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blood transfusion protocol

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https://www.readbyqxmd.com/read/29120972/comparison-of-anti-xa-and-activated-partial-thromboplastin-time-monitoring-for-heparin-dosing-in-vascular-surgery-patients-a-single-center-retrospective-study
#1
Elsie Rizk, Allison D Wilson, Michelle U Murillo, David R Putney, Bcps-Aq Cardiology
BACKGROUND: Vascular surgery patients often require anticoagulation with intravenous unfractionated heparin monitored via anti-Xa levels or the activated partial thromboplastin time (aPTT). This study compares the two monitoring strategies in terms of major bleeding events in the vascular surgery population. METHODS: This was a single center, retrospective study that included patients treated with a pharmacy-managed heparin protocol monitored by either anti-Xa or aPTT after vascular surgery...
November 8, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29102095/resource-utilization-after-snakebite-severity-score-implementation%C3%A2-into-treatment-algorithm-of-crotaline-bite
#2
Amanda L Fowler, Darrel W Hughes, Mark T Muir, Elizabeth M VanWert, Conrado D Gamboa, John G Myers
BACKGROUND: Crotaline envenomation clinical manifestations vary considerably among patients. Current recommendations for treatment with Crotalidae polyvalent immune Fab require assessment of envenomation control. Determining control of envenomation, particularly when patients are evaluated by different providers in separate clinical settings, can be difficult. OBJECTIVE: To determine if a difference in total vials of Crotalidae antivenin therapy exists between pre-protocol and post-Snakebite Severity Score (SSS) protocol...
October 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29099347/the-morbidity-pattern-of-children-with-sickle-cell-disorders-admitted-to-the-queen-elizabeth-hospital-barbados-2009-2013
#3
D Grannum, Paula M Lashley
A retrospective study was conducted by examining all the medical files of all the children with sickle cell anaemia (Hb SS) admitted from 1 January 2009 to 31 December 2013. A total of 220 admission notes (59 patients aged 5 months-16 years) were analysed. Of these, 53.2% were boys; 85.8% of the patients had Hb SS. The most common reason for admission was vaso-occlusive crisis. Blood transfusions were used in 39.7% of admissions There were no deaths during the study period. We note the number of sickle cell-related admissions and morbidity has increased, along with an increase in the number of blood transfusions...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/29089726/the-use-of-idarucizumab-for-dabigatran-reversal-in-clinical-practice-a-case-series
#4
Pavel Goriacko, Vicken Yaghdjian, Issam Koleilat, Mark Sinnett, Harshal Shukla
PURPOSE: To describe the use of idarucizumab (Praxbind, Boehringer Ingelheim) in routine clinical practice at a large urban academic medical center. SUMMARY: Seven total doses of idarucizumab were administered to six unique patients from October 31, 2015, to October 31, 2016. The reversal agent was used in conjunction with local bleeding control measures, blood product transfusions, and acid-suppressive therapy. In 86% of cases, idarucizumab administration resulted in a successful cessation of bleeding by clinical assessment...
November 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29076249/expanding-access-to-transfusion-medicine-and-improving-practice-guidelines-patient-blood-management-protocols-and-products
#5
EDITORIAL
D J Roberts
No abstract text is available yet for this article.
October 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29076098/good-manufacturing-practice-gmp-translation-of-advanced-cellular-therapeutics-lessons-for-the-manufacture-of-erythrocytes-as-medicinal-products
#6
Neil W A McGowan, John D M Campbell, Joanne C Mountford
Blood transfusion is a mainstay of modern medical practice. In many parts of the world the use of this life-saving therapy is hampered by issues of supply and the potential for transfusion transmitted infections. Accordingly, there are many studies seeking to find an alternative to donated red blood cells (RBCs) for transfusion, including large-scale production from adult and pluripotent stem cells, or erythroid cell lines. Translating basic studies, using any cell lineage, into protocols that are suitable for the generation of cellular therapies requires a wide range of biological and regulatory procedures to be put in place...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29072372/misoprostol-treatment-vs-expectant-management-in-early-non-viable-pregnancy-in-women-with-vaginal-bleeding-a-pragmatic-randomized-controlled-trial
#7
A Fernlund, L Jokubkiene, P Sladkevicius, L Valentin
OBJECTIVES: To compare vaginal misoprostol treatment with expectant management in early non-viable pregnancies with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days. METHODS: Parallel randomized controlled, open label, trial conducted in Skåne university hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown-rump length <33mm) and vaginal bleeding were randomly allocated to either expectant management or single dose 800μg of misoprostol vaginally...
