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massive blood transfusion

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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
#1
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/29025385/the-impact-of-preoperative-variables-on-intraoperative-blood-loss-and-transfusion-requirements-during-orthotopic-liver-transplant
#2
Mohammad Hossein Eghbal, Kazem Samadi, Mohammad Bagher Khosravi, Mohammad Ali Sahmeddini, Sina Ghaffaripoor, Mohammad Ghorbani, Sakineh Shokrizadeh
OBJECTIVES: Liver transplant traditionally and potentially is associated with the risk of massive blood loss and transfusion, which can adversely affect transplant outcomes. Many variables influence the amount of bleeding, and these can be categorized as patient related, surgery related, and graft related. We aimed to assess the effects of these variables on the amount of bleeding and transfusion during liver transplant; predicting the risk of massive blood loss can help transplant teams to select and manage patients more effectively...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29025378/transfusion-related-acute-lung-injury-trali-and-transfusion-associated-circulatory-overload-taco-in-liver-transplantation-a-case-report-and-focused-review
#3
Natalie K Smith, Sang Kim, Bryan Hill, Andrew Goldberg, Samuel DeMaria, Jeron Zerillo
Liver transplantation (LT) is a complex procedure in a patient with multi-organ system dysfunction and coagulation defects. The surgical procedure involves dissection, major vessel manipulation, and pathophysiologic effects of graft storage and reperfusion. As a result, LT frequently involves significant hemorrhage. Subsequent massive transfusion carries high risk of transfusion-associated complications. Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are the leading causes of transfusion associated mortality...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29023857/preceding-haemorrhagic-shock-as-a-detrimental-risk-factor-for-respiratory-distress-after-excessive-allogeneic-blood-transfusion
#4
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
#5
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/28990242/blood-utilization-in-revision-versus-first-time-cardiac-surgery-an-update-in-the-era-of-patient-blood-management
#6
Nadia B Hensley, Megan P Kostibas, William W Yang, Todd C Crawford, Kaushik Mandal, Pranjal B Gupta, Steven M Frank, Charles H Brown
BACKGROUND: Relative to first-time (primary) cardiac surgery, revision cardiac surgery is associated with increased transfusion requirements, but studies comparing these cohorts were performed before patient blood management (PBM) and blood conservation measures were commonplace. The current study was performed as an update to determine if this finding is still evident in the PBM era. STUDY DESIGN AND METHODS: Primary and revision cardiac surgery cases were compared in a retrospective database analysis at a single tertiary care referral center...
October 8, 2017: Transfusion
https://www.readbyqxmd.com/read/28989927/metastatic-uterine-cancer-looking-as-cervical-fibroid-in-recurrent-breast-cancer-woman-a-case-report
#7
So Young Seo, Jin Yong Shin, Yong Il Ji
Metastasis to the female genital tract from extragenital primary cancer is uncommon. In this case, a 46-year-old woman was diagnosed with invasive lobular carcinoma of the left breast in 2011. She had left breast conserving surgery, chemotherapy, radiation, and hormonal therapy (gosereline and tamoxifen). However, she developed menorrhagia after interruption of hormonal therapy and incidentally, the ultrasonogram of her pelvis showed a solid, large mass in the cervix. It looked like leiomyoma. Because of massive vaginal bleeding requiring multiple blood transfusions, she underwent total hysterectomy with bilateral salpingo-oophorectomy...
September 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28988805/prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#8
Jacqueline V Mclennan, Kevin C Mackway-Jones, Jason E Smith
BACKGROUND: The predominant cause of preventable trauma death is bleeding, and many of these patients need resuscitation with massive blood transfusion. In resource-constrained environments, early recognition of such patients can improve planning and reduce wastage of blood products. No existing decision rule is sufficiently reliable to predict those patients requiring massive blood transfusion. This study aims to produce a decision rule for use on arrival at hospital for patients sustaining battlefield trauma...
