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massive transfusion protocols

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https://www.readbyqxmd.com/read/29415812/prediction-of-massive-bleeding-in-a-prehospital-setting-validation-of-six-scoring-systems
#1
L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, H Domínguez-Aguado, R Viejo-Moreno, J Barea-Mendoza, R Gómez-Soler, I Casado-Flores, M Chico-Fernández
OBJECTIVE: To validate the diagnostic ability of six different scores to predict massive bleeding in a prehospital setting. DESIGN: Retrospective cohort. SETTING: Prehospital attention of patients with severe trauma. SUBJECTS: Subjects with more than 15 years, a history of severe trauma (defined by code 15 criteria), that were initially assisted in a prehospital setting by the emergency services between January 2010 and December 2015 and were then transferred to a level one trauma center in Madrid...
February 4, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29404656/-hypovolemic-and-hemorrhagic-shock
#2
H Lier, M Bernhard, B Hossfeld
The term "shock" refers to a life-threatening circulatory failure caused by an imbalance between the supply and demand of cellular oxygen. Hypovolemic shock is characterized by a reduction of intravascular volume and a subsequent reduction in preload. The body compensates the loss of volume by increasing the stroke volume, heart frequency, oxygen extraction rate, and later by an increased concentration of 2,3-diphosphoglycerate with a rightward shift of the oxygen dissociation curve. Hypovolemic hemorrhagic shock impairs the macrocirculation and microcirculation and therefore affects many organ systems (e...
February 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29392728/soluble-antigens-in-plasma-allow-mismatched-transfusion-without-hemolysis
#3
James Sikora, Jason Gregory, Alan George, Simon Clayton, Baiming Zou, Matthew Robinson, Faisal Mukhtar, Joseph P Pelletier
BACKGROUND: Universal plasma is a scarce resource when a massive transfusion protocol has been initiated. Previous studies have reported success using group A plasma in place of the universal plasma, group AB. It is unclear why there are not more reports of hemolytic reactions occurring from this practice. One possible explanation is the presence of water-soluble antigens in the patient plasma that bind to, and neutralize, the soluble antibodies present in the transfused plasma. STUDY DESIGN AND METHODS: Expired units of plasma were used to make dilutions that consisted of mixtures of group A and B plasma and saline...
February 1, 2018: Transfusion
https://www.readbyqxmd.com/read/29389749/trauma-and-transfusion-in-the-geriatric-patient
#4
Corey Scott Scher
PURPOSE OF REVIEW: The percentage of people over the age of 65 is growing rapidly and anesthesiologists must develop a medical understanding that is comprehensive to meet the unique medical needs of this population. The changing physiology of an elderly population makes them extremely vulnerable to trauma and the administration of blood products. Although most of these cases involve orthopedic attention, it is not less dangerous as a blunt trauma case. RECENT FINDINGS: This article addresses some of the main concerns for the anesthesiologists of providing a hemostatic resuscitation in the geriatric population...
January 30, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29290073/implementation-of-trauma-center-and-massive-transfusion-protocol-improves-outcomes-for-major-trauma-patients-a-study-at-a-single-institution-in-korea
#5
Kyungjin Hwang, Junsik Kwon, Jayun Cho, Yunjung Heo, John Cook-Jong Lee, Kyoungwon Jung
BACKGROUND: This study evaluated the effectiveness and clinical outcomes of the implementation of a trauma center and massive transfusion protocol (TCMTP) in a developing country without a well-established trauma system. METHODS: We included patients (1) aged >15 years, (2) with an Injury Severity Score >15, (3) who received ≥10 units of packed red blood cells (PRBCs) within 24 h, (4) who directly visited our institution from 2010 to 2016, and (5) who survived for ≥24 h...
