-trauma-a-case-report
#13
Jack Louro, Katherine Andersen, Roman Dudaryk
Coagulopathy induced by trauma or cirrhosis is a well-recognized entity. Viscoelastic testing has been used in either condition for goal-directed transfusion and detection of fibrinolysis since conventional coagulation tests do not correlate with clinical risk of bleeding. Hemostatic resuscitation may not be adequate for a trauma patient with liver disease due to complex alterations in coagulation systems and occasionally require adjuvant therapy. We report a case of trauma-induced coagulopathy presenting as severe hyperfibrinolysis in a cirrhotic patient who was refractory to hemostatic resuscitation but was rapidly corrected by the administration of tranexamic acid and recombinant Factor VIIa...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28470853/role-of-red-blood-cells-in-the-anemia-associated-bleeding-under-high-shear-conditions
#14
H Yaoi, Y Shida, K Ogiwara, K Hosokawa, M Shima, K Nogami
BACKGROUND: Red blood cells (RBCs) contribute to hemostasis under blood-flow, and anemia might contribute to a hemorrhagic diathesis. The majority of current laboratory techniques to assess hemostasis do not consider the effects of RBCs. An assay to determine the role of RBCs in hemostasis could be beneficial for clinical management. OBJECTIVES: To investigate the influence of RBCs in hemostasis. METHODS: Hemostasis was investigated using a novel microchip flow-chamber system (T-TAS(®) ) in an anemic patient with von Willebrand disease...
May 4, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28452886/platelet-transfusions-reduce-fibrinolysis-but-do-not-restore-platelet-function-during-trauma-hemorrhage
#15
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/28452883/kaolin-based-hemostatic-dressing-improves-hemorrhage-control-from-a-penetrating-inferior-vena-cava-injury-in-coagulopathic-swine
#16
Kiavash R Koko, Brian M McCauley, John P Gaughan, Ryan S Nolan, Marc W Fromer, Ashleigh L R Hagaman, Rachel L Choron, Spencer A Brown, Joshua P Hazelton
BACKGROUND: Retrohepatic inferior vena cava (RIVC) injuries are often lethal due to challenges in obtaining hemorrhage control. We hypothesized that packing with a new kaolin-based hemostatic dressing (Control+; Z-Medica, Wallingford, CT) would improve hemorrhage control from a penetrating RIVC injury compared with packing with standard laparotomy sponges alone. METHODS: Twelve male Yorkshire pigs received a 25% exchange transfusion of blood for refrigerated normal saline to induce a hypothermic coagulopathy...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452876/leukocyte-filtration-lesion-impairs-functional-coagulation-in-banked-whole-blood
#17
Anaar Siletz, Sigrid Burruss, Terry Gruber, Alyssa Ziman, Victor Marder, Henry Magill Cryer
BACKGROUND: Whole blood (WB) transfusion is a promising alternative to component therapy in hemostatic resuscitation. Use of banked WB requires filtration of white blood cells (leukoreduction) and an established shelf life during which WB retains coagulant capacities. The goal of this study was to define the time course of coagulation stability in leukoreduced compared to unfiltered WB under standard refrigeration conditions. METHODS: Twelve WB units were donated by healthy volunteers after routine screening...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28451050/-tubulopapillary-carcinoma-in-a-17-year-old-female-patient-a-case-report-and-review-of-the-literature
#18
REVIEW
Adil Kallat, Hicham Ouazize, Otheman Fahsi, Hani Abousaleh, Hachem El Sayegh, Ali Iken, Lounis Benslimane, Yassine Nouini
Tubulopapillary carcinomas account for 10% of renal cell carcinomas. They are more frequent in men than in women (sex ratio:8/1). The average period is the sixth decade. There are two anatomopathological types:the 1 corresponding to a proliferation of basophilic cells and type 2 corresponding to a proliferation of eosinophilic cells. We report the case of a 17-year old female patient with no particular past medical history presenting to the emergency department with pain in the right lumbar fossa and in the right flank associated with hematuria evolving for two days before admission, with loss of body weight and deterioration of the general status...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28443944/the-role-of-thromboelastometry-in-the-assessment-and-treatment-of-coagulopathy-in-liver-transplant-patients
#19
Raffael Pereira Cezar Zamper, Thiago Chaves Amorim, Luiz Guilherme Villares da Costa, Flávio Takaoka, Ary Serpa
Perioperative monitoring of coagulation is vital to assess bleeding risks, diagnose deficiencies associated with hemorrhage, and guide hemostatic therapy in major surgical procedures, such as liver transplantation. Routine static tests demand long turnaround time and do not assess platelet function; they are determined on plasma at a standard temperature of 37°C; hence these tests are ill-suited for intraoperative use. In contrast, methods which evaluate the viscoelastic properties of whole blood, such as thromboelastogram and rotational thromboelastometry, provide rapid qualitative coagulation assessment and appropriate guidance for transfusion therapy...
April 20, 2017: Einstein
https://www.readbyqxmd.com/read/28443942/hemostatic-disorders-induced-by-skin-contact-with-lonomia-obliqua-lepidoptera-saturniidae-caterpillars
#20
Ida Sigueko Sano-Martins, Alaour Candida Duarte, Belsy Guerrero, Roberto Henrique Pinto Moraes, Elvino José Guardão Barros, Carmen Luisa Arocha-Piñango
Patients envenomed by Lonomia sp caterpillars initially experience a mild burning pain, headache, nausea, vomiting, and skin and mucosal hemorrhages. Some patients can rapidly progress to a severe coagulopathy that presents as visceral or intracerebral hemorrhaging. We studied the hemostatic alterations that occurred in 14 patients who were envenomed by Lonomia obliqua in Southern Brazil and presented at the Hospital São Vicente de Paulo (Passo Fundo, RS), Brazil during the summers of 1993 and 1994 when Lonomia antivenom was not yet available for treatment...
April 20, 2017: Revista do Instituto de Medicina Tropical de São Paulo
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