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https://www.readbyqxmd.com/read/27903009/temperature-controlled-continuous-cold-flow-device-after-total-knee-arthroplasty-a-randomized-controlled-trial-study
#1
Alberto Ruffilli, Francesco Castagnini, Francesco Traina, Isabella Corneti, Domenico Fenga, Sandro Giannini, Cesare Faldini
Total knee arthroplasty (TKA) is a widely accepted and successful procedure for end-stage arthritis. Nevertheless, fast-track may be compromised by many factors, such as pain, edema, and blood loss. Cryotherapy has been advocated as a safe and effective strategy to improve the postoperative results, acting on pain, edema, and blood loss. This study is a prospective randomized controlled study, involving 50 patients after primary TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm GmbH, Germany)...
November 30, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27900630/current-delivery-of-hyperthermic-intraperitoneal-chemotherapy-with-cytoreductive-surgery-cs-hipec-and-perioperative-practices-an-international-survey-of-high-volume-surgeons
#2
Allison H Maciver, Eisar Al-Sukhni, Jesus Esquivel, Joseph J Skitzki, John M Kane, Valerie A Francescutti
BACKGROUND: Cytoreductive surgery and heated intraperitoneal chemotherapy (CS/HIPEC) is performed for selected indications at a limited number of specialized centers worldwide. Currently there is no standardized approach to the perioperative care process. We sought to capture current practices in the perioperative management of patients who undergo CS/HIPEC at high-volume centers. METHODS: Surgeon members of the American Society of Peritoneal Surface Malignancies working at high-volume CS/HIPEC centers (>10 cases/year) were invited to complete an online survey...
November 29, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27894500/prediction-of-massive-transfusion-in-trauma
#3
REVIEW
Paul M Cantle, Bryan A Cotton
Hemorrhage is the leading cause of preventable death in trauma. Damage control resuscitation relies on permissive hypotension, minimizing crystalloid use, and early implementation of massive transfusion protocols with established blood component ratios. These protocols improve the survival of the severely injured patient. Trauma physicians must quickly and accurately predict when a massive transfusion protocol should be activated. Several validated transfusion scores have been developed for this purpose. Many of these scores are useful for resuscitation research...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27894494/optimal-fluid-therapy-for-traumatic-hemorrhagic-shock
#4
REVIEW
Ronald Chang, John B Holcomb
The resuscitation of traumatic hemorrhagic shock has undergone a paradigm shift in the last 20 years with the advent of damage control resuscitation (DCR). Major principles of DCR include minimization of crystalloid, permissive hypotension, transfusion of a balanced ratio of blood products, and goal-directed correction of coagulopathy. In particular, plasma has replaced crystalloid as the primary means for volume expansion for traumatic hemorrhagic shock. Predicting which patient will require DCR by prompt and accurate activation of a massive transfusion protocol, however, remains a challenge...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27878613/intermittent-low-dose-bevacizumab-in-hereditary-hemorrhagic-telangiectasia-a%C3%A2-case-report
#5
Florian Huemer, Martin Dejaco, Christoph Grabmer, Thomas Melchardt, Daniel Neureiter, Georg Mayer, Alexander Egle, Richard Greil, Lukas Weiss
BACKGROUND: Hereditary hemorrhagic telangiectasia is an inherited autosomal dominant disease presenting with recurrent bleeding episodes and iron deficiency anemia due to vascular malformations. Hereditary hemorrhagic telangiectasia is associated with an increased risk of stroke, gastrointestinal bleeding and pulmonary hypertension and life expectancy is significantly reduced. Excess vascular endothelial growth factor (VEGF) plays a key role in the pathophysiology of the disease. CASE PRESENTATION: Here we report about a male patient with hereditary hemorrhagic telangiectasia presenting with pulmonary and central nervous system involvement experiencing repetitive nosebleeds, necessitating frequent local cauterization and transfusion of more than 100 units of packed red blood cells...
November 23, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27871539/liberal-or-restrictive-fluid-management-during-elective-surgery-a-systematic-review-and-meta-analysis
#6
REVIEW
Pim B B Schol, Ivon M Terink, Marcus D Lancé, Hubertina C J Scheepers
This article reviews if a restrictive fluid management policy reduces the complication rate if compared to liberal fluid management policy during elective surgery. The PubMed database was explored by 2 independent researchers. We used the following search terms: "Blood transfusion (MESH); transfusion need; fluid therapy (MESH); permissive hypotension; fluid management; resuscitation; restrictive fluid management; liberal fluid management; elective surgery; damage control resuscitation; surgical procedures, operative (MESH); wounds (MESH); injuries (MESH); surgery; trauma patients...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27855097/combination-with-intravenous-iron-supplementation-or-doubling-erythropoietin-dose-for-patients-with-chemotherapy-induced-anaemia-inadequately-responsive-to-initial-erythropoietin-treatment-alone-study-protocol-for-a-randomised-controlled-trial
#7
Lin Chen, Hong Jiang, Wei Gao, Ye Tu, Ying Zhou, Xi Li, Zhe Zhu, Qixin Jiang, Haifeng Zhan, Jiangming Yu, Chuangang Fu, Yong Gao
INTRODUCTION: Erythropoietin (EPO) is a commonly used option in the treatment of chemotherapy-induced anaemia (CIA). However, ∼30-50% of patients fail to achieve an adequate response after initial treatment. Prior studies have demonstrated that intravenous iron might synergistically improve therapeutic response to EPO treatment in this patient population. METHODS AND ANALYSIS: We will perform this multicentre, randomised, open-label, parallel-group, active controlled non-inferiority study to compare the two combination therapies of EPO plus intravenous iron regimen versus doubling the dose of EPO in patients with CIA who have an inadequate response to initial EPO treatment at a routine dose...
