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Massive Transfusion

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https://www.readbyqxmd.com/read/29673931/-appropriate-use-of-red-blood-cell-transfusion-in-the-emergency-department-before-and-after-a-specific-protocol
#1
M-L Langlais, M Dargère, C Le Niger, D Goetghebeur
The purpose of this study was to assess appropriateness of red blood cell (RBC) transfusion in the emergency department before and after a specific protocol. METHODS: A retrospective monocenter study was realized during two six-month periods at the emergency unit. A protocol based on the French national guidelines (HAS) in 2014 was set up between the two periods. All the adult patients, except in a context of massive transfusion, were included in the study. The principal criteria analysed was the rate of appropriate transfusion...
April 16, 2018: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29664514/-damage-control-resuscitation-in-pediatric-severe-trauma
#2
Adriana Wegner Araya
INTRODUCTION: Trauma is an important cause of morbidity and mortality in the pediatric population. It has the first place in mortality in our country without considering perinatal pathologies and congenital malformations. An important percentage of early and late deaths secondary to this cau se, as well as its sequelae, could be prevented with optimal and timely resuscitation. OBJECTIVE: To review the applicability of damage control resuscitation (DCR) in severe pediatric trauma, with emphasis on medical management...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29662708/emergency-peripartum-hysterectomy-in-the-dubai-health-system-a-fifteen-year-experience
#3
Muna Abdulrazzaq Tahlak, Mahera Abdulrahman, Nawal Mahmood Hubaishi, Mushtaq Omar, Fatima Cherifi, Shazia Magray, Frederick Robert Carrick
Objective: To determine the incidence, demographic data, risk factors, indications, outcome and complications of emergency peripartum hysterectomy (EPH) performed in two major tertiary care hospitals in Dubai, and to compare the results with the literature. Materials and Methods: The records of all women who underwent EPH from January 2000 to December 2015 in two major tertiary care hospitals in Dubai were accessed and reviewed. Maternal characteristics, hysterectomy indications, outcomes, and postoperative complications were recorded using descriptive statistics to describe the cohort...
March 2018: Turkish Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29661410/use-of-prothrombin-complex-concentrate-for-management-of-coagulopathy-after-cardiac-surgery-a-propensity-score-matched-comparison-to-plasma
#4
J Fitzgerald, M Lenihan, J Callum, S A McCluskey, C Srinivas, A van Rensburg, K Karkouti
BACKGROUND: An important cause of coagulopathy in cardiac surgery is impaired thrombin generation. While plasma is often used to correct this element of the coagulopathy, studies in vitro suggest that prothrombin complex concentrates (PCCs) might be more effective. Comparative data, however, are scant. METHODS: We compared the outcomes of those who received only plasma with those who received PCCs (with or without plasma) for management of coagulopathy in patients who underwent cardiac surgery with cardiopulmonary bypass at a single institution from 2012 to 2016...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29658985/using-rotational-thromboelastometry-clot-firmness-at-5-minutes-rotem-%C3%A2-extem-a5-to-predict-massive-transfusion-and-in-hospital-mortality-in-trauma-a-retrospective-analysis-of-1146-patients
#5
J M Kelly, S Rizoli, P Veigas, S Hollands, A Min
Viscoelastic assays such as TEG® and ROTEM® are increasingly used to guide transfusion of blood products. The EXTEM assay maximum clot firmness (MCF) is a ROTEM measure available after 25-29 min used to guide early decisions. EXTEM A10, the clot firmness at 10 min, is an accepted early surrogate, but investigators differ on whether A5, the clot firmness at 5 min, is acceptable. We re-examined this in a retrospective observational analysis of 1146 trauma patients in one centre who had ROTEM data recorded. A5 and A10 both correlated well with maximum clot firmness, with Pearson coefficients of r = 0...
April 16, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#6
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29627883/platelet-transfusion-increases-risk-for-acute-respiratory-distress-syndrome-in-non-massively-transfused-blunt-trauma-patients
#7
George Kasotakis, Nichole Starr, Erek Nelson, Bedabrata Sarkar, Peter Ashley Burke, Daniel George Remick, Ronald Gary Tompkins
PURPOSE: While damage control resuscitation is known to confer a survival advantage in severely injured patients, high-ratio blood component therapy should be initiated only in carefully selected trauma patients, due to the morbidity associated with blood product use. With this project, we aim to identify the effect of platelet transfusion in non-massively transfused bluntly injured patients. METHODS: The Glue Grant database was retrospectively queried and severely injured blunt trauma patients who underwent non-massive transfusion were identified...