December 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29273362/the-risk-factors-of-venous-thromboembolism-in-massively-transfused-patients
#6
Navpreet K Dhillon, Eric J T Smith, Ara Ko, Megan Y Harada, Audrey R Yang, Kavita A Patel, Galinos Barmparas, Eric J Ley
BACKGROUND: Massive transfusion protocols (MTPs) are necessary for hemodynamically unstable trauma patients with active bleeding. Thrombotic events have been associated with blood transfusion; however, the risk factors for the development of venous thromboembolism (VTE) in trauma patients receiving MTP are unknown. METHODS: A retrospective review was conducted by reviewing the electronic medical records of all trauma patients admitted to a Level I trauma center who received MTP from 2011 to 2016...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29241907/a-systematic-review-of-massive-transfusion-protocol-in-obstetrics
#7
REVIEW
Hiroaki Tanaka, Shigetaka Matsunaga, Tomoyuki Yamashita, Toshiyuki Okutomi, Atsushi Sakurai, Akihiko Sekizawa, Junichi Hasegawa, Katsuo Terui, Yasutaka Miyake, Jun Murotsuki, Tomoaki Ikeda
Post-partum obstetric haemorrhage is a leading cause of mortality among Japanese women, generally treated with haemostatic measures followed by supplementary transfusion. Commonly used in the setting of severe trauma, massive transfusion protocols (MTPs), preparations of red blood cell concentrate (RBC) and fresh frozen plasma (FFP) with additional supplements, have proved effective in decreasing patient mortality following major obstetric bleeding events. Although promising, the optimal configuration of RBC and FFP utilized for obstetric bleeding needs to be verified...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29238996/quality-management-of-a-massive-transfusion-protocol
#8
John R Hess, Patrick J Ramos, Nina E Sen, Virginia G Cruz-Cody, Erin E Tuott, Max J Louzon, Eileen M Bulger, Saman Arbabi, Monica B Pagano, Ryan A Metcalf
BACKGROUND: Massive transfusion is a response to massive uncontrolled hemorrhage. To be effective, it must be timely and address the patient's needs for blood volume, oxygen transport, and hemostasis. STUDY DESIGN AND METHODS: A review was performed on all activations of the massive transfusion protocol (MTP) in a hospital with large emergency medicine, trauma, and vascular surgery programs. Indications, transfused amounts, and outcomes were determined for each MTP event to determine appropriateness of MTP use...
December 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29225746/comparison-of-the-impact-of-applications-of-targeted-transfusion-protocol-and-massive-transfusion-protocol-in-trauma-patients
#9
Shahram Paydar, Hosseinali Khalili, Golnar Sabetian, Behnam Dalfardi, Shahram Bolandparvaz, Mohammad Hadi Niakan, Hamidreza Abbasi, Donat R Spahn
Background: The current study assessed a recently developed resuscitation protocol for bleeding trauma patients called the Targeted Transfusion Protocol (TTP) and compared its results with those of the standard Massive Transfusion Protocol (MTP). Methods: Per capita utilization of blood products such as packed red blood cells (RBCs), fresh frozen plasma (FFP), and platelet concentrates was compared along with mortality rates during two 6-month periods, one in 2011 (when the standard MTP was followed) and another in 2014 (when the TTP was used)...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29224239/personalized-stepwise-vascular-control-during-complex-hepatectomy-involving-hepatocaval-confluence
#10
Lei Dou, Zong-Ping Yu, Hui-Yuan Yang, Ji Ran, Yi-Fa Chen, Xiao-Ping Chen
BACKGROUND: This study introduces an innovative stepwise vascular control technique to address the high risk of massive bleeding from main hepatic veins and the retro-hepatic inferior vena cava during hepatectomy involving hepatocaval confluence. METHODS: From January 2010 to July 2016, 80 patients underwent stepwise vascular occlusion during complex liver resection involving hepatocaval confluence. Relevant clinical data were collected and compared with those obtained in parallel studies...
December 10, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29208320/efficacy-of-a-massive-transfusion-protocol-for-hemorrhagic-trauma-resuscitation
#11
George Lim, Katrina Harper-Kirksey, Ram Parekh, Alex F Manini
OBJECTIVES: New paradigm shifts in trauma resuscitation recommend that early reconstitution of whole blood ratios with massive transfusion protocols (MTP) may be associated with improved survival. We performed a preliminary study on the efficacy of MTP at an urban, Level 1 trauma center and its impact on resuscitation goals. METHODS: A case-control study was performed on consecutive critically-ill trauma patients over the course of 1 year. The trauma captain designated patients as either MTP activation (cases) or routine care without MTP (controls) in matched, non-randomized fashion...
November 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#12
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29200079/external-validation-of-a-smartphone-app-model-to-predict-the-need-for-massive-transfusion-using-five-different-definitions
#13
E I Hodgman, M W Cripps, M J Mina, E M Bulger, M A Schreiber, K J Brasel, M J Cohen, P C Muskat, J G Myers, L H Alarcon, M H Rahbar, J B Holcomb, B A Cotton, E E Fox, D J Del Junco, C E Wade, H A Phelan
INTRODUCTION: Previously, a model to predict massive transfusion protocol (activation) was derived using a single-institution dataset. The PROMMTT database was used to externally validate this model's ability to predict both massive transfusion protocol (MTP) activation and massive transfusion (MT) administration using multiple MT definitions. METHODS: The app model was used to calculate the predicted probability of massive transfusion protocol activation or massive transfusion delivery...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29189355/massive-transfusion-protocols-when-to-turn-on-and-off-the-fire-hose
#14
Jonathan P Wanderer, Naveen Nathan
No abstract text is available yet for this article.
