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Massive Transfusion

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https://www.readbyqxmd.com/read/28213059/multidisciplinary-team-learning-in-the-management-of-the-morbidly-adherent-placenta-outcome-improvements-over-time
#1
Alireza A Shamshirsaz, Karin A Fox, Hadi Erfani, Steven L Clark, Bahram Salmanian, B Wycke Baker, Michael Coburn, Amir A Shamshirsaz, Zhoobin H Bateni, Jimmy Espinoza, Ahmed A Nassr, Edwina J Popek, Shiu-Ki Hui, Jun Teruya, Celestine Shauching Tung, Jeffery A Jones, Martha Rac, Gary A Dildy, Michael A Belfort
BACKGROUND: Morbidly adherent placenta (MAP) is a serious obstetric complication causing mortality and morbidity. OBJECTIVE: To evaluate whether outcomes of patients with morbidly adherent placenta improve with increasing experience within a well-established multidisciplinary team at a single referral center. STUDY DESIGN: All singleton pregnancies with pathology-confirmed MAP (including placenta accreta, increta or percreta) managed by a multidisciplinary team between January 2011 and August 2016 were included in this retrospective study...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#2
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28199784/allosensitization-following-bone-graft
#3
Eoin D O'Sullivan, Richard K Battle, Sharon Zahra, John F Keating, Lorna P Marson, David M Turner
It is recognised that patients may become sensitized to donor-specific HLA antigens as a result of previous antigenic exposures, classically through previous transplantation, pregnancy or blood transfusion. We present an unusual case of a patient who unexpectedly developed a range of anti-HLA antibodies following orthopaedic surgery where a bone graft was deployed intraoperatively. We describe the case of a 52-year-old male awaiting a renal transplantation, undergoing elective orthopaedic surgery requiring a small volume bone graft...
February 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#4
W Nussbaumer, M Amato, H Schennach, M Astl, C Y Chen, J-S Lin, L Corash, R J Benjamin
BACKGROUND: Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients. METHODS: Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation...
February 15, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28193282/preoperative-embolization-in-patients-with-metastatic-spinal-cord-compression-mandatory-or-optional
#5
Chul Gie Hong, Jae Hwan Cho, Dae Chul Suh, Chang Ju Hwang, Dong-Ho Lee, Choon Sung Lee
BACKGROUND: The contribution of preoperative embolization in reducing intraoperative blood loss and its clinical importance are unclear. So, we aimed to compare the perioperative clinical outcomes based on whether preoperative embolization was performed and assess the role and safety of preoperative embolization in metastatic spinal cord compression (MSCC) patients. METHODS: We enrolled 52 patients (men, 37; women, 15) who underwent palliative decompression for MSCC...
February 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28188760/long-term-clinical-efficacy-and-safety-profile-of-transurethral-resection-of-prostate-vs-plasmakinetic-resection-of-the-prostate-for-benign-prostatic-hyperplasia
#6
Zhe Liu, Yuan Wei Li, Wan Rui Wu, Qiang Lu
OBJECTIVE: To investigate differences on clinical efficacy, complications and safety profile between transurethral resection of prostate (TURP) and bipolar plasmakinetic resection of the prostate (PKRP) for benign prostatic hyperplasia (BPH). METHODS: 690 patients of BPH were recruited from May 2008 to May 2011 and divided into TURP group and PKRP group, IPSS, QoL, PVR, Qmax, complications, IIEF-5 and retrograde ejaculation were used for evaluation of clinical effective, safety and sexual function between two groups...
February 8, 2017: Urology
https://www.readbyqxmd.com/read/28181262/descriptive-characteristics-and-in-hospital-mortality-of-critically-bleeding-patients-requiring-massive-transfusion-results-from-the-australian-and-new-zealand-massive-transfusion-registry
#7
R Ruseckaite, Z K McQuilten, J C Oldroyd, T H Richter, P A Cameron, J P Isbister, E M Wood
BACKGROUND AND OBJECTIVES: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). MATERIALS AND METHODS: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015...
