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J C Oldroyd, K M Venardos, N J Aoki, A J Zatta, Z K McQuilten, L E Phillips, N Andrianopoulos, D J Cooper, P A Cameron, J P Isbister, E M Wood
BACKGROUND: The Australian and New Zealand (ANZ) Massive Transfusion (MT) Registry (MTR) has been established to improve the quality of care of patients with critical bleeding (CB) requiring MT (≥ 5 units red blood cells (RBC) over 4 h). The MTR is providing data to: (1) improve the evidence base for transfusion practice by systematically collecting data on transfusion practice and clinical outcomes; (2) monitor variations in practice and provide an opportunity for benchmarking, and feedback on practice/blood product use; (3) inform blood supply planning, inventory management and development of future clinical trials; and (4) measure and enhance translation of evidence into policy and patient blood management guidelines...
October 6, 2016: BMC Research Notes
C Montan, U Hammar, A Wikman, E Berlin, J Malmstedt, J Holst, C M Wahlgren
OBJECTIVES: The aim was to study blood transfusions and blood product ratios in massively transfused patients treated for ruptured abdominal aortic aneurysms (rAAAs). METHODS: This was a registry based cohort study of rAAA patients repaired at three major vascular centres between 2008 and 2013. Data were collected from the Swedish Vascular Registry, hospitals medical records, and local transfusion registries. The transfusion data were analysed for the first 24 h of treatment...
September 4, 2016: European Journal of Vascular and Endovascular Surgery
Ronald Tesoriero, Brandon Bruns, Mayur Narayan, Joseph Dubose, Sundeep Guliani, Megan Brenner, Sharon Boswell, Deborah M Stein, Thomas Scalea
INTRODUCTION: Major pelvic disruption with hemorrhage has a high rate of lethality. Angiographic embolization remains the mainstay of treatment. Delays to angiography have been shown to worsen outcomes, in part because time spent awaiting mobilization of resources needed to perform angiography allows ongoing hemorrhage. Alternative techniques like pelvic pre-peritoneal packing (PPP) and aortic balloon occlusion (REBOA) now exist. We hypothesized that time to angiographic embolization at our level 1 trauma center would be longer than 90 minutes...
September 16, 2016: Journal of Trauma and Acute Care Surgery
A Le Gouez, F J Mercier
Major obstetric hemorrhage is a challenge for anesthesiologists because it remains responsible for over 10% of maternal deaths in high-income countries. A standardized multidisciplinary management, described in locally validated protocols and based on international guidelines is mandatory to prevent these deaths. The first difficulty relies on the systematic underestimation of the bleeding. Collection bags must be used to facilitate the diagnosis and therefore rapid management. The etiologies in antenatal or postpartum must be well-known in order to be treated adequately...
August 31, 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Irina Catanescu, Graham Long, Paul Bove, Michael Khoury, Otto Brown, Steve Rimar, Youssef Rizk, Maciej Uzieblo, Sachinder Hans
OBJECTIVES: Reported results of ruptured abdominal aortic aneurysm (rAAA) in patients with antecedent endovascular repair (EVAR) to those presenting with de novo rupture show a similar or slightly improved outcome. The aim of this study was to compare differences in the presentation and outcomes of rAAA with and without prior EVAR. METHODS: A retrospective review of one hundred twenty-one (121) patients with rAAA, ruptured identified two groups. Group A included 17 patients (rAAA n= 17) with antecedent EVAR and Group B consisted of 104 patients (rAAA n= 104) with de novo ruptures, from January 2001 to March 2015 in three teaching hospitals...
August 11, 2016: Annals of Vascular Surgery
Ramesh Kumar, Mohammed Jaber Sedky, Sunny Joseph Varghese, Osama Ebrahim Sharawy
Transfusion related acute Lung injury (TRALI) though a serious blood transfusion reaction with a fatality rate of 5-25 % presents with acute respiratory distress with hypoxaemia and noncardiac pulmonary oedema within 6 h of transfusion. In non fatal cases, it may resolve within 72 h or earlier. Although reported with an incidence of 1:5000, its true occurrence is rather unknown. Pathogenesis is believed to be related to sequestration and adhesion of neutrophils to the pulmonary capillary endothelium and its activation leading to its destruction and leaks...
September 2016: Indian Journal of Hematology & Blood Transfusion
N Martínez-Calle, F Hidalgo, A Alfonso, M Muñoz, M Hernández, R Lecumberri, J A Páramo
OBJECTIVE: To audit the impact upon mortality of a massive bleeding management protocol (MBP) implemented in our center since 2007. DESIGN: A retrospective, single-center study was carried out. Patients transfused after MBP implementation (2007-2012, Group 2) were compared with a historical cohort (2005-2006, Group 1). BACKGROUND: Massive bleeding is associated to high mortality rates. Available MBPs are designed for trauma patients, whereas specific recommendations in the medical/surgical settings are scarce...