October 26, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29055003/anti-cd20-antibody-prevents-red-blood-cell-alloimmunization-in-a-mouse-model
#8
Rahma Elayeb, Marie Tamagne, Marion Pinheiro, Julie Ripa, Rachid Djoudi, Philippe Bierling, France Pirenne, Benoît Vingert
Alloimmunization against RBCs can cause life-threatening delayed hemolytic transfusion reactions. Anti-CD20 Ab has recently been used to prevent alloimmunization. However, its effects remain unclear, particularly in lymphoid organs. We investigated the impact of murine anti-CD20 Ab in the blood and spleen. We assessed protocols for preventing primary alloimmunization and for abolishing established alloimmunization. Prophylactic protocols prevented alloimmunization. However, anti-CD20 treatment could only limit the further amplification of established alloimmunization...
October 20, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
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
#9
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
#10
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/29021846/the-influence-of-residual-apixaban-on-bleeding-complications-during-and-after-catheter-ablation-of-atrial-fibrillation
#11
Yutaro Mukai, Kyoichi Wada, Koji Miyamoto, Kazuki Nakagita, Mai Fujimoto, Kouichi Hosomi, Takeshi Kuwahara, Mitsutaka Takada, Kengo Kusano, Akira Oita
BACKGROUND: The periprocedural protocol for atrial fibrillation (AF) ablation commonly includes anticoagulation therapy. Apixaban, a direct oral anticoagulant, is currently approved for clinical use; however, little is known about the effects of residual apixaban concentration on bleeding complications during/after AF ablation. Therefore, we measured residual apixaban concentration by using mass spectrometry and examined the anticoagulant's residual effects on bleeding complications. METHODS: Fifty-eight patients (Mean age of 64...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29017806/implementation-of-a-bundled-protocol-significantly-reduces-risk-of-spinal-cord-ischemia-after-branched-or-fenestrated-endovascular-aortic-repair
#12
Salvatore T Scali, Moses Kim, Paul Kubilis, Robert J Feezor, Kristina A Giles, Brittney Miller, Javairiah Fatima, Thomas S Huber, Scott A Berceli, Martin Back, Adam W Beck
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication after branched or fenestrated endovascular aortic repair (B/FEVAR) for thoracoabdominal aortic disease. The purpose of this analysis was to describe the impact of a bundled clinical care protocol designed to reduce the risk of SCI in this population of patients. METHODS: A bundled SCI prevention protocol including cerebrospinal fluid drainage, blood pressure parameters, transfusion goals, and pharmacologic adjuncts (steroids, naloxone) was initiated in May 2015...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29017765/accuracy-of-shock-index-versus-abc-score-to-predict-need-for-massive-transfusion-in-trauma-patients
#13
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/28979536/citrate-versus-non-citrate-anticoagulation-in-continuous-renal-replacement-therapy-results-following-a-change-in-local-critical-care-protocol
#14
Samina R Chowdhury, Tom Lawton, Aaqid Akram, Robert Collin, James Beck
Continuous renal replacement therapy necessitates the use of anticoagulation. The anticoagulant of choice has traditionally been heparin. Emerging evidence has highlighted the deleterious effects of systemic heparin anticoagulation in the critically ill. Regional citrate anticoagulation has been used as an alternative in the setting of continuous renal replacement therapy. Our retrospective before-and-after cohort study aimed to ascertain if regional citrate anticoagulation is associated with any benefit in terms of circuit longevity, rates of complications, blood transfusion requirements and mortality, when introduced to a large general intensive care unit with a case mix of acute medical patients and acute and elective surgical patients...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28973227/effect-of-an-early-resuscitation-protocol-on-in-hospital-mortality-among-adults-with-sepsis-and-hypotension-a-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Ben Andrews, Matthew W Semler, Levy Muchemwa, Paul Kelly, Shabir Lakhi, Douglas C Heimburger, Chileshe Mabula, Mwango Bwalya, Gordon R Bernard
Importance: The effect of an early resuscitation protocol on sepsis outcomes in developing countries remains unknown. Objective: To determine whether an early resuscitation protocol with administration of intravenous fluids, vasopressors, and blood transfusion decreases mortality among Zambian adults with sepsis and hypotension compared with usual care. Design, Setting, and Participants: Randomized clinical trial of 212 adults with sepsis (suspected infection plus ≥2 systemic inflammatory response syndrome criteria) and hypotension (systolic blood pressure ≤90 mm Hg or mean arterial pressure ≤65 mm Hg) presenting to the emergency department at a 1500-bed referral hospital in Zambia between October 22, 2012, and November 11, 2013...