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29123874/early-administration-of-fibrinogen-concentrates-improves-the-short-term-outcomes-of-severe-pelvic-fracture-patients
#15
Koichi Inokuchi, Makoto Sawano, Koji Yamamoto, Atsushi Yamaguchi, Satoru Sugiyama
Aim: Hemorrhage from pelvic fracture is a major cause of mortality after blunt trauma. Several studies have suggested that early fibrinogen supplementation improves outcomes of traumatic hemorrhage. Thus, we revised our massive transfusion protocol (MTP) in April 2013 to include early off-label administration of fibrinogen concentrate. The objective of this study was to evaluate the impact of the revision on the short-term outcomes of pelvic fracture patients. Methods: This was a single-center, retrospective, cohort study...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#16
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29023857/preceding-haemorrhagic-shock-as-a-detrimental-risk-factor-for-respiratory-distress-after-excessive-allogeneic-blood-transfusion
#17
R Masuda, T Iijima, R Kondo, Y Itoda, M Matsuhashi, S Hashimoto, T Kohira, N Kobayashi, H Okazaki
BACKGROUND AND OBJECTIVES: Whether transfusion-associated circulatory overload arises as a simple result of over-transfusion or requires another trigger remains unclear. Here, we examined whether respiratory distress could be reproduced by massive transfusion alone in an animal model. MATERIALS AND METHODS: A total of 20 anaesthetized swine were equipped with monitors. Allogeneic blood was obtained from 10 donor swine. A 4-stage loading protocol with each stage equivalent to 25% of the blood volume (BV) in the recipient swine was then used to infuse crystalloid (CR), hydroxyethyl starch (HES) or allogeneic blood (TR) (n = 5 each)...
October 11, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29017765/accuracy-of-shock-index-versus-abc-score-to-predict-need-for-massive-transfusion-in-trauma-patients
#18
Rebecca Schroll, David Swift, Danielle Tatum, Stuart Couch, Jiselle B Heaney, Monica Llado-Farrulla, Shana Zucker, Frances Gill, Griffin Brown, Nicholas Buffin, Juan Duchesne
BACKGROUND: Various scoring systems have been developed to predict need for massive transfusion in traumatically injured patients. Assessments of Blood Consumption (ABC) score and Shock Index (SI) have been shown to be reliable predictors for Massive Transfusion Protocol (MTP) activation. However, no study has directly compared these two scoring systems to determine which is a better predictor for MTP activation. The primary objective was to determine whether ABC or SI better predicted the need for MTP in adult trauma patients with severe hemorrhage...
September 15, 2017: Injury
https://www.readbyqxmd.com/read/28985912/patterns-of-vasopressor-utilization-during-the-resuscitation-of-massively-transfused-trauma-patients
#19
Galinos Barmparas, Navpreet K Dhillon, Eric Jt Smith, Russell Mason, Nicolas Melo, Gretchen M Thomsen, Daniel R Margulies, Eric J Ley
BACKGROUND: The use of vasopressors (VP) in the resuscitation of massively transfused trauma patients might be considered a marker of inadequate resuscitation. We sought to characterize the utilization of VP in patients receiving massive transfusion and examine the association of their use with mortality. METHODS: Trauma patients admitted from January 2011 to October 2016 receiving massive transfusion, defined as 3 units of pRBC within the first hour from admission, were selected for analysis...
September 27, 2017: Injury
https://www.readbyqxmd.com/read/28958369/balanced-resuscitation-in-trauma-management
#20
REVIEW
Paul M Cantle, Bryan A Cotton
Over the past decade substantial knowledge has been gained in understanding both the coagulopathy of trauma and the complications associated with aggressive crystalloid-based resuscitation. Balanced resuscitation, which includes permissive hypotension, limiting crystalloid use, and the transfusion of blood products in ratios similar to whole blood, has changed the previous standard of care. Prompt initiation of massive transfusion and the protocolled use of 1:1:1 product ratios have improved the morbidity and mortality of patients with trauma in hemorrhagic shock...
October 2017: Surgical Clinics of North America
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