October 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27850802/1165-massive-transfusion-protocol-in-a-community-nontrauma-setting-is-blood-product-wastage-avoidable
#8
Noubar Kevorkian, Sharon Weintraub, Nancy Bienkowski, Peg Basch, Stacy Pagliaruli, Susan Parker, Jacobs Barry, Rekha Singh
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850380/742-blood-transfusions-colloids-and-protocols-differ-between-neurologic-versus-non-neurologic-patients
#9
Peter Hou, Raghu Seethala, Michael Billington, Sukjhjit Takhar, Reza Askari, Imo Aisiku
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843040/a-phase-iv-study-of-thromboembolic-and-bleeding-events-following-hip-and-knee-arthroplasty-using-oral-factor-xa-inhibitor
#10
David Gomez, Helen Razmjou, Andrea Donovan, Vikas B Bansal, Jeffrey D Gollish, John J Murnaghan
BACKGROUND: Multiple randomized controlled trials have documented the effectiveness of rivaroxaban in the prevention of venous thromboembolism up to 1-month following total joint arthroplasty. However, the effectiveness and safety of rivaroxaban in the real-world setting, outside of the strict protocols used by randomized clinical trials, are unknown. METHODS: This was a prospective, observational, noninterventional, phase IV study of 3914 consecutive patients who underwent total joint arthroplasty from June 2010 to December 2012...
October 4, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27815579/extracorporeal-membrane-oxygenation-improves-coagulopathy-in-an-experimental-traumatic-hemorrhagic-model
#11
M Larsson, P Forsman, P Hedenqvist, A Östlund, J Hultman, A Wikman, L Riddez, B Frenckner, M Bottai, C-M Wahlgren
PURPOSE: Hemorrhage is the most common cause of preventable death after trauma. Coagulopathy plays a central role in uncontrolled bleeding and is caused by multiple factors. Extracorporeal Membrane Oxygenation (ECMO) is an established treatment for patients with respiratory failure and has in recent years also been used in severely injured trauma patients with cardiopulmonary failure and coexisting bleeding shock. The aim of this study was to evaluate the effect of ECMO on hypothermia, acidosis, and coagulopathy in a traumatic hemorrhagic rabbit model...
November 4, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27813101/gender-as-a-risk-factor-for-adverse-intraoperative-and-postoperative-outcomes-of-elective-pancreatectomy
#12
Aditya Mazmudar, Dominic Vitello, Mackenzie Chapman, James S Tomlinson, David J Bentrem
BACKGROUND AND OBJECTIVES: Patient selection remains paramount when developing and adopting quality-based assessment and reimbursement models, and enhanced recovery protocols. Gender is a patient characteristic known before surgery which can inform risk stratification. Our aim was to evaluate the effect of gender on intraoperative blood transfusions, operative time, length of hospital stay, estimated blood loss (EBL) as well as postoperative surgical site infections (SSIs), and mortality...
