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https://www.readbyqxmd.com/read/28213059/multidisciplinary-team-learning-in-the-management-of-the-morbidly-adherent-placenta-outcome-improvements-over-time
#1
Alireza A Shamshirsaz, Karin A Fox, Hadi Erfani, Steven L Clark, Bahram Salmanian, B Wycke Baker, Michael Coburn, Amir A Shamshirsaz, Zhoobin H Bateni, Jimmy Espinoza, Ahmed A Nassr, Edwina J Popek, Shiu-Ki Hui, Jun Teruya, Celestine Shauching Tung, Jeffery A Jones, Martha Rac, Gary A Dildy, Michael A Belfort
BACKGROUND: Morbidly adherent placenta (MAP) is a serious obstetric complication causing mortality and morbidity. OBJECTIVE: To evaluate whether outcomes of patients with morbidly adherent placenta improve with increasing experience within a well-established multidisciplinary team at a single referral center. STUDY DESIGN: All singleton pregnancies with pathology-confirmed MAP (including placenta accreta, increta or percreta) managed by a multidisciplinary team between January 2011 and August 2016 were included in this retrospective study...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28197273/clinical-and-surgical-strategies-for-avoiding-or-reducing-allogeneic-blood-transfusions
#2
Antonio Alceu Dos Santos, Jose Francisco Baumgratz, Jose Henrique Andrade Vila, Rodrigo Moreira Castro, Rodrigo Freire Bezerra
Blood transfusions have still been used as a standard therapy to treat severe anemia. Current evidences point to both excessive allogeneic blood consumption and decreased donations, which result in reduced stocks in blood banks. Several studies have increasingly suggested a more restrictive transfusion practice for blood products. Currently, a number of autologous blood conservation protocols in surgeries have been noted. We report a case of severe anemia with 2.9 g/dL hemoglobin, which was successfully handled without using the standard therapy to treat anemia with hemotransfusions...
April 2016: Cardiology Research
https://www.readbyqxmd.com/read/28194493/oral-health-of-adult-patients-undergoing-hematopoietic-cell-transplantation-pre-transplant-assessment-and-care
#3
REVIEW
Agnieszka Bogusławska-Kapała, Kazimierz Hałaburda, Ewa Rusyan, Hubert Gołąbek, Izabela Strużycka
Hematopoietic cell transplantation (HCT) is now one of the frequent procedures used for treatment of malignant and non-malignant blood diseases, autoimmune disorders, and certain solid tumors. Despite improvements of therapeutic protocols, HCT still carries a high risk of non-relapse mortality due to early and late complications. Side effects of the therapy regimen frequently occur in the oral cavity and often significantly decrease the patients' quality of life. The complications may result from or may be exacerbated by improper oral preparation of the patient before transplantation...
February 13, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#4
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28188036/outcomes-of-an-accelerated-care-pathway-for-pediatric-blunt-solid-organ-injuries-in-a-public-healthcare-system
#5
Oluwatomilayo Daodu, Mary Brindle, Carlos R Alvarez-Allende, Lisette Lockyer, Bryce Weber, Steven R Lopushinsky
PURPOSE: An accelerated clinical care pathway for solid organ abdominal injuries was implemented at a level one pediatric trauma center. The impact on resource utilization and demonstration of protocol safety was assessed. METHODS: Data were collected retrospectively on patients admitted with blunt abdominal solid organ injuries from 2012 to 2015. Patients were subdivided into pre- and post-protocol groups. Length of hospital stay (LOS) and failure of non-operative treatment were the primary outcomes of interest...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28166812/efficacy-of-high-intensity-focused-ultrasound-assisted-hepatic-resection-hifu-ar-on-blood-loss-reduction-in-patients-with-liver-metastases-requiring-hepatectomy-study-protocol-for-a-randomized-controlled-trial
#6
Aurélien Dupré, David Pérol, Ellen Blanc, Patrice Peyrat, Valéria Basso, Yao Chen, Jérémy Vincenot, Anthony Kocot, David Melodelima, Michel Rivoire
BACKGROUND: Liver resection is the only potentially curative treatment for colorectal liver metastases (LM). It is considered a safe procedure, but is often associated with blood loss during liver transection. Blood transfusions are frequently needed, but they are associated with increased morbidity and risk of recurrence. Many surgical devices have been developed to decrease blood loss. However, none of them has proven superior to the standard crushing technique. We developed a new, powerful intra-operative high-intensity focused ultrasound (HIFU) transducer which destroys tissue by coagulative necrosis...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28161216/the-impact-of-perioperative-red-blood-cell-transfusions-in-patients-undergoing-liver-resection-a-systematic-review
#7
REVIEW
Sean Bennett, Laura K Baker, Guillaume Martel, Risa Shorr, Timothy M Pawlik, Alan Tinmouth, Daniel I McIsaac, Paul C Hébert, Paul J Karanicolas, Lauralyn McIntyre, Alexis F Turgeon, Jeffrey Barkun, Dean Fergusson
BACKGROUND: Liver resection is associated with a high proportion of red blood cell transfusions. There is a proposed association between perioperative transfusions and increased risk of complications and tumor recurrence. This study reviews the evidence of this association in the literature. METHODS: The Medline, EMBASE, and Cochrane databases were searched for clinical trials or observational studies of patients undergoing liver resection that compared patients who did and did not receive a perioperative red blood cell transfusion...
