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https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28068852/maternal-outcomes-following-the-initiation-of-an-institutional-delayed-cord-clamping-protocol-an-observational-case-control-study
#7
Kelly Kuo, Priyanka Gohale, David N Hackney, Chayatat Ruangkit, Monika Bhola, Melissa I March
OBJECTIVE: To evaluate maternal outcomes before and after implementation of an institutional delayed cord clamping (DCC) protocol. STUDY DESIGN: We performed a secondary analysis of a retrospective cohort study of deliveries occurring at <34 weeks at a tertiary care center in 2013-2014. 139 women who underwent early cord clamping were compared to 130 women delivered after DCC protocol implementation. Maternal estimated blood loss (EBL) was the primary outcome of interest...
January 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28061906/bilateral-rectus-sheath-haematoma-complicating-dengue-virus-infection-in-a-patient-on-warfarin-for-mechanical-aortic-valve-replacement-a-case-report
#8
Chamith Thushanga Rosa, Mitrakrishnan Rayno Navinan, Sincy Samarawickrama, Himam Hamza, Maheshika Gunarathne, Arulprashanth Arulanantham, Neeha Subba, Udari Samarasiri, Thushara Mathias, Aruna Kulatunga
BACKGROUND: The management of Dengue virus infection can be challenging. Varied presentations and numerous complications intrinsic to dengue by itself increase the complexity of treatment and potential mortality. When burdened with the presence of additional comorbidities and the need to continue compulsory medications, clear stepwise definitive guidance is lacking and patients tend to have more complex complications and outcomes calling to question the clinical decisions that may have been taken...
January 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28053156/targeted-clinical-control-of-trauma-patient-coagulation-through-a-thrombin-dynamics-model
#9
Amor A Menezes, Ryan F Vilardi, Adam P Arkin, Mitchell J Cohen
We present a methodology for personalizing the clinical treatment of severely injured patients with acute traumatic coagulopathy (ATC), an endogenous biological response of impaired coagulation that occurs early after trauma and shock and that is associated with increased bleeding, morbidity, and mortality. Despite biological characterization of ATC, it is not easily or rapidly diagnosed, not always captured by slow laboratory testing, and not accurately represented by coagulation models. This lack of knowledge, combined with the inherent time pressures of trauma treatment, forces surgeons to treat ATC patients according to empirical resuscitation protocols...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28041583/combination-of-ofatumumab-and-reduced-dose-chop-for-diffuse-large-b-cell-lymphomas-in-patients-aged-80-years-or-older-an-open-label-multicentre-single-arm-phase-2-trial-from-the-lysa-group
#10
Frédéric Peyrade, Serge Bologna, Vincent Delwail, Jean François Emile, Laurent Pascal, Christophe Fermé, Jean-Marc Schiano, Bertrand Coiffier, Bernadette Corront, Hassan Farhat, Christophe Fruchart, Herve Ghesquieres, Margaret Macro, Hervé Tilly, Bachra Choufi, Richard Delarue, Olivier Fitoussi, Jean Gabarre, Corinne Haioun, Fabrice Jardin
BACKGROUND: In 2011 we reported a rituximab plus miniCHOP (reduced-dose cyclophosphamide, doxorubicin, vincristine, and prednisone) combination for patients older than 80 years with diffuse large B-cell lymphoma (DLBCL). The 2-year overall survival was 59% (95% CI 49-67) with an excess of early toxicity. To improve those results we tested the same chemotherapy protocol in combination with ofatumumab and a pre-phase treatment. METHODS: For this open-label, multicentre, single-group, phase 2 trial, we recruited patients older than 80 years with untreated histologically-proven CD20-positive DLBCL, Ann Arbor stage I to IV, from 41 academic and hospital centres in France and Belgium...
January 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28028997/comparative-analysis-of-clinical-samples-showing-weak-serum-reaction-on-autovue-system-causing-abo-blood-typing-discrepancies
#11
Su Yeon Jo, Ju Mi Lee, Hye Lim Kim, Kyeong Hwa Sin, Hyeon Ji Lee, Chulhun Ludgerus Chang, Hyung Hoi Kim
BACKGROUND: ABO blood typing in pre-transfusion testing is a major component of the high workload in blood banks that therefore requires automation. We often experienced discrepant results from an automated system, especially weak serum reactions. We evaluated the discrepant results by the reference manual method to confirm ABO blood typing. METHODS: In total, 13,113 blood samples were tested with the AutoVue system; all samples were run in parallel with the reference manual method according to the laboratory protocol...
March 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28026726/-intra-articular-application-of-tranexamic-acid-significantly-reduces-blood-loss-and-transfusion-requirement-in-primary-total-knee-arthroplasty
#12
J Lošťák, J Gallo, J Špička, K Langová
PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28026072/activation-of-klf1-enhances-the-differentiation-and-maturation-of-red-blood-cells-from-human-pluripotent-stem-cells
#13
Cheng-Tao Yang, Rui Ma, Richard A Axton, Melany Jackson, A Helen Taylor, Antonella Fidanza, Lamin Marenah, Jan Frayne, Joanne C Mountford, Lesley M Forrester
Blood transfusion is widely used in the clinic but the source of red blood cells (RBCs) is dependent on donors, procedures are susceptible to transfusion-transmitted infections and complications can arise from immunological incompatibility. Clinically-compatible and scalable protocols that allow the production of RBCs from human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) have been described but progress to translation has been hampered by poor maturation and fragility of the resultant cells...