February 8, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28166080/stress-induced-gastric-ulcers-presenting-as-massive-rectal-bleeding-in-a-newborn
#8
A Joshi, P S Shrestha, S Dangol, N C Shrestha, P Poudyal, A Shrestha A
Severe gastrointestinal bleeding in newborn period is a serious but uncommon phenomenon that has a broad differential diagnosis. Primary duodenal ulcers are rare in children but stress induced ulceration in stomach occurs more often in neonatal period due to birth asphyxia, prolonged labour, cesarean deliveries, instrumentations, respiratory distress syndrome and sepsis. These present as acute onset of gastrointestinal bleeding commonly as altered gastric aspirate, hematemesis or malena. We report a case of a neonate with stress induced gastric bleeding following birth asphyxia who presented with massive gastrointestinal bleed manifesting as hematemesis and massive rectal bleeding...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28150393/acquired-hemophilia-a-manifesting-as-plasma-transfusion-uncontrolled-severe-bleeding-2-weeks-after-chorioamnionitis-induced-abortion
#9
Ayumi Matsuoka, Hiromasa Sasaki, Chiharu Sugimori, Shinya Hirabuki, Tsutomu Hoshiba, Hiroshi Fujiwara
Acquired hemophilia A (AHA) is a serious and rare complication of pregnancy, caused by autoantibodies to coagulation factor VIII after delivery. We here report the case of a 36-year-old primigravida woman who developed AHA following chorioamnionitis-caused miscarriage in the second trimester. Thirteen days after abortion, sudden, massive vaginal bleeding occurred with marked prolongation of activated partial thromboplastin time (APTT) in the absence of other abnormal coagulation data. Sequential transfusion of fresh frozen plasma did not achieve normalization of APTT...
February 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28149824/early-high-ratio-platelet-transfusion-in-trauma-resuscitation-and-its-outcomes
#10
Ruben Peralta, Adarsh Vijay, Ayman El-Menyar, Rafael Consunji, Ibrahim Afifi, Ismail Mahmood, Mohammed Asim, Rifat Latifi, Hassan Al-Thani
INTRODUCTION: The optimal ratio of platelets (PLTs) to packed red blood cell (PRBC) in trauma patients requiring massive transfusion protocol (MTP) is still controversial. This report aims to describe the effect of attaining a high PLT:PRBC ratio (≥1:1.5) within 4 h postinjury on the outcomes of trauma patients receiving MTP. METHODS: Over a 24-month period, records of all adult patients with traumatic injury who received MTP were retrospectively reviewed. Data were analyzed with respect to PLT:PRBC ratio ([high-MTP ≥1:1...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28149244/monitoring-and-treatment-of-coagulation-abnormalities-in-burn-patients-an-international-survey-on-current-practices
#11
A Lavrentieva, N Depetris, E Kaimakamis, M Berardino, M Stella
The magnitude of coagulation abnormalities, and the definition and treatment of coagulopathy in burn patients are inadequately understood and continue to be discussed in the literature. We aimed to analyse physicians' views on monitoring and treating coagulation abnormalities in burn patients. A total of 350 questionnaires were distributed electronically to burn ICU physicians. Participation was voluntary and anonymous. Responses were analysed electronically and comparisons were made according to the region of the ICU or the specialty of the physician...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28148274/severity-dependent-differences-in-early-management-of-thoracic-trauma-in-severely-injured-patients%C3%A2-analysis-based-on-the-traumaregister-dgu%C3%A2
#12
J Bayer, R Lefering, S Reinhardt, J Kühle, N P Südkamp, T Hammer
BACKGROUND: Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management...
February 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28145042/safety-of-catheter-directed-thrombolysis-for-massive-and-submassive-pulmonary-embolism-results-of-a-multicenter-registry-and-meta-analysis
#13
Tyler L Bloomer, Georges E El-Hayek, Michael C McDaniel, Breck C Sandvall, Henry A Liberman, Chandan M Devireddy, Gautam Kumar, Pete P Fong, Wissam A Jaber
OBJECTIVES: To evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) in the treatment of acute pulmonary embolism (PE). BACKGROUND: The use of CDT for the treatment of acute submassive and massive PE is increasing in frequency. However, its safety and efficacy have not been well elucidated. METHODS: This study is made of two parts: one is a two-center registry of acute PE patients treated with CDT. The safety outcome evaluated was any major complication including fatal, intracranial (ICH), intraocular, or retroperitoneal hemorrhage or any overt bleeding requiring transfusion or surgical repair...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28144603/early-prediction-of-ongoing-hemorrhage-in-severe-trauma-presentation-of-the-existing-scoring-systems
#14
Martin L Tonglet
Early prediction of ongoing hemorrhage may reduce mortality via the earlier delivery of blood products, adequate orientation of the patient in a dedicated highly specialized and trained infrastructure, and by earlier correction of acute traumatic coagulopathy. We identified 14 scores or algorithms developed for the prediction of ongoing hemorrhage and the need for massive transfusion in severe trauma patients.