February 1, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28151829/haemotherapy-algorithm-for-the-management-of-trauma-induced-coagulopathy-an-australian-perspective
#8
James Winearls, Biswadev Mitra, Michael C Reade
PURPOSE OF REVIEW: Recent advances in the understanding of the pathophysiological processes associated with traumatic haemorrhage and trauma-induced coagulopathy have resulted in improved outcomes for seriously injured trauma patients. However, a significant number of trauma patients still die from haemorrhage. This article reviews the various transfusion strategies utilized in the management of traumatic haemorrhage and describes the major haemorrhage protocol (MHP) strategy employed by an Australian trauma centre...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28149824/early-high-ratio-platelet-transfusion-in-trauma-resuscitation-and-its-outcomes
#9
Ruben Peralta, Adarsh Vijay, Ayman El-Menyar, Rafael Consunji, Ibrahim Afifi, Ismail Mahmood, Mohammed Asim, Rifat Latifi, Hassan Al-Thani
INTRODUCTION: The optimal ratio of platelets (PLTs) to packed red blood cell (PRBC) in trauma patients requiring massive transfusion protocol (MTP) is still controversial. This report aims to describe the effect of attaining a high PLT:PRBC ratio (≥1:1.5) within 4 h postinjury on the outcomes of trauma patients receiving MTP. METHODS: Over a 24-month period, records of all adult patients with traumatic injury who received MTP were retrospectively reviewed. Data were analyzed with respect to PLT:PRBC ratio ([high-MTP ≥1:1...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28131428/a-new-intraoperative-protocol-for-reducing%C3%A2-perioperative-transfusions-in%C3%A2-cardiac-surgery
#10
J Hunter Mehaffey, Sarah A Schubert, Michael G Gelvin, Eric J Charles, Robert B Hawkins, Lily E Johnston, Gorav Ailawadi, Irving L Kron, Leora T Yarboro
BACKGROUND: Perioperative anemia and blood product transfusion increases short-term and long-term morbidity and mortality during cardiac surgery. We hypothesized that streamlined cardiopulmonary bypass circuit and rotational thromboelastometry (ROTEM) would reduce blood product usage and improve outcomes. METHODS: All patients with Society of Thoracic Surgeons risk scores at our institution from January 2013 to June 2015 were included. Individuals were chronologically stratified into 2 groups according to institutional changes to a streamlined bypass circuit and ROTEM-guided transfusion...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28131117/identification-and-management-of-obstetric-hemorrhage
#11
REVIEW
Emily J Baird
Obstetric hemorrhage remains the leading cause of maternal death and severe morbidity worldwide. Although uterine atony is the most common cause of peripartum bleeding, abnormal placentation, coagulation disorders, and genital tract trauma contribute to adverse maternal outcomes. Given the inability to reliably predict patients at high risk for obstetric hemorrhage, all parturients should be considered susceptible, and extreme vigilance must be exercised in the assessment of blood loss and hemodynamic stability during the peripartum period...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28129780/manubrium-limited-ministernotomy-versus-conventional-sternotomy-for-aortic-valve-replacement-mavric-study-protocol-for-a-randomised-controlled-trial
#12
Enoch Akowuah, Andrew T Goodwin, W Andrew Owens, Helen C Hancock, Rebecca Maier, Adetayo Kasim, Adrian Mellor, Khalid Khan, Gavin Murphy, James Mason
BACKGROUND: Aortic valve replacement is one of the most common cardiac surgical procedures performed worldwide. Conventional aortic valve replacement surgery is performed via a median sternotomy; the sternum is divided completely from the sternal notch to the xiphisternum. Minimally invasive aortic valve replacement, using a new technique called manubrium-limited ministernotomy, divides only the manubrium from the sternal notch to 1 cm below the manubrio-sternal junction. More than one third of patients undergoing conventional sternotomy develop clinically significant bleeding requiring post-operative red blood cell transfusion...
January 28, 2017: Trials
https://www.readbyqxmd.com/read/28115278/the-role-of-thromboelastography-teg-in-pediatric-patients-with-sinusoidal-obstructive-syndrome-receiving-defibrotide
#13
Joanna L Gendreau, Christine Knoll, Roberta H Adams, Leon L Su
Sinusoidal obstructive syndrome (SOS) is a potentially fatal form of hepatic injury following hematopoietic stem cell transplant (HSCT). Patients can develop liver dysfunction, portal hypertension, ascites, coagulopathies, and multi-system organ failure. The mortality rate of severe SOS has been reported as high as 98% by Day 100 post-transplant. Defibrotide, which is now approved for the treatment of SOS, has significantly decreased mortality. Defibrotide is a polynucleotide with pro-fibrinolytic, anti-ischemic, and anti-inflammatory activity...
