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https://www.readbyqxmd.com/read/28925290/differences-in-the-clinical-course-of-516-japanese-patients-with-upper-gastrointestinal-bleeding-between-weekday-and-weekend-admissions
#1
Minoru Fujita, Noriaki Manabe, Takahisa Murao, Motoyasu Osawa, Shinsuke Hirai, Shinya Fukushima, Yo Shogen, Rui Nakato, Manabu Ishii, Hiroshi Matsumoto, Jiro Hata, Akiko Shiotani
BACKGROUND AND AIMS: Patients suspected of having upper gastrointestinal bleeding (UGIB) admitted during the weekend tend to have a poor outcome in western countries. However, no Japanese studies have been reported on this matter. We aimed to evaluate differences in the clinical course of patients with UGIB between weekday and weekend admissions in Japan. METHODS: Medical records of patients who had undergone emergency endoscopy for UGIB were retrospectively reviewed...
September 19, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28922227/incidence-and-risk-factors-of-coagulation-profile-derangement-after-liver-surgery-implications-for-the-use-of-epidural-analgesia-a-retrospective-cohort-study
#2
Pierre Jacquenod, Grégoire Wallon, Mathieu Gazon, Benjamin Darnis, Pierre Pradat, Victor Virlogeux, Olivier Farges, Frédéric Aubrun
BACKGROUND: Hepatic surgery is a major abdominal surgery. Epidural analgesia may decrease the incidence of postoperative morbidities. Hemostatic disorders frequently occur after hepatic resection. Insertion or withdrawal (whether accidental or not) of an epidural catheter during coagulopathic state may cause an epidural hematoma. The aim of the study is to determine the incidence of coagulopathy after hepatectomy, interfering with epidural catheter removal, and to identify the risk factors related to coagulopathy...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28905392/cryopreserved-platelets-demonstrate-reduced-activation-responses-and-impaired-signaling-after-agonist-stimulation
#3
Lauren Waters, Matthew P Padula, Denese C Marks, Lacey Johnson
BACKGROUND: Room temperature-stored (20-24°C) platelets (PLTs) have a shelf life of 5 days, making it logistically challenging to supply remote medical centers with PLT products. Cryopreservation of PLTs in dimethyl sulfoxide (DMSO) and storage at -80°C enables an extended shelf life up to 2 years. Although cryopreserved PLTs have been widely characterized under resting conditions, their ability to undergo agonist-induced activation is yet to be fully explored. STUDY DESIGN AND METHODS: Buffy coat PLTs were cryopreserved at -80°C with 5% to 6% DMSO and sampled before freezing and after thawing...
September 14, 2017: Transfusion
https://www.readbyqxmd.com/read/28880362/cold-platelets-for-trauma-associated-bleeding-regulatory-approval-accreditation-approval-and-practice-implementation-just-the-tip-of-the-iceberg
#4
James R Stubbs, Sheryl A Tran, Richard L Emery, Scott A Hammel, De Anna L Haugen, Martin D Zielinski, Scott P Zietlow, Donald Jenkins
BACKGROUND: Laboratory and clinical evidence suggest that cold-stored platelets (CS-PLTs) might be preferable to room temperature platelets (RT-PLTs) for active bleeding. Ease of prehospital use plus potential hemostatic superiority led our facility to pursue approval of CS-PLTs for actively bleeding trauma patients. STUDY DESIGN AND METHODS: From November 18, 2013, through October 8, 2015, correspondence was exchanged between our facility, the AABB, and the US Food and Drug Administration (FDA)...
September 6, 2017: Transfusion
https://www.readbyqxmd.com/read/28877325/perioperative-blood-loss-during-total-hip-arthroplasty-among-patients-with-ankylosing-spondylitis
#5
Yong Hu, Wei-Zhou Jiang, Zhi-Fa Huang, Tahsin Tarik Torsha, De-Sheng Yang, Jun Xiao
Intraoperative blood loss is frequently an overarching concern during total hip arthroplasty (THA) for patients who have ankylosing spondylitis with hip involvement. However, the factors that affect blood loss have not been identified. The goal of this study was to investigate these factors among patients with ankylosing spondylitis. Patients in the authors' department who had ankylosing spondylitis and underwent unilateral THA from 2011 to 2016 were studied retrospectively. Demographic characteristics, perioperative laboratory values, intraoperative data, transfusion rate, transfusion volume, and data on hemostatic use were collected and analyzed statistically...
September 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28870821/self-made-cost-reducing-hemostatic-agent-for-use-in-spine-surgery
#6
Fernando Alonso, Tarush Rustagi, Joe Iwanaga, Christian Fisahn, Rod Oskouian, R Shane Tubbs, Andrew Dailey, Jens R Chapman
Operative bleeding complications can lead to patient morbidity and mortality as well as longer and increased hospitalization costs. The use of matrix hemostatic sealants are commonly used to shorten the time to hemostasis, operative times and the need for blood transfusion. Commercially available hemostatic powders are used in spine surgery due to their ability to conform to wounds and decrease bleeding in difficult to access surgical sites. Hospital costs for these agents are variable and are dependent on negotiated institutional contracted prices...
September 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28865948/a-new-topical-hemostatic-agent-tt-173-reduces-blood-loss-in-a-sheep-model-of-total-knee-arthroplasty
#7
Alberto Centeno, Santiago Rojas, Belén Arias, Ignasi Miquel, Pilar Sánchez, Claudia Ureta, Esther Rincón, Ramón López, Jesús Murat
BACKGROUND: Total knee arthroplasty is associated with blood loss during the intervention and may require allogenic blood transfusion. Treatments such as tranexamic acid and fibrin sealants improved the bleeding control in several clinical trials, but the hemorrhage associated with the intervention is still significant. Thus far, very few studies have evaluated hemostatic treatments in animal models of total knee arthroplasty. This work describes a sheep model of bleeding associated with total knee arthroplasty and investigates a new class of hemostatic treatment based on recombinant tissue factor...
