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hemostatic transfusion

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https://www.readbyqxmd.com/read/28350974/topical-hemostasis-in-laparoscopic-surgery
#1
REVIEW
R Vecchio, R Catalano, F Basile, C Spataro, M Caputo, E Intagliata
A major goal during any surgical intervention is minimization of blood loss, which reduces the need for blood transfusion. In open surgery, the possibility for the surgeon to use the hands directly in contact with the bleeding tissues for hemostasis, makes mechanical methods, such as compression, ligatures or sutures, important to achieve proper hemostasis. In laparoscopic surgery, where the intervention is performed by means of small incisions through which the surgeon's hand cannot directly achieve the tissues, the problem of hemostasis is critical and needs more attention...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28338599/volumetric-control-of-whole-blood-collection-in-austere-environments
#2
Michael A Meledeo, Andrew D Fisher, Grantham C Peltier, Ethan A Miles, William B Muse, Win B Kerr, Shawn C Nessen, Andrew P Cap
INTRODUCTION: Fresh whole blood transfusions are a powerful tool in prehospital care; however, the lack of equipment such as a scale in field situations frequently leads to collections being under- or overfilled, leading to complications for both patient and donor. This study describes two methods for simple, rapid control of collection bag volume: (1) a length of material to constrict the bag, and (2) folding/clamping the bag. METHOD: Whole blood collection bags were allowed to fill with saline via gravity...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333829/acute-traumatic-coagulopathy-the-elephant-in-a-room-of-blind-scientists
#3
Michael A Meledeo, Maryanne C Herzig, James A Bynum, Xiaowu Wu, Anand K Ramasubramanian, Daniel N Darlington, Kristin M Reddoch, Andrew P Cap
Acute traumatic coagulopathy (ATC) is the failure of coagulation homeostasis that can rapidly arise following traumatic injury, hemorrhage, and shock; it is associated with higher injury severity, coagulation abnormalities, and increased blood transfusions. ATC has historically been defined by a prolonged prothrombin time (PT), although newer, more informative measurements of hemostatic function have been employed to improve diagnosis and support clinical decision making. The underlying biochemical mechanisms of and best practice therapeutics for ATC remain under active investigation because of its significant correlation to poor outcomes...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28320573/bleeding-related-complications-and-readmission-rates-associated-with-fibrin-sealant-use-in-patients-undergoing-coronary-artery-bypass-graft-surgery-in-the-united-states
#4
Yin Wan, Sangtaeck Lim, Xin Gao, Walter A Danker, Richard Kocharian, Gaurav Gangoli, Ashley P DeAnglis, James Hart
OBJECTIVES: To compare the clinical and economic outcomes of EVICEL (Ethicon, Inc., Somerville, NJ) and TISSEEL (Baxter Healthcare Corporation, Westlake Village, CA) use in patients undergoing primary coronary artery bypass graft (CABG) surgery. DESIGN: Retrospective database analysis. SETTING: Premier prospective hospital database (June 2009 through March 2014) covering approximately 20% of hospital discharges in the United States. PARTICIPANTS: Adults undergoing primary CABG surgery who received either EVICEL or TISSEEL on the day of surgery (index date)...
November 10, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28319549/therapeutic-plasma-transfusion-in-bleeding-patients-a-systematic-review
#5
Jerrold H Levy, Oliver Grottke, Dietmar Fries, Sibylle Kozek-Langenecker
Plasma products, including fresh frozen plasma, are administered extensively in a variety of settings from massive transfusion to vitamin K antagonist reversal. Despite the widespread use of plasma as a hemostatic agent in bleeding patients, its effect in comparison with other available choices of hemostatic therapies is unclear. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed Central, and databases of ongoing trials for randomized controlled trials that assessed the efficacy and/or safety of therapeutic plasma as an intervention to treat bleeding patients compared with other interventions or placebo...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28302286/viscoelastic-hemostatic-assays-in-the-management-of-the-pediatric-trauma-patient
#6
Christine M Leeper, Barbara A Gaines
Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28297575/selective-inhibition-of-adam17-efficiently-mediates-glycoprotein-ib%C3%AE-retention-during-ex-vivo-generation-of-human-induced-pluripotent-stem-cell-derived-platelets
#7
Shinji Hirata, Takahiko Murata, Daisuke Suzuki, Sou Nakamura, Ryoko Jono-Ohnishi, Hidenori Hirose, Akira Sawaguchi, Satoshi Nishimura, Naoshi Sugimoto, Koji Eto
Donor-independent platelet concentrates for transfusion can be produced in vitro from induced pluripotent stem cells (iPSCs). However, culture at 37°C induces ectodomain shedding on platelets of glycoprotein Ibα (GPIbα), the von Willebrand factor receptor critical for adhesive function and platelet lifetime in vivo, through temperature-dependent activation of a disintegrin and metalloproteinase 17 (ADAM17). The shedding can be suppressed by using inhibitors of panmetalloproteinases and possibly of the upstream regulator p38 mitogen-activated protein kinase (p38 MAPK), but residues of these inhibitors in the final platelet products may be accompanied by harmful risks that prevent clinical application...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28296287/bio-inspired-nanomedicine-strategies-for-artificial-blood-components
#8
REVIEW
Anirban Sen Gupta
Blood is a fluid connective tissue where living cells are suspended in noncellular liquid matrix. The cellular components of blood render gas exchange (RBCs), immune surveillance (WBCs) and hemostatic responses (platelets), and the noncellular components (salts, proteins, etc.) provide nutrition to various tissues in the body. Dysfunction and deficiencies in these blood components can lead to significant tissue morbidity and mortality. Consequently, transfusion of whole blood or its components is a clinical mainstay in the management of trauma, surgery, myelosuppression, and congenital blood disorders...