April 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29626027/lesson-of-the-month-1-massive-spontaneous-haematomas-in-an-elderly-man
#8
Francesco Fiorini, Louise Braddick, Hasnain Hashim, Robert M Ayto, Alana Jacobs, Yetunde Baoku, Shahir S Hamdulay
A 73-year-old man presented with bilateral leg pain and swelling, and no history of trauma or bleeding disorders. Clinical examination, biochemistry and magnetic resonance imaging of the thighs were suggestive of muscle haematomas. These progressed significantly during the admission, requiring blood transfusion. Normal vascular anatomy on computed tomography, renal and liver function, and absence of infection made a bleeding diathesis more likely. This may be caused by coagulation defects, platelet disorders and vascular fragility...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29607593/massive-transfusions-for-critical-bleeding-is-everything-old-new-again
#9
REVIEW
A W J Flint, Z K McQuilten, E M Wood
Massive transfusion or major haemorrhage protocols have been widely adopted in the treatment of critically bleeding patients. Following evidence that higher ratios of transfused plasma and platelets to red blood cells may offer survival benefits in military trauma patients, these ratios are now commonly incorporated into massive transfusion protocols. They more closely resemble the effects of whole blood transfusion, which in the second half of last century was largely replaced by individual blood component transfusion based on laboratory-guided indicators...
April 1, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29606404/the-utility-of-abnormal-initial-arterial-blood-gas-values-in-determining-clinical-futility-of-trauma-cases-with-severe-hemorrhage
#10
Andrew Katirai, Mark J Landau, Jack M Berger
BACKGROUND: Patients who experience trauma with severe hemorrhage requiring immediate surgery and massive blood transfusion often present with markedly abnormal laboratory values. These cases require valuable resources; however, little is known regarding prognostic factors that correlate with mortality. The purpose of this study was to determine whether abnormal initial arterial blood gas (ABG) pH, a marker for severe blood loss, could serve as a prognostic indicator for these patients...
March 23, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29605431/combination-of-blood-lactate-level-with-assessment-of-blood-consumption-abc-scoring-system-a-more-accurate-predictor-of-massive-transfusion-requirement
#11
Wongsakorn Chaochankit, Osaree Akaraborworn, Burapat Sangthong, Komet Thongkhao
PURPOSE: Exsanguination is the most common leading cause of death in trauma patients. The massive transfusion (MT) protocol may influence therapeutic strategies and help provide blood components in timely manner. The assessment of blood consumption (ABC) score is a popular MT protocol but has low predictability. The lactate level is a good parameter to reflect poor tissue perfusion or shock states that can guide the management. This study aimed to modify the ABC scoring system by adding the lactate level for better prediction of MT...
March 3, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29571592/risk-of-maternal-mortality-in-women-with-severe-anaemia-during-pregnancy-and-post-partum-a-multilevel-analysis
#12
Jahnavi Daru, Javier Zamora, Borja M Fernández-Félix, Joshua Vogel, Olufemi T Oladapo, Naho Morisaki, Özge Tunçalp, Maria Regina Torloni, Suneeta Mittal, Kapila Jayaratne, Pisake Lumbiganon, Ganchimeg Togoobaatar, Shakila Thangaratinam, Khalid S Khan
BACKGROUND: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. METHODS: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia...
March 20, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29569247/heparin-binding-protein-as-a-biomarker-of-post-injury-sepsis-in-trauma-patients
#13
H D Halldorsdottir, J Eriksson, B P Persson, H Herwald, L Lindbom, E Weitzberg, A Oldner
BACKGROUND: Heparin-binding protein (HBP) is a neutrophil-derived protein advocated as a biomarker in sepsis. We evaluated plasma HBP as a predictor of post-injury sepsis in trauma patients. METHODS: Ninety-seven trauma patients were studied during the first week of intensive care. Injury-related data were collected and clinical parameters registered daily. Plasma HBP was sampled on day 1, 3 and 5 after trauma and evaluated for associations with injury-related parameters and sepsis...
March 22, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29563683/hemophagocytic-lymphohistiocytosis-in-an-infant-with-multiple-triggers
#14
Sataroopa Mishra, Amitabh Singh, Lavleen Singh, Anirban Mandal, Rahul Jain
Hemophagocytic lymphohistiocytosis (HLH) is a disorder of immune dysregulation secondary to a massive unregulated cytokine storm and its downstream consequences. HLH is being increasingly recognized as a cause of pyrexia of unknown origin, unexplained cytopenias, and hepatic dysfunction. However, this potentially treatable condition is often missed due to lack of suspicion, variable, and nonspecific presentations, inability to fulfil all the diagnostic criteria and availability of diagnostic tests in resource limited settings...