August 30, 2017: Knee
https://www.readbyqxmd.com/read/28857793/initiation-and-termination-of-massive-transfusion-protocols-current-strategies-and-future-prospects
#8
John C Foster, Joshua W Sappenfield, Robert S Smith, Sean P Kiley
The advent of massive transfusion protocols (MTP) has had a significant positive impact on hemorrhaging trauma patient morbidity and mortality. Nevertheless, societal MTP guidelines and individual MTPs at academic institutions continue to circulate opposing recommendations on topics critical to MTPs. This narrative review discusses up-to-date information on 2 such topics, the initiation and termination of an MTP. The discussion for each begins with a review of the recommendations and supporting literature presented by MTP guidelines from 3 prominent societies, the American Society of Anesthesiologists, the American College of Surgeons, and the task force for Advanced Bleeding Care in Trauma...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-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 by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28802751/acute-management-of-hemostasis-in-patients-with-neurological-injury
#10
REVIEW
M Irem Baharoglu, Anneke Brand, Maria M Koopman, Marinus Vermeulen, Yvo B W E M Roos
Neurological injuries can be divided into those with traumatic and nontraumatic causes. The largest groups are traumatic brain injury (TBI) and nontraumatic stroke. TBI patients may present with intracranial hemorrhages (contusions, or subdural or epidural hematomas). Strokes are ischemic or hemorrhagic. In all these disorders, thrombosis and hemostasis play a major role. Treatment aims to either cease bleeding and/or restore perfusion. We reviewed hemostatic and thrombolytic therapies in patients with neurological injuries by MEDLINE and EMBASE search using various key words for neurological disorders and hemostatic therapies restricted to English language and human adults...
July 13, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28797918/oral-tranexamic-acid-can-reduce-blood-loss-after-total-knee-and-hip-arthroplasty-a-meta-analysis
#11
REVIEW
Guang-Lei Li, Yong-Mei Li
OBJECTIVE: The aim of the present study was to compare the efficacy and safety of oral tranexamic acid (TXA) with controls or intravenous TXA in patients undergoing total joint arthroplasty (TJA) in a systematic review and meta-analysis. METHODS: We systematically searched randomized controlled trials (RCTs) from PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and Google databases. Any studies comparing oral TXA versus a control group or intravenous TXA for patients prepared for TJA were included...
August 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28771656/transfusion-practice-in-trauma-resuscitation
#12
REVIEW
Ashley M Eckel, John R Hess
Recognition of the acute coagulopathy of trauma and the limits of reconstituting whole blood with conventional blood components has led to a radical change in the way trauma patients with severe injuries are resuscitated. Massive transfusion protocols (MTP) have evolved toward the administration of conventional blood components in fixed ratios. Administration of a 1:1:1 unit ratio of fresh frozen plasma to whole-blood-derived platelets to packed red blood cells is now the most common strategy and the stated goal of directors of >80% of the level I trauma centers in the United States...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28765353/hemostatic-management-of-trauma-induced-coagulopathy
#13
Janise B Phillips, Phillip L Mohorn, Rebecca E Bookstaver, Tanya O Ezekiel, Christopher M Watson
Trauma-induced coagulopathy is a primary factor in many trauma-related fatalities. Management hinges upon rapid diagnosis of coagulation abnormalities and immediate administration of appropriate hemostatic agents. Use of crystalloids and packed red blood cells has traditionally been the core of trauma resuscitation, but current massive transfusion protocols include combination therapy with fresh frozen plasma and predefined ratios of platelets to packed red blood cells, limiting crystalloid administration. Hemostatic agents such as tranexamic acid, prothrombin complex concentrate, fibrinogen concentrate, and, in cases of refractory bleeding, recombinant activated factor VIIa may also be warranted...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28748286/normalized-levels-of-red-blood-cells-expressing-phosphatidylserine-their-microparticles-and-activated-platelets-in-young-patients-with-%C3%AE-thalassemia-following-bone-marrow-transplantation
#14
Phatchanat Klaihmon, Sinmanus Vimonpatranon, Egarit Noulsri, Surapong Lertthammakiat, Usanarat Anurathapan, Nongnuch Sirachainan, Suradej Hongeng, Kovit Pattanapanyasat
Bone marrow transplantation (BMT) serves as the only curative treatment for patients with β-thalassemia major; however, hemostatic changes have been observed in these BMT patients. Aggregability of thalassemic red blood cells (RBCs) and increased red blood cell-derived microparticles (RMPs) expressing phosphatidylserine (PS) are thought to participate in thromboembolic events by initially triggering platelet activation. To our knowledge, there has been no report providing quantitation of these circulating PS-expressing RBCs and RMPs in young β-thalassemia patients after BMT...
July 26, 2017: Annals of Hematology
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
#15
Aránzazu Gonzalez-Osuna, Sebastián Videla, Esther Cánovas, Gerard Urrútia, Santiago Rojas, Ramón López, Jesús Murat, Xavier Aguilera
BACKGROUND: Several hemostatic treatments intended to reduce the bleeding associated to total knee arthroplasty have been investigated with varying degrees of success. TT-173 is a new topical agent based on recombinant tissue factor that activates the extrinsic pathway of coagulation. This trial aim is 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
#16
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
#17
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...
August 2017: Transfusion
https://www.readbyqxmd.com/read/28655456/reflections-on-multiple-strategies-to-reduce-transfusion-in-cancer-patients-a-joint-narrative
#18
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
#19
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...
September 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
#20
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
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