September 28, 2017: Injury
https://www.readbyqxmd.com/read/28978859/patient-blood-management-and-transfusion-therapy-for-hemostasis
#9
Koji Yamamoto
Restrictive transfusion is the most common and appropriate treatment for patients with bleeding disorders because it is associated with better prognosis. However, hematologists are not familiar with the indication for and effect of using fresh frozen plasma (FFP) for transfusions, which has been inappropriately used to date. FFP should not be transfused for preventing bleeding or improving coagulation test results (i.e., PT and APTT). Instead, FFP transfusion should be performed to manage hemostasis, based on the fibrinogen levels of <150 mg/dl in patients' plasmas...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28970693/acute-respiratory-distress-syndrome-in-a-neonate-due-to-possible-transfusion-related-acute-lung-injury
#10
Arti Maria, Sheetal Agarwal, Anu Sharma
Transfusion-related acute lung injury (TRALI) is a potentially life-threatening complication of blood component transfusion. It is relatively underdiagnosed entity in neonates with scant literature. We report a case of TRALI in a preterm neonate developing acute respiratory distress within 6 h of blood product transfusion in the absence of preexisting lung disease. Prompt ventilator and supportive management were instituted. The baby showed clinical and radiological improvement within 12 h; however, he succumbed to death due to acute massive pulmonary hemorrhage 36 h later...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28964508/platelet-adenosine-diphosphate-receptor-inhibition-provides-no-advantage-in-predicting-need-for-platelet-transfusion-or-massive-transfusion
#11
Gregory R Stettler, Ernest E Moore, Hunter B Moore, Geoffrey R Nunns, Benjamin R Huebner, Peter Einersen, Arsen Ghasabyan, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Thrombelastography platelet mapping is a useful assay to assess antiplatelet therapy. Inhibited response to the adenosine diphosphate receptor on platelets occurs early after injury, but recent work suggests this alteration occurs even with minor trauma. However, the utility of thrombelastography platelet mapping, specifically the percent of adenosine diphosphate receptor inhibition, in predicting outcomes and guiding platelet transfusion in trauma-induced coagulopathy remains unknown We assessed the role of percent of adenosine diphosphate-inhibition in predicting survival, requirement for massive transfusion or platelet transfusion in patients at risk for trauma-induced coagulopathy...
September 27, 2017: Surgery
https://www.readbyqxmd.com/read/28958369/balanced-resuscitation-in-trauma-management
#12
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
#13
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...
September 26, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28940001/dabigatran-induced-massive-spontaneous-hemothorax
#14
Jing Huang, Wei Lin, Dan Lv, Li Yu, Lun Wu, Haiying Jin, Zaichun Deng, Qunli Ding
Spontaneous hemothorax due to anticoagulant use is extremely rare in clinical practice. Dabigatran is a novel anticoagulant to prevent stroke or thromboembolic episodes in patients with nonvalvular atrial fibrillation. We report on an 83-year-old man who received dabigatran therapy (110 mg twice daily) for 7 months and developed massive spontaneous hemothorax and acute renal failure. The patient was admitted to the hospital with complaint of a dull ache in the chest and dyspnea. Chest computed tomography scan revealed massive pleural effusion in the left hemithorax with atelectasis...
September 22, 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28934519/intra-pericardial-use-of-recombinant-factor-viia-in-a-patient-with-acute-hemorrhagic-pericardial-effusion-following-transcutaneous-aortic-valve-replacement-a-case-report
#15
Vanya Jaitly, Kimberly Klein, Hlaing Tint, Alice Chen, Paul Allison, Bindu Akkanti, Pranav Loyalka, Brian Castillo
Perioperative bleeding can be a serious life-threatening complication in adult patients undergoing cardiac surgery, given the older age and additional comorbidities present in this patient population. The standard treatment options include transfusion of blood components and surgical re-exploration. We report the first case of an elderly female patient treated with local administration of recombinant factor VIIa (rFVIIa) for intractable hemorrhagic pericardial effusion, which developed following a transcutaneous aortic valve replacement (TAVR) procedure for severe aortic stenosis...