July 14, 2016: Medicina Intensiva
Moeun Son, Brett D Einerson, Patrick Schneider, Ian C Fields, William A Grobman, Emily S Miller
Objective Determine whether the indication for intrauterine balloon tamponade (IUBT) is associated with failure rates. Study Design Cohort study of women who underwent IUBT for postpartum hemorrhage (PPH) from 2007 to 2014. The indication was categorized as uterine atony or placental-site bleeding. Primary outcome was IUBT failure, defined as the need for uterine artery embolization or hysterectomy. Secondary outcomes were estimated blood loss (EBL) after balloon placement, transfusion of red blood cells (RBC), transfusion of fresh frozen plasma (FFP) and/or cryoprecipitate, and intensive care unit (ICU) admission...
July 1, 2016: American Journal of Perinatology
Sabrina Goudjil, Christèle Chazal, François Moreau, André Leke, Guy Kongolo, Tayeb Chouaki
INTRODUCTION: Serum (1-3)-beta-d-glucan (BDG) assay has been proposed as an adjunct for the rapid diagnosis of invasive fungal infection (IFI). However, false-positive results have been reported following transfusion of blood products in adults. AIMS: To assess the relationship between blood product transfusion and elevated BDG in neonates. METHOD: Retrospective study including neonates ≤32 weeks, with no fungal colonization or infection, in whom BDG assay was performed for suspicion of IFI...
June 8, 2016: Journal of Maternal-fetal & Neonatal Medicine
B Stoffels, S J Enkirch, M W von Websky, T O Vilz, D Pantelis, S Manekeller, N Schäfer, J C Kalff
BACKGROUND: Posthepatectomy liver failure (PHLF) is one of the most serious complications after major liver resections and an important factor in terms of perioperative morbidity and mortality. Despite many advances in the understanding and grading of PHLF, the definitions found in literature are very heterogeneous, which complicates the identification of high-risk patients. In this study we analysed the results of extended liver resections and potential risk factors for PHLF based on patient data derived from our tertiary referral centre...
August 2016: Zentralblatt Für Chirurgie
S L Morley, C L Hudson, C A Llewelyn, A W Wells, A L Johnson, L M Williamson
OBJECTIVE: To determine the long-term survival of adult recipients (>16 years) transfused with red blood cells (RBC), platelets (PLT) and fresh frozen plasma (FFP) in England and Wales. STUDY DESIGN AND METHODS: The EASTR study (Epidemiology and Survival of Transfusion Recipients) was a national multi-centre epidemiological study with cross-sectional sampling from 29 representative hospitals in England supplied by NHS Blood and Transplant (NHSBT). Three separate groups of RBC (n = 9142), FFP (n = 4232) and PLT (3584) recipients were sampled over 1 year (1 October 2001-30 September 2002), with prospective survival monitoring for 10 years...
August 2016: Transfusion Medicine
N Sargant, A Roy, S Simpson, K Chandrakumaran, S Alves, J Coakes, J Bell, J Knight, P Wilson, F Mohamed, T Cecil, B Moran
BACKGROUND AND AIMS: The treatment of peritoneal malignancies with cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to be associated with massive surgical blood loss. Maintaining high fibrinogen levels throughout surgery may reduce blood loss in these patients. The primary aim of the study was to see if Tranexamic Acid (TXA) and cryoprecipitate reduced surgical blood loss and hence red cell transfusions. A comparison was made with a cohort of patients treated with fresh frozen plasma (FFP) alone...
April 2016: Transfusion Medicine
S L Morley, C L Hudson, C A Llewelyn, A W Wells, A L Johnson, L M Williamson
OBJECTIVE: To describe the epidemiology of blood transfusion in children: including the incidence of transfusion, the diagnoses leading to transfusion, donor exposure (DE) and post-transfusion survival. STUDY DESIGN AND METHODS: The Epidemiology and Survival of Transfusion Recipients (EASTR) Study was a multi-centre epidemiological study with prospective survival monitoring. Cross-sectional sampling of adult and paediatric transfusion recipients in 29 hospitals was used to select three separate cohorts of red cell (RBC), platelet (PLT) and fresh frozen plasma (FFP) recipients between October 2001 and September 2002...
April 2016: Transfusion Medicine
Fatih Aygün, Mehmet Özülkü, Murat Günday
OBJECTIVE: The present study consisted of patients who underwent on-pump coronary artery bypass grafting (CABG) and off-pump CABG and investigated effect of using cardiopulmonary bypass (CPB) on the amount of postoperative drainage and blood products, red blood cell (RBC), free frozen plasma (FFP) given in the intensive care unit in 60-80-year-old patients who underwent CABG. METHODS: The present study comprises a total of 174 patients who have undergone coronary artery bypass graft (off-pump or on-pump CABG) surgery in our clinic in between 2012-2015 year...