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#15
Melissa Schwartz, Kristin Powell
Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28122682/fibrinogen-level-on-admission-is-a-predictor-for-massive-transfusion-in-patients-with-severe-blunt-trauma-analyses-of-a-retrospective-multicentre-observational-study
#16
Yoshihiko Nakamura, Hiroyasu Ishikura, Shigeki Kushimoto, Fumiaki Kiyomi, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogura, Tetsuya Matsuoka, Toshifumi Uejima, Naoto Morimura, Mineji Hayakawa, Akiyoshi Hagiwara, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Daisuke Kudo, Kunihiko Maekawa, Takashi Kanemura, Takayuki Shibusawa, Yasushi Hagihara, Shintaro Furugori, Atsushi Shiraishi, Kiyoshi Murata, Gou Mayama, Arino Yaguchi, Shiei Kim, Osamu Takasu, Kazutaka Nishiyama
INTRODUCTION: In the early phase of trauma, fibrinogen (Fbg) plays an important role in clot formation. However, to the best of our knowledge, few studies have analysed methods of predicting the need for massive transfusion (MT) based on Fbg levels using multiple logistic regression. Therefore, the present study aimed to evaluate whether Fbg levels on admission can be used to predict the need for MT in patients with trauma. METHODS: We conducted a retrospective multicentre observational study...
January 16, 2017: Injury
https://www.readbyqxmd.com/read/28121282/how-to-identify-patients-at-risk-of-abdominal-compartment-syndrome-after-surgical-repair-of-ruptured-abdominal-aortic-aneurysms-in-the-operating-room-a-pilot-study
#17
Betty Leclerc, Lucie Salomon Du Mont, Guillaume Besch, Simon Rinckenbach
Objectives Abdominal compartment syndrome (ACS) is poorly identified in surgery for ruptured abdominal aortic aneurysm and an early management is crucial. The aim of this study was to validate how many risk factors were needed to predict ACS. Secondary objectives were to assess its prevalence and the 30-day mortality. Methods All patients operated for ruptured abdominal aortic aneurysm during 5 years were included. An independent committee performed a retrospective diagnosis of ACS. Eight criteria were selected from the literature, and corresponded to pre- and intraoperative period: anemia (hemoglobin lower than 10 g/dL), prolonged shock (systolic blood pressure <90 mmHg more than 18 min), preoperative cardiac arrest, obesity (body mass index > 30), massive fluid resuscitation (≥3500 mL per hour for at least 1 h) and transfusions (>10 units packed blood red cell since the beginning of the treatment), severe hypothermia (≤33℃), acidosis (pH < 7...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28119900/non-puerperal-uterine-inversion-presented-with-hypovolemic-shock
#18
Yong Jung Song, Juseok Yang, Hyun Sil Yun, Sun Kyung Lee, Hwi Gon Kim, Dong Hyung Lee, Ook Hwan Choi, Yong Jin Na
We report a non-puerperal uterine inversion with nulliparous women caused by huge pedunculated submucosal fibroid. Massive bleeding from protruding mass through vagina brought the heart to stop in 42-year-old nulliparous woman. She became cardiopulmonary resuscitation survivor in emergency room and then underwent laparotomy which ended in successful myomectomy rather than hysterectomy considering her demand for future fertility. Meticulous and adequate fluid therapy and transfusion was also administered to recover from hypovolemic status...
December 2016: Journal of Menopausal Medicine
https://www.readbyqxmd.com/read/28110840/use-of-fresh-frozen-plasma-from-the-2012-french-guidelines-to-recent-advances
#19
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...
December 30, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28109111/-efficacy-of-high-versus-low-plasma-red-blood-cell-ratio-resuscitation-in-patients-with-severe-trauma-requiring-massive-blood-transfusion-a-meta-analysis
#20
Fang Yu, Tao Zhong, Gang Wu
OBJECTIVE: To evaluate the efficacy of high (≥1:2) and low (<1:2) plasma: red blood cell (RBC) ratio resuscitation in patients with severe trauma requiring massive blood transfusion. METHODS: The databases including the Cochrane Library, Pubmed, Web of Science, and EMBASE were systemically searched for relevant studies published between January, 2009 and April, 2016. The selection of studies, assessment of methodological quality and data extraction were performed by two researchers independently according to the inclusion and exclusion criteria...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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