October 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28971084/the-use-of-tranexamic-acid-in-patients-submitted-to-primary-total-hip-arthroplasty-an-evaluation-of-its-impact-in-different-administration-protocols
#16
Gustavus Lemos Ribeiro Melo, Daniel Souza Lages, João Lopo Madureira Junior, Guilherme de Paula Pellucci, João Wagner Junqueira Pellucci
OBJECTIVES: There is still no consensus as to the best form and dosages of use of tranexamic acid. The aim of this study was to evaluate the use of tranexamic acid in total hip arthroplasty, in order to reduce blood loss and decrease hemoglobin, taking into account different administration protocols. METHODS: 42 patients submitted to total hip arthroplasty were divided into three groups. The study was prospective and randomized. Group 1 received a venous dose of tranexamic acid of 15 mg/kg, 20 min prior to bolus incision...
2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28970679/dedicated-donor-unit-transfusions-reduces-donor-exposure-in-pediatric-surgery-patients
#17
Satyam Arora, Neelam Marwaha, Hari Krishan Dhawan, K L N Rao
BACKGROUND: Many strategies have been explored to reduce multiple donor exposures in neonates such as use of restrictive transfusion protocols, limiting iatrogenic blood loss, use of recombinant erythropoietin and single donor programs. METHOD: In our study we assessed the feasibility of dedicating single donor units with reserving all the components from the same donor for the specified neonates/infants undergoing surgery and estimating reduction of donor exposure...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28964688/administering-blood-products-before-selected-interventional-radiology-procedures-developing-applying-and-monitoring-a-standardized-protocol
#18
Nam S Hoang, Nishita Kothary, Seema Saharan, Jarrett Rosenberg, Andrew A Tran, Shaughnessy B Brown, David M Hovsepian
PURPOSE: To apply and monitor a single institution's adherence to internally established guidelines for the preoperative administration of platelets and/or fresh frozen plasma (FFP) before a specified subset of minimally invasive interventional radiology (IR) procedures. MATERIALS AND METHODS: Beginning in December 2008, we implemented a set of restrictive guidelines for preoperative platelet and/or FFP administration before IR procedures at a single academic hospital...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28958369/balanced-resuscitation-in-trauma-management
#19
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
https://www.readbyqxmd.com/read/28953556/uncontrolled-bleeding-of-the-gastrointestinal-tract
#20
Alain D'Hondt, Lionel Haentjens, Nicolas Brassart, Frédéric Flamme, Jean-Charles Preiser
PURPOSE OF REVIEW: Acute gastrointestinal bleeding is a frequent emergency situation, whose incidence will likely rise as a result of the increasing use of direct anticoagulants and of the medical progresses resulting in longer life expectancy with underlying comorbidities. Updated guidelines and improvements in the diagnostic and therapeutic tools are now available and will likely improve the management of massive gastrointestinal bleeding in the near future. RECENT FINDINGS: The assessment of severity has been improved by validated scores useable upon admission...
December 2017: Current Opinion in Critical Care
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