January 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28111825/effect-of-red-blood-cell-preservation-by-droplet-freezing-with-non-permeable-cryoprotective-agents-in-blood-group-antigen-reactivity
#14
M A B Chagas, D G Chaves, S K Haddad, E M A Ubiali, L C Schmidt, M C F Silva-Malta
BACKGROUND: In the last few decades, various red blood cell (RBC) freezing techniques have been developed and improved to enable the preservation of erythrocytes for future use in pre-transfusion tests in reference immunohaematology laboratories. However, not all these techniques have been sufficiently evaluated for the preservation of blood group antigens. OBJECTIVES: In this study, we evaluated the antigenic pattern of RBCs preserved by droplet freezing in liquid nitrogen in a blood bank context...
January 22, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#15
Ankit Kansagra, Chester Andrzejewski, Robert Krushell, Andrew Lehman, Jordan Greenbaum, Paul Visintainer, Joan McGirr, Kathleen Mahoney, Darlene Cloutier, Alice Ehresman, Mihaela S Stefan
Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28102730/alloimmunisation-in-transfused-patients-serial-cross-matching-in-a-population-of-hospitalised-cats
#16
Layla Hourani, Christiane Weingart, Barbara Kohn
Objectives Cross-matching is currently recommended as part of pre-transfusion testing for repeat transfusions in cats 4 days after having received an initial transfusion. This prospective study determined when and if cats developed positive cross-match (CM) results after having been transfused with AB-compatible blood. Methods Donors were selected according to standard transfusion safety protocols. Twenty-one hospitalised anaemic recipients (blood type A: n = 20; blood type B: n = 1) received 1-4 (median 2) whole-blood transfusions (WBTs) over 1-6 days (median 2) in 33 transfusion instances...
January 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28097705/non-polar-lipids-accumulate-during-storage-of-transfusion-products-and-do-not-contribute-to-the-onset-of-transfusion-related-acute-lung-injury
#17
A L Peters, M A T Vervaart, R van Bruggen, D de Korte, R Nieuwland, W Kulik, A P J Vlaar
BACKGROUND AND OBJECTIVES: The accumulation of non-polar lipids arachidonic acid, 5-hydroxyeicosatetraenoic acid (HETE), 12-HETE and 15-HETE during storage of transfusion products may play a role in the onset of transfusion-related acute lung injury (TRALI), a syndrome of respiratory distress after transfusion. MATERIALS AND METHODS: We investigated non-polar lipid accumulation in red blood cells (RBCs) stored for 42 days, plasma stored for 7 days at either 4 or 20°C and platelet (PLT) transfusion products stored for 7 days...
January 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28089863/prevention-of-thrombosis-in-hypercoagulable-patients-undergoing-microsurgery-a-novel-anticoagulation-protocol
#18
Jonas A Nelson, Cyndi U Chung, Andrew R Bauder, Liza C Wu
BACKGROUND: Hypercoagulable conditions are often considered relative contraindications to free flap reconstruction. This paper presents and critically examines a novel anticoagulation regimen developed to address this disease state. METHODS: Hypercoagulable patients who underwent free tissue transfer between 2007 and 2015 were identified. From 2011, all such patients were subjected to a novel anticoagulation protocol involving an intravenous bolus of 2000 U of unfractionated heparin prior to microvascular pedicle anastomosis, followed by a heparin infusion at 500 U/h, which was postoperatively increased to therapeutic levels...
December 18, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28089410/microparticle-detection-to-guide-platelet-management-for-the-reduction-of-platelet-refractoriness-in-children-a-study-proposal
#19
REVIEW
Peter Kanzler, Andrew Mahoney, Gerda Leitner, Volker Witt, Elisabeth Maurer-Spurej
Microparticles have been shown to shed from a variety of viable cells as a consequence of inflammatory processes, activation or physical stress. Seventy to 90% of circulating microparticles are thought to be platelet-derived. The content of microparticles in blood collected from normal blood donors is highly variable and transfers into the final blood component. Elevated microparticle content (MPC) in donor blood might indicate an asymptomatic clinical condition of the donor which might affect the transfusion recipient, particularly pediatric patients...
December 29, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28080215/laparoscopy-assisted-duhamel-z-anastomosis-for-total-colonic-aganglionosis-outcome-assessed-by-fecal-continence-evaluation
#20
Go Miyano, Hiroki Nakamura, Shogo Seo, Ryo Sueyoshi, Manabu Okawada, Takashi Doi, Hiroyuki Koga, Geoffrey J Lane, Tadaharu Okazaki, Atsuyuki Yamataka
BACKGROUND: A Z-shaped colorectal side-to-side anastomosis was introduced to improve the Duhamel procedure by eliminating the rectal blind pouch. We retrospectively reviewed all total colonic aganglionosis patients treated by laparoscopy-assisted Duhamel-Z (LapDZ) between 2009 and 2014 focusing on annual fecal continence evaluation scores (CES) as an indicator of outcome. METHODS: LapDZ was performed conventionally. Postoperatively, defecation was regulated with medications and enemas according to our standard protocol...
January 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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