November 2015: Brazilian Journal of Cardiovascular Surgery
Akiyoshi Hagiwara, Shigeki Kushimoto, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogura, Tetsuya Matsuoka, Toshifumi Uejima, Mineji Hayakawa, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Yasuhiro Otomo, Hiroyuki Yokota, Teruo Sakamoto, Hiroshi Tanaka, Atsushi Shiraishi, Naoto Morimura, Hiroyasu Ishikura
BACKGROUND: This study investigated the effect of a high ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) within the first 6 and 24  h after admission on mortality in patients with severe, blunt trauma. METHODS: This retrospective observational study included 189 blunt trauma patients with an Injury Severity Score (ISS) ≥16 requiring RBC transfusions within the first 24  h. Receiver operating characteristic (ROC) curve analysis was performed to calculate cut-off values of the FFP/RBC ratio for outcome...
May 2016: Shock
Loïc Sentilhes, Christophe Vayssière, Catherine Deneux-Tharaux, Antoine Guy Aya, Françoise Bayoumeu, Marie-Pierre Bonnet, Rachid Djoudi, Patricia Dolley, Michel Dreyfus, Chantal Ducroux-Schouwey, Corinne Dupont, Anne François, Denis Gallot, Jean-Baptiste Haumonté, Cyril Huissoud, Gilles Kayem, Hawa Keita, Bruno Langer, Alexandre Mignon, Olivier Morel, Olivier Parant, Jean-Pierre Pelage, Emmanuelle Phan, Mathias Rossignol, Véronique Tessier, Frédéric J Mercier, François Goffinet
Postpartum haemorrhage (PPH) is defined as blood loss ≥500mL after delivery and severe PPH as blood loss ≥1000mL, regardless of the route of delivery (professional consensus). The preventive administration of uterotonic agents just after delivery is effective in reducing the incidence of PPH and its systematic use is recommended, regardless of the route of delivery (Grade A). Oxytocin is the first-line prophylactic drug, regardless of the route of delivery (Grade A); a slowly dose of 5 or 10 IU can be administered (Grade A) either IV or IM (professional consensus)...
March 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Giangiuseppe Cappabianca, Giovanni Mariscalco, Fausto Biancari, Daniele Maselli, Francesca Papesso, Marzia Cottini, Sandro Crosta, Simona Banescu, Aamer B Ahmed, Cesare Beghi
BACKGROUND: Bleeding after cardiac surgery requiring surgical reexploration and blood component transfusion is associated with increased morbidity and mortality. Although prothrombin complex concentrate (PCC) has been used satisfactorily in bleeding disorders, studies on its efficacy and safety after cardiopulmonary bypass are limited. METHODS: Between January 2005 and December 2013, 3454 consecutive cardiac surgery patients were included in an observational study aimed at investigating the efficacy and safety of PCC as first-line coagulopathy treatment as a replacement for fresh frozen plasma (FFP)...
2016: Critical Care: the Official Journal of the Critical Care Forum
Laura Green, Marian Knight, Frances Seeney, Cathy Hopkinson, Peter W Collins, Rachel E Collis, Nigel A B Simpson, Andrew Weeks, Simon J Stanworth
Understanding the coagulopathy of major-obstetric-haemorrhage (MOH) that leads to massive-transfusion (MT) is fundamental to improving outcomes. This study reports on the haematological features and transfusion management of women experiencing MT [defined as transfusion of ≥8 units of red blood cells (RBC) within 24 h of delivery]. One hundred and eighty-one cases [median (interquartile range; IQR) age 33 years (29-36)] were identified from all UK hospitals, using the UK Obstetric Surveillance System between July 2012 and June 2013...
February 2016: British Journal of Haematology
Kirsten Balvers, Michiel Coppens, Susan van Dieren, Ingeborg H M van Rooyen-Schreurs, Henriëtte J Klinkspoor, Sacha S Zeerleder, Holger M Baumann, J Carel Goslings, Nicole P Juffermans
BACKGROUND: Massive transfusion protocols (MTPs) are increasingly used in the transfusion practice and are developed to provide the standardized and early delivery of blood products and procoagulant agents and to supply the transfusion of blood products in a well-balanced ratio. AIM: The aim of this study was to investigate the effect of a hospital-wide introduction of an MTP on blood product ratio and a waste of blood products. MATERIALS AND METHODS: Retrospective analysis was performed to compare the transfusion practice in massive bleeding patients before and after the introduction of an MTP and between the use of an MTP and transfusion off-protocol...
October 2015: Journal of Emergencies, Trauma, and Shock
Lama Ghazi, Thomas A Schwann, Milo C Engoren, Robert H Habib
BACKGROUND: Postoperative deep vein thrombosis (DVT) is associated with significant morbidity. Even with maximal thromboprophylaxis, postoperative DVT is present in 10% of cardiac surgery patients, and is linked to receiving transfusion. We hypothesized that the incidence of DVT varies with the transfused blood product type, and increases with transfusion dose. STUDY DESIGN AND METHODS: 139/1070 cardiac surgery patients have DVT despite maximal chemo and mechanical prophylaxis...
December 2015: Thrombosis Research
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