December 27, 2016: Stem Cells
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#14
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28007780/ficin-treated-red-cells-help-identify-clinically-significant-alloantibodies-masked-as-reactions-of-undetermined-specificity-in-gel-microtubes
#15
Ben C Hill, Courtney A Hanna, Jill Adamski, Huy P Pham, Marisa B Marques, Lance A Williams
Non-specific antibodies or antibodies of undetermined significance (AUS) often pose problems for a blood bank technologist and physician. It is well known that antibodies can weaken and evanesce over time, thus eluding detection by routine blood bank techniques. Special enhancement techniques exist (eg, ficin treatment); however, they are often underutilized due to concerns over expense. Ficin is known to enhance reactivity caused by antibodies in the ABO, Rh, Kidd, Lewis, I, and P blood group systems, while destroying reactivity of antibodies in the Duffy, and MNS blood group systems...
December 22, 2016: Laboratory Medicine
https://www.readbyqxmd.com/read/27994385/exchange-transfusion-for-babesiosis-when-how-and-how-long
#16
Pramod K Guru, John C O Horo, Heidi D Lehrke, Jeffrey L Winters, John W Wilson
Babesiosis is a zoonotic disease transmitted by Ixodes ticks seen in the United States and parts of Europe. Because of the typically mild course of most infections, the disease is uncommonly seen in clinical practice. However, asplenic patients can develop a life-threatening infection. The first line of therapy for Babesia infections is antiparasitic medications; however, red blood cell (RBC) exchange transfusion has been described as an adjunct therapy. We describe a severe case of babesiosis in an asplenic patient and review the evidence, indications, and protocols for RBC exchange transfusion in this setting...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27994256/a-novel-centrifugation-method-using-a-cell-salvage-device-offers-an-alternative-to-the-use-of-leukocyte-depleting-filters-for-autologous-blood-transfusions
#17
Michael Barchilon, Cristina Gaspar, Angela Mexas, Don Nieter
Autotransfusion protocols often use the use of costly filters, such as leukocyte-depleting filters (LDFs), to minimize reinfusion of activated leukocytes and inflammatory mediators associated with reperfusion injury (RI). LDFs are used extensively in hospital settings; however, they represent an additional capital expenditure for hospitals, as well as a constraint on the reinfusion rate of blood products for health-care providers. We compared a commonly used LDF to a novel centrifugation method employing a widely used cell salvage device...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27993881/flow-cytometric-panel-reactive-antibody-results-and-the-ability-to-find-transfusion-compatible-platelets-after-antibody-desensitization-for-allogeneic-bone-marrow-transplant
#18
Eric R Rosenbaum, Soumya Pandey, Terry O Harville, Gina A Drobena, Michele Cottler-Fox
BACKGROUND: Panel reactive antibody (PRA) reduction protocols are used to decrease anti-HLA antibodies with concomitant PRA monitoring as a measure of successful treatment prior to organ and haploidentical blood and marrow transplant (BMT). We hypothesized that the more sensitive flow cytometry (FC) based assays for PRA [FlowPRA(®) and Luminex(®) based Single Antigen Bead (SAB)] would also correlate with the ability to find compatible platelets for allosensitized recipients. METHODS: A female patient with myelodysplastic syndrome and a high HLA class I PRA [>90% PRA and cPRA by complement-dependent cytotoxicity (CDC) assay and Flow PRA] required allogeneic BMT...
December 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27993880/providing-hemostatic-and-blood-conservation-options-for-jehovah-s-witness-patients-in-a-large-medical-system
#19
Yu Bai, Brian S Castillo, Amanda Tchakarov, Miguel A Escobar, Bryan A Cotton, John B Holcomb, Robert E Brown
People of the Jehovah's Witness faith believe that they shall "abstain from blood." Because of this belief, we encounter the challenges from Jehovah's Witness patients who actively seek medical care for themselves and their children, but refuse the transfusion of blood products, which may result in increased morbidity and mortality in this patient population. With the development/availability of new hemostatic/coagulation products and the advances in medical technology, we, in collaboration with our clinical colleagues and our local Jehovah's Witness leadership, have developed a clinical guideline comprising medical protocol and surgical strategy for patients refusing blood products...
December 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27987348/conservative-management-of-post-partum-hemorrhage-secondary-to-placenta-previa-accreta-with-hypogastric-artery-ligation-and-endo-uterine-hemostatic-suture
#20
Melekoglu Rauf, Celik Ebru, Eraslan Sevil, Buyukkurt Selim
AIM: The aim of this study was to investigate maternal and neonatal outcomes of conservative management of post-partum hemorrhage due to placenta previa-accreta using hypogastric artery ligation and endo-uterine hemostatic suture to lower uterine segment. METHODS: The records of 38 patients who were managed conservatively with hypogastric artery ligation and endo-uterine hemostatic suture to control post-partum hemorrhage secondary to placenta previa-accreta between April 2014 and January 2016, were reviewed retrospectively...
December 17, 2016: Journal of Obstetrics and Gynaecology Research
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