January 2018: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/29563670/prevalence-of-irregular-red-cell-antibody-in-healthy-blood-donors-attending-a-tertiary-care-hospital-in-north-india
#15
Raj Nath Makroo, Saroj Rajput, Soma Agarwal, Mohit Chowdhry, Bindu Prakash, Prashant Karna
BACKGROUND: Alloantibodies may be detected in blood donors who have either been transfused previously or female donors with previous obstetric events. These antibodies can occasionally cause severe transfusion reaction, if a large amount of plasma or whole blood is transfused, as in massive transfusions and pediatric patients. AIMS: The present study aims to assess the prevalence of red cell antibodies in healthy blood donors at a tertiary care hospital-based blood bank in India...
January 2018: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/29554046/the-evolution-of-pediatric-transfusion-practice-during-combat-operations-2001-2013
#16
Jeremy W Cannon, Lucas P Neff, Heather F Pidcoke, James K Aden, Philip C Spinella, Michael A Johnson, Andrew P Cap, Matthew A Borgman
BACKGROUND: Hemostatic resuscitation principles have significantly changed adult trauma resuscitation over the past decade. Practice patterns in pediatric resuscitation likely have changed as well; however, this evolution has not been quantified. We evaluated pediatric resuscitation practices over time within a combat trauma system. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric patients (<18 years). Patients with burns, drowning, and missing injury severity score (ISS) were excluded...
March 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29554040/pre-hospital-low-titer-cold-stored-whole-blood-philosophy-for-ubiquitous-utilization-of-o-positive-product-for-emergency-use-in-hemorrhage-due-to-injury
#17
Ashley C McGinity, Caroline S Zhu, Leslie Greebon, Elly Xenakis, Elizabeth Waltman, Eric Epley, Danielle Cobb, Rachelle Jonas, Susannah E Nicholson, Brian J Eastridge, Ronald M Stewart, Donald H Jenkins
The mortality from hemorrhage in trauma patients remains high. Early balanced resuscitation improves survival. These truths, balanced with the availability of local resources and our goals for positive regional impact, were the foundation for the development of our pre-hospital whole blood initiative-using low titer cold stored O RhD positive whole blood (LTOWB). The main concern with use of RhD positive blood is the potential development of isoimmunization in RhD negative patients. We used our retrospective massive transfusion protocol (MTP) data to analyze the anticipated risk of this change in practice...
March 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29537335/conservative-management-of-interstitial-pregnancies-experience-of-a-single-centre
#18
Semih Zeki Uludag, Mehmet Serdar Kutuk, Mehmet Dolanbay, Mahmut Tuncay Ozgun, Gunel Eliyeva, Ozguc Altun
The aim of this study was to compare the effect of local intracavitary methotrexate (MTX) injection and laparoscopic (L/S) cornuostomy in the treatment of interstitial pregnancy (IP) in terms of clinical and reproductive outcome. The data of patients with IP (n:10) who were treated between September 2011 and December 2016 with either an intra-amniotic MTX injection (n:7) or L/S cornuostomy (n:3) were retrospectively evaluated. All cases (7/7) in the local injection group and two (2/3) in the L/S group were successfully treated with the initial treatment...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29535988/endoscopic-band-ligation-to-treat-a-massive-hemorrhoidal-hemorrhage-following-a-transrectal-ultrasound-guided-prostate-biopsy
#19
Nadim Mahmud, Kirk J Wangensteen
Prostate cancer is commonly diagnosed by using a transrectal ultrasound (TRUS)-guided biopsy. Although this procedure is usually well tolerated, rarely it may be complicated by massive rectal bleeding. We report a case of a 77-year-old male who underwent a TRUS biopsy and subsequently developed recurrent episodes of rectal bleeding with syncope and anemia requiring the transfusion of multiple units of blood. A sigmoidoscopy revealed the source of the bleeding: a large hemorrhoid on the anterior wall of the rectum with an overlying ulceration...
February 2018: Annals of Coloproctology
https://www.readbyqxmd.com/read/29522519/role-of-heme-in-lung-bacterial-infection-after-trauma-hemorrhage-and-stored-red-blood-cell-transfusion-a-preclinical-experimental-study
#20
Brant M Wagener, Parker J Hu, Joo-Yeun Oh, Cilina A Evans, Jillian R Richter, Jaideep Honavar, Angela P Brandon, Judy Creighton, Shannon W Stephens, Charity Morgan, Randal O Dull, Marisa B Marques, Jeffrey D Kerby, Jean-Francois Pittet, Rakesh P Patel
BACKGROUND: Trauma is the leading cause of death and disability in patients aged 1-46 y. Severely injured patients experience considerable blood loss and hemorrhagic shock requiring treatment with massive transfusion of red blood cells (RBCs). Preclinical and retrospective human studies in trauma patients have suggested that poorer therapeutic efficacy, increased severity of organ injury, and increased bacterial infection are associated with transfusion of large volumes of stored RBCs, although the mechanisms are not fully understood...
March 2018: PLoS Medicine
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