August 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28934089/postpartum-hemorrhage-with-transfusion-trends-near-misses-risk-factors-and-management-at-the-scale-of-a-perinatal-network
#16
M Marocchini, J Lauféron, C Quantin, P Sagot
OBJECTIVES: To analyze temporal trends and management of postpartum hemorrhage (PPH) with transfusion and its related maternal near-miss (MNM) cases between 2006 and 2014 and to study risk factors. MATERIAL AND METHODS: This retrospective cohort study from two prospective databases included 156,047 women giving birth in all the maternity hospitals of Burgundy. We analyzed temporal trends and the distribution of PPH with transfusion, the circumstances of transfer of patients between hospitals and factors associated with PPH with transfusion...
May 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28930957/clot-dynamics-and-mortality-the-ma-r-ratio
#17
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing thromboelastography (TEG) to identify those at risk of subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28916408/robot-assisted-kidney-transplantation-the-european-experience
#18
Alberto Breda, Angelo Territo, Luis Gausa, Volkan Tuğcu, Antonio Alcaraz, Mireia Musquera, Karel Decaestecker, Liesbeth Desender, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Giampaolo Siena, Sergio Serni, Luis Guirado, Carma Facundo, Nicolas Doumerc
BACKGROUND: Robot-assisted kidney transplantation (RAKT) has recently been introduced to reduce the morbidity of open kidney transplantation (KT). OBJECTIVE: To evaluate perioperative and early postoperative RAKT outcomes. DESIGN, SETTING AND PARTICIPANTS: This was a multicenter prospective observational study of 120 patients who underwent RAKT, predominantly with a living donor kidney, in eight European institutions between July 2015 and May 2017, with minimum follow-up of 1 mo...
September 12, 2017: European Urology
https://www.readbyqxmd.com/read/28913787/mortality-rates-and-risk-factors-for-emergent-open-repair-of-abdominal-aortic-aneurysms-in-the-endovascular-era
#19
Felice Pecoraro, Steffen Gloekler, Caecilia E Mader, Malgorzata Roos, Lyubov Chaykovska, Frank J Veith, Neal S Cayne, Nicola Mangialardi, Thomas Neff, Mario Lachat
The background of this paper is to report the mortality at 30 and 90 days and at mean follow-up after open abdominal aortic aneurysms (AAA) emergent repair and to identify predictive risk factors for 30- and 90-day mortality. Between 1997 and 2002, 104 patients underwent emergent AAA open surgery. Symptomatic and ruptured AAAs were observed, respectively, in 21 and 79% of cases. Mean patient age was 70 (SD 9.2) years. Mean aneurysm maximal diameter was 7.4 (SD 1.6) cm. Primary endpoints were 30- and 90-day mortality...
September 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28904480/association-of-massive-transfusion-for-resuscitation-in-gastrointestinal-bleeding-with-transfusion-related-acute-lung-injury
#20
James J Case, Nasreen Khan, Michael Delrahim, Jasmina Dizdarevic, Dane J Nichols, Martin A Schreiber, Thomas G Deloughery, Akram Khan
BACKGROUND AND AIMS: This study aimed to understand the use of massive transfusion (MT) for gastrointestinal bleeding (GIB). PATIENTS AND METHODS: We performed a retrospective analysis of patients admitted to our medical Intensive Care Unit (ICU) with GIB for the type of bleeding, quantity of blood products transfused, and risk of transfusion-related acute lung injury (TRALI) and death. MT was defined as transfusion of 10 or more units of red blood cell (RBC) within a 24-h period in a 1-unit RBC: 1-unit fresh frozen plasma: and 1-unit platelet ratio...
August 2017: Indian Journal of Critical Care Medicine
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