March 15, 2017: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#9
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288507/anticoagulation-in-cirrhosis-a-new-paradigm
#10
Filippo Leonardi, Nicola De Maria, Erica Villa
The liver plays a crucial role in coagulation cascade. Global hemostatic process is profoundly influenced by the presence of liver disease and its complications. Patients with cirrhosis have impaired synthesis of most of the factors involved in coagulation and fibrinolysis process due to a reduced liver function and altered platelet count secondary to portal hypertension. Altered routine tests and thrombocytopenia were considered in the past as associated with increased risk of bleeding. These concepts explain both the routine use of plasma and/or platelets transfusion in patients with liver cirrhosis, especially before invasive procedures, and why these patients were considered "auto-anticoagulated"...
March 14, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28287015/cost-consequence-analysis-of-two-different-active-flowable-hemostatic-matrices-in-spine-surgery-patients
#11
D Makhija, M Rock, S Ikeme, E Kuntze, J D Epstein, G Nicholson, J S Price, V Patel
OBJECTIVES: A recently published retrospective analysis comparing two different active flowable hemostatic matrices (FLOSEAL and SURGIFLO Kit with Thrombin) showed significantly increased resource use and complications (surgery time, risk of blood product transfusion, and amount of matrix used) with SURGIFLO use compared to FLOSEAL in major spine surgery, and also significantly increased surgical time with SURGIFLO use in severe spine surgery. This analysis was developed as a follow-up to this prior analysis, to evaluate the cost-consequence of using FLOSEAL vs SURGIFLO in major and severe spine surgery...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28273299/association-between-ratio-of-fresh-frozen-plasma-to-red-blood-cells-during-massive-transfusion-and-survival-among-patients-without-traumatic-injury
#12
Tomaz Mesar, Andreas Larentzakis, Walter Dzik, Yuchiao Chang, George Velmahos, Daniel Dante Yeh
Importance: Hemostatic resuscitation has been shown to be beneficial for patients with trauma, but there is little evidence that it is equally beneficial for bleeding patients without trauma. The practice of a high transfusion ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) has spread to other surgical and medical fields. Objective: To identify whether ratio-based resuscitation in patients without trauma is associated with improved survival. Design, Setting, and Participants: This study is a retrospective review of all massive transfusions provided in an urban academic hospital from January 1, 2009, through December 31, 2012...
March 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28270041/bleeding-gastric-and-duodenal-ulcers-case-control-study-comparing-angioembolization-and-surgery
#13
Taina Nykänen, Erno Peltola, Leena Kylänpää, Marianne Udd
OBJECTIVES: To compare the safety, efficacy and feasibility of transcatheter arterial embolization (TAE) and surgery in the treatment of bleeding gastric and duodenal ulcers (BGDUs). MATERIALS AND METHODS: The study group comprised patients receiving TAE or surgery for BGDUs after failed endoscopic hemostasis in Helsinki University Hospital (HUH) during 2000-2015. Hospital medical records provided study data. 30-d mortality and rebleeding rates were the primary outcomes...
