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Massive Transfusion

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https://www.readbyqxmd.com/read/28343934/hitchhiker-s-guide-to-the-red-cell-storage-galaxy-omics-technologies-and-the-quality-issue
#1
REVIEW
Angelo D'Alessandro, Jerard Seghatchian
Red blood cell storage in the blood bank makes millions of units of available for transfusion to civilian and military recipients every year. From glass bottles to plastic bags, from anticoagulants to complex additives, from whole blood to leukocyte filtered packed red blood cells: huge strides have been made in the field of blood component processing and storage in the blood bank during the last century. Still, refrigerated preservation of packed red blood cells under blood bank conditions results in the progressive accumulation of a wide series of biochemical and morphological changes to the stored erythrocytes, collectively referred to as the storage lesion(s)...
March 9, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28333829/acute-traumatic-coagulopathy-the-elephant-in-a-room-of-blind-scientists
#2
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/28333704/massive-transfusion-in-cardiac-surgery-the-impact-of-blood-component-ratios-on-clinical-outcomes-and-survival
#3
Meghan Delaney, Paul C Stark, Minhyung Suh, Darrell J Triulzi, John R Hess, Marie E Steiner, Christopher P Stowell, Steven R Sloan
BACKGROUND: Cardiac surgery is the most common setting for massive transfusion in medically advanced countries. Studies of massive transfusion after injury suggest that the ratios of administered plasma and platelets (PLT) to red blood cells (RBCs) affect mortality. Data from the Red Cell Storage Duration Study (RECESS), a large randomized trial of the effect of RBC storage duration in patients undergoing complex cardiac, were analyzed retrospectively to investigate the association between blood component ratios used in massively transfused patients and subsequent clinical outcomes...
March 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#4
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28321971/risk-factors-for-perioperative-mortality-and-transfusion-in-sacrococcygeal-teratoma-resections
#5
Rebecca S Isserman, Olivia Nelson, Kha M Tran, Lingyu Cai, Marcia Polansky, Julia M Rosenbloom, Theodora K Goebel, Elaina E Lin
BACKGROUND: Sacrococcygeal teratomas are a common congenital tumor. Surgical resection can occur in utero, in the neonatal period, or in the postneonatal period. AIMS: We describe patient and tumor factors associated with mortality and transfusion in this population. METHODS: We did a retrospective chart review of patients who underwent sacrococcygeal teratoma resection between January 1998 and March 2016. Demographic data, transfusion data, and tumor characteristics were collected...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#6
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28319549/therapeutic-plasma-transfusion-in-bleeding-patients-a-systematic-review
#7
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/28316839/tranexamic-acid-txa-in-trauma-patients-barriers-to-use-among-trauma-surgeons-and-emergency-physicians
#8
Abdulaziz Alburaih
Objective. Tranexamic Acid (TXA) is currently the only drug with prospective clinical evidence supporting its use in bleeding trauma patients. We sought to better understand the barriers preventing its use and elicit suggestions to further its use in trauma patients in the state of Maryland. Methods. This is a cross-sectional study. Results. The overall response rate was 38%. Half of all participants reported being familiar with the CRASH-2 trial and MATTERs study. Half reported being aware of TXA as part of their institution's massive transfusion protocol...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28302244/disseminated-intravascular-coagulation-developing-after-cranioplasty
#9
Wenming Wang, Hua Liu, Jian Yang, Yafang Shen
Disseminated intravascular coagulation (DIC) developing after cranioplasty, a skull reconstructive surgical procedure, is very rare. The presently reported patient underwent cranioplasty for cranial trauma under general anaesthesia using titanium prostheses. Her laboratory data was unremarkable. She underwent three operations, each complicated by excessive postoperative bleeding. Although the patient received massive blood transfusions, but no cryoprecipitate coagulum was given during the first two re-operations, and excessive bleeding was evident...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28301393/potential-contribution-of-mitochondrial-mt-dna-damage-associated-molecular-patterns-damps-in-transfusion-products-to-the-development-of-acute-respiratory-distress-syndrome-ards-after-multiple-transfusions
#10
Jon D Simmons, Yann-Leei L Lee, Viktor M Pastukh, Gina Capley, Cherry A Muscat, David C Muscat, Michael L Marshall, Sidney B Brevard, Mark N Gillespie
INTRODUCTION: Massive transfusions are accompanied by an increased incidence of a particularly aggressive and lethal form of acute lung injury (delayed TRALI) which occurs >24 hours after transfusions. In light of recent reports showing that mtDNA DAMPs are potent pro-inflammatory mediators, and that their abundance in the sera of severely injured or septic patients is predictive of clinical outcomes, we explored the idea that mtDNA DAMPs are present in transfusion products and are associated with the occurrence of delayed TRALI...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28296737/incidence-influencing-factors-and-prognostic-impact-of-intraoperative-massive-blood-loss-in-adolescents-with-neuromuscular-scoliosis-a-strobe-compliant-retrospective-observational-analysis
#11
Rui Jia, Na Li, Bi-Yun Xu, Wei Zhang, Xiao-Ping Gu, Zheng-Liang Ma
Factors influencing massive blood loss for neuromuscular scoliosis (NMS) patients.Despite advances in surgical and anesthetic techniques, scoliosis surgery is still associated with intraoperative massive blood loss, which can result in postoperative mortality and morbidity. The aim of this study was to assess the incidence, influencing factors, and prognostic impact of intraoperative massive blood loss in adolescents with NMS.A retrospective review of adolescents who underwent posterior spinal instrumentation and fusion for NMS was performed...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28292321/prothrombin-time-is-predictive-of-low-plasma-prothrombin-concentration-and-clinical-outcome-in-patients-with-trauma-hemorrhage-analyses-of-prospective-observational-cohort-studies
#12
Clare A Balendran, Ann Lövgren, Kenny M Hansson, Karin Nelander, Marita Olsson, Karin J Johansson, Karim Brohi, Dietmar Fries, Anders Berggren
BACKGROUND: Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outcome is unknown. METHODS: We have utilized two trauma patient databases (database 1 n = 358 and database 2 n = 331) to investigate the relationship of plasma prothrombin concentration on clinical outcome and coagulation status. Database 1 has been used to assess the relationship of plasma prothrombin to administered packed red blood cells (PRBC), clinical outcome and coagulation biomarkers (Prothrombin Time (PT), ROTEM EXTEM Coagulation Time (CT) and Maximum Clot Firmness (MCF))...