November 4, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27805995/rapid-thrombelastography-r-teg-thresholds-for-goal-directed-resuscitation-of-patients-at-risk-for-massive-transfusion
#13
Peter M Einersen, Ernest E Moore, Michael P Chapman, Hunter B Moore, Eduardo Gonzalez, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Uncontrolled hemorrhage is a leading cause of mortality following trauma accounting for up to 40% of deaths. Massive transfusion protocols (MTPs) offer a proven benefit in resuscitation of these patients. Recently, the superiority of thrombelastography (TEG)-guided resuscitation over strategies guided by conventional clotting assays (CCA) has been established. We seek to determine optimal thresholds for r-TEG driven resuscitation. METHODS: R-TEG data were reviewed for 190 patients presenting to our Level 1 Trauma Center from 2010 to 2015...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27795535/transfusion-medicine-in-practice
#14
Shigeyoshi Makino
The safety and stability of the supply of blood products must be ensured for appropriate blood transfusion therapy. Various security measures need to be taken and a balanced blood donation system should be maintained by the Japanese Red Cross Society. Based on such a system, each institute needs to establish a proper management protocol and to assure adequate use of blood products, as well as creating measures to deal with adverse events associated with blood transfusion. The system for preventing transfusion errors is particularly essential...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27793239/ethical-and-legal-duty-of-anesthesiologists-regarding-jehovah-s-witness-patient-care-protocol
#15
Augusto Key Karazawa Takaschima, Thiago Mamôru Sakae, Alexandre Karazawa Takaschima, Renata Dos Santos Teodoro Takaschima, Breno José Santiago Bezerra de Lima, Roberto Henrique Benedetti
BACKGROUND AND OBJECTIVES: Jehovah's Witnesses patients refuse blood transfusions for religious reasons. Anesthesiologists must master specific legal knowledge to provide care to these patients. Understanding how the Law and the Federal Council of Medicine treat this issue is critical to know how to act in this context. The aim of this paper was to establish a treatment protocol for the Jehovah's Witness patient with emphasis on ethical and legal duty of the anesthesiologist. CONTENT: The article analyzes the Constitution, Criminal Code, resolutions of the Federal Council of Medicine, opinions, and jurisprudence to understand the limits of the conflict between the autonomy of will of Jehovah's Witnesses to refuse transfusion and the physician's duty to provide the transfusion...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27779982/impact-of-massive-transfusion-and-aging-blood-in-acute-trauma
#16
Tanya Anand, Rajesh Ramnanan, Ruby Skinner, Maureen Martin
Blood transfusions cause altered immunity and the duration of storage is contributory. In the era of massive transfusion protocols (MTPs) this impact is unclear, particularly as it relates to balanced transfusions. Trauma patients requiring our MTP after admission to our Level II trauma center were studied. The average age of blood transfused was calculated; old blood was a storage time of ≥14 days versus new blood <14 days. Blood to plasma ratios of 1:1 were compared with ratios >1:1. Infections, organ dysfunction multiorgan injury (MOI), and death were compared based on ratios and blood storage times...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27779597/abnormalities-in-fibrinolysis-at-the-time-of-admission-are-associated-with-dvt-mortality-and-disability-in-a-pediatric-trauma-population
#17
Christine M Leeper, Matthew D Neal, Christine McKenna, Jason Sperry, Barbara A Gaines
BACKGROUND: Abnormalities in fibrinolysis are common and associated with increased mortality in injured adults. While hyperfibrinolysis (HF) and fibrinolysis shutdown (SD) are potential prognostic indicators and treatment targets in adults, these derangements are not well-described in a pediatric trauma cohort. METHODS: Prospective analysis of highest level trauma activations age 0-18 presenting to our academic center between 6/1/2015-7/31/2016 with admission rapid thromboelastogram (TEG)...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27779592/improved-outcomes-following-implementation-of-an-acute-gastrointestinal-bleeding-multidisciplinary-protocol
#18
Tyler J Loftus, Kristina L Go, Steven J Hughes, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: Effective multidisciplinary management of gastrointestinal bleeding (GIB) requires effective communication. We instituted a protocol to standardize communication practices with the hypothesis that outcomes would improve following protocol initiation. METHODS: We performed a retrospective cohort analysis of 442 patients who required procedural management of acute GIB at our institution during a 50 month period spanning 25 months before and 25 months after implementation of a multidisciplinary communication protocol...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27774614/blood-component-transfusion-and-wastage-rates-in-the-setting-of-massive-transfusion-in-three-regional-trauma-centers
#19
Nancy M Dunbar, Nicholas J Olson, Zbigniew M Szczepiorkowski, Eric D Martin, Ryan M Tysarcyk, Darrell J Triulzi, Louis H Alarcon, Mark H Yazer
BACKGROUND: The purpose of massive transfusion protocols (MTPs) is to provide large quantities of blood products rapidly to exsanguinating patients. The expected rates of blood product transfusion and wastage in this setting have not been defined. This study was undertaken to assess the transfusion and wastage rates for bleeding patients requiring emergency issue of blood components at three American Level I trauma centers. STUDY DESIGN AND METHODS: Three hospitals participated, all of which are Level I trauma centers that have MTPs in place where uncrossmatched red blood cells (RBCs) can be ordered with or without platelets (PLTs), plasma, and cryoprecipitate...
October 23, 2016: Transfusion
https://www.readbyqxmd.com/read/27749352/massive-transfusion-protocols-a-survey-of-academic-medical-centers-in-the-united-states
#20
Angela B Treml, Jed B Gorlin, Richard P Dutton, Barbara M Scavone
BACKGROUND: Massive transfusion protocols (MTPs) have been adopted in many hospitals, and they may improve outcomes, as well as decrease the number of blood products transfused. However, there are no specific guidelines regarding the number and types of products that should be included in these protocols. MTPs may vary from hospital to hospital. METHODS: A short, web-based survey was sent to blood bank medical directors at academic institutions to learn details about MTPs...
October 3, 2016: Anesthesia and Analgesia
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