May 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#14
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28261426/is-intraoperative-use-of-quikclot-combat-gauze-effective-for-hemostasis-after-total-knee-arthroplasty
#15
Jung Ho Noh, Jae Woo Lee, Young Joon Nam, Ki Yong Choi
BACKGROUND: To assess the hemostatic effect of QuikClot Combat Gauze (QCG) compared to that of standard gauze during cruciate-retaining total knee arthroplasty (TKA). METHODS: Sixty knees underwent TKA using a pneumatic tourniquet in this prospective randomized study. After implantation of the femoral and tibial components and hardening of the bone cement, the tourniquet was deflated and QCG (group 1) or standard gauze (group 2) was packed into the joint cavity for 5 minutes for hemostasis...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28236302/pathogen-inactivation-treatment-of-plasma-and-platelet-concentrates-and-their-predicted-functionality-in-massive-transfusion-protocols
#16
Ahmad F Arbaeen, Peter Schubert, Katherine Serrano, Cedric J Carter, Brankica Culibrk, Dana V Devine
BACKGROUND: Trauma transfusion packages for hemorrhage control consist of red blood cells, plasma, and platelets at a set ratio. Although pathogen reduction improves the transfusion safety of platelet and plasma units, there is an associated reduction in quality. This study aimed to investigate the impact of riboflavin/ultraviolet light-treated plasma or platelets in transfusion trauma packages composed of red blood cell, plasma, and platelet units in a ratio of 1:1:1 in vitro by modeling transfusion scenarios for trauma patients and assessing function by rotational thromboelastometry...
February 24, 2017: Transfusion
https://www.readbyqxmd.com/read/28174415/comparison-of-enoxaparin-and-rivaroxaban-in-balance-of-anti-fibrinolysis-and-anticoagulation-following-primary-total-knee-replacement-a-pilot-study
#17
Jinwei Xie, Jun Ma, Qiang Huang, Chen Yue, Fuxing Pei
BACKGROUND This study aimed to assess whether the efficacy of tranexamic acid (TXA) would be altered when rivaroxaban or enoxaparin was used for thromboprophylaxis in primary total knee replacement (TKR). It was hypothesized that the hemostatic effect of TXA would be better with the use of enoxaparin. MATERIAL AND METHODS A randomized clinical trial was conducted on 194 patients undergoing primary TKR for osteoarthritis. An intravenous dose of 15 mg/kg (TXA) and 1 g topical TXA were used. Patients randomly received enoxaparin or rivaroxaban prophylaxis when the drainage was less than 30 ml/h 6-8 h postoperatively...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28168995/starch-derived-absorbable-polysaccharide-hemostat-enhances-bone-healing-via-bmp-2-protein
#18
Wen Niu, Yanxia Wang, Yi Liu, Bo Zhang, Manling Liu, Ying Luo, Pengtao Zhao, Yao Zhang, Hanrong Wu, Lei Ma, Zhichao Li
Surgical hemostasis is critical in reducing the likelihood of excessive bleeding and blood transfusion. In treating some cases, commonly used hemostatic agent showed limited efficacy and prolonged degradation and clearance, causing an inhibition of bone healing. Starch absorbable polysaccharide (SAPH) is a novel hemostatic agent made from a plant starch, which can be completely absorbed and achieve better hemostatic effects than many commonly used hemostatic agents. However, whether SAPH can induce a promotion of bone healing remains unknown...
February 3, 2017: Acta Histochemica
https://www.readbyqxmd.com/read/28128747/use-of-thrombin-generation-test-for-monitoring-hemostasis-in-coronary-bypass-surgery
#19
Gruzdeva Olga, Uchasova Evgenya, Fanaskova Elena, Akbasheva Olga, Penskaya Tatyana, Plotnikov Georgy, Dyleva Yulia, Barbarash Olga
To evaluate the parameters of the thrombin generation test (TGT) in coronary artery disease (CAD) patients on prolonged aspirin therapy during on-pump coronary artery bypass grafting (CABG) after donor platelet concentrate transfusion. A total of 148 patients with CAD on prolonged aspirin therapy (75-100 mg/day) who have undergone elective on-pump CABG were consecutively included in the study. Patients were divided randomly into two groups. Group 1 (n = 76) received donor platelet transfusions after cardiopulmonary bypass, whereas Group 2 (n = 72) did not...
January 27, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28110840/use-of-fresh-frozen-plasma-from-the-2012-french-guidelines-to-recent-advances
#20
REVIEW
Samy Figueiredo, Dan Benhamou
Fresh frozen plasma (FFP) is widely used by anesthetists and/or intensivists managing bleeding patients. In this context, two clinical situations with different benefit/risk ratio for FFP transfusion should be distinguished: moderate or controlled hemorrhage on one side, and massive hemorrhage on the other. In the former situation, administration of FFP is most often ineffective, associated with potential side effects (pulmonary complications, product shortage) and should therefore be restricted. In case of massive hemorrhage, transfusion of FFP, red blood cells and platelets using a ratio close to 1:1:1 is recommended based on a large number of studies...
February 2017: Transfusion and Apheresis Science
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