March 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28292261/genome-wide-analysis-of-a-avirulent-and-reveal-the-strain-induces-pro-tective-immunity-against-challenge-with-virulent-streptococcus-suis-serotype-2
#13
Jing Wang, Youjun Feng, Changjun Wang, Feng Zheng, Bachar Hassan, Liming Zhi, Wenjuan Li, Yi Yao, Elaine He, Shibo Jiang, Jiaqi Tang
BACKGROUND: It was previously reported in China that two recent large-scale outbreaks of Streptococcus suis serotype 2 (S. suis 2) infections in human were caused by two highly virulent S. suis 2 strains, from which a novel genomic island (GEI), associated with disease onset and progression and designated 89 K, was identified. Here, an avirulent strain, 05HAS68, was isolated from a clinically healthy pig. RESULTS: By comparing the genomes of this avirulent strain with virulent strains, it was found that massive genomic rearrangements occurred, resulting in alterations in gene expression that caused enormous single gene gain and loss...
March 14, 2017: BMC Microbiology
https://www.readbyqxmd.com/read/28280628/multiple-angiodysplasia-diagnosed-by-capsule-endoscopy
#14
Giulia Diamantini, Giovanni Battista Levi Sandri, Fabio Procacciante
A 28-year-old Caucasian man was admitted in our unit for acute massive rectal bleeding. Past medical and family history was unremarkable. Hemoglobin was 7.6 g/dL. Blood transfusions were required. Computed tomography and gastrointestinal endoscopy were negative for active bleeding. When patient's hemoglobin was normalized and stable, a video capsule endoscopy was performed. Video relieved the presence of multiple digiunal and ileal angiodysplastic lesions. A double endoscopic argon plasma coagulation procedure was planned on general anaesthesia...
February 2017: Journal of Gastrointestinal Oncology
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
#15
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/28272567/-thromboelastography-useful-in-cases-of-bleeding
#16
Aurora Espinosa, Marit Seim Ekeland
Blood products are a limited resource. A number of studies have shown that the use of thromboelastography (TEG) may reduce the need for blood transfusions. The analysis can be used in acute situations in patients with massive haemorrhage as a guide to transfusion therapy. Use of TEG may play an important role in targeting transfusion therapy.
March 2017: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#17
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/28263173/modelling-the-effects-of-blood-component-storage-lesions-on-the-quality-of-haemostatic-resuscitation-in-massive-transfusion-for-trauma
#18
REVIEW
James A Mays, John R Hess
BACKGROUND: All blood components undergo loss of potency during storage. These loss-of-potency storage lesions are important in trauma resuscitation because they reduce the haemostatic capacity of mixtures of components that attempt to reconstitute whole blood. Even red cell storage-related loss of potency, which averages 17% with modern additive solutions, is important because 6 units of red cells must be given to achieve the effect of 5 fully potent units. MATERIALS AND METHODS: Loss of potency of stored units of red blood cells, plasma, platelets, and cryoprecipitate were summed for dilutional, storage-related, pathogen reduction-related, and splenic sequestration-related causes and expressed as fractional plasma coagulation factor concentrations and platelet counts...
March 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28260994/risk-factors-for-intraoperative-massive-transfusion-in-pediatric-liver-transplantation-a-multivariate-analysis
#19
Seok-Joon Jin, Sun-Key Kim, Seong-Soo Choi, Keum Nae Kang, Chang Joon Rhyu, Shin Hwang, Sung-Gyu Lee, Jung-Man Namgoong, Young-Kug Kim
Background: Pediatric liver transplantation (LT) is strongly associated with increased intraoperative blood transfusion requirement and postoperative morbidity and mortality. In the present study, we aimed to assess the risk factors associated with massive transfusion in pediatric LT, and examined the effect of massive transfusion on the postoperative outcomes. Methods: We enrolled pediatric patients who underwent LT between December 1994 and June 2015. Massive transfusion was defined as the administration of red blood cells ≥100% of the total blood volume during LT...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28256411/-newborn-outcomes-after-radiofrequency-ablation-for-selective-reduction-in-the-complicated-monochorionic-pregnancies
#20
M Panciatici, B Tosello, J Blanc, J-B Haumonté, C D'Ercole, C Gire
OBJECTIVE: To describe perinatal data and to evaluate the neonatal neurological outcome of monochorionic twin pregnancies with selective termination by radiofrequency ablation. METHODS: Retrospective data of perinatal data for nine consecutive monochorionic pregnancies eligible for radiofrequency ablation from January 2013 to August 2015 were collected. A prospective observational study of the neurological outcome of nine children was conducted using the Ages & Stages Questionnaire (ASQ), 2nd edition, French version, adapted to the age...
February 27, 2017: Gynecol Obstet Fertil Senol
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