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transfusion physiology

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https://www.readbyqxmd.com/read/29775962/preterm-birth-and-oxidative-stress-effects-of-acute-physical-exercise-and-hypoxia-physiological-responses
#1
Agnès Martin, Camille Faes, Tadej Debevec, Chantal Rytz, Grégoire Millet, Vincent Pialoux
Preterm birth is a global health issue that can induce lifelong medical sequela. Presently, at least one in ten newborns are born prematurely. At birth, preterm newborns exhibit higher levels of oxidative stress (OS) due to the inability to face the oxygen rich environment in which they are born into. Moreover, their immature respiratory, digestive, immune and antioxidant defense systems, as well as the potential numerous medical interventions following a preterm birth, such as oxygen resuscitation, nutrition, phototherapy and blood transfusion further contribute to high levels of OS...
May 1, 2018: Redox Biology
https://www.readbyqxmd.com/read/29773498/special-considerations-for-the-use-of-pathogen-reduced-blood-components-in-pediatric-patients-an-overview
#2
REVIEW
Raymond P Goodrich, Jerard Segatchian
Pediatric patients requiring transfusion constitute one of the most challenging areas of transfusion practice. Due to the limitations posed by their particular physiological conditions they routinely require specialized component support and more personalised transfusion care than what is routinely utilized in the care of adult patients. Pediatric patients, unlike many adult patients requiring transfusion support, also generally have significant lifespans post-transfusion. This combined with the possibility of long term consequences to adverse events related to transfusion such as infection or change in immunological status drives the need to continue to use improved blood components in the transfusion support of pediatric patients...
May 14, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29726824/advances-in-the-management-of-pediatric-septic-shock-old-questions-new-answers
#3
Javed Ismail, M Jayashree
Septic shock in children is associated with high mortality, especially in developing countries. Management includes early recognition, timely antibiotics, aggressive fluid resuscitation, and appropriate vasoactive therapy, to achieve the therapeutic end points. The evidence at each step in management has evolved over the past decade with a paradigm shift in emphasis from a 'protocolized care' to an 'individualized physiology-based care'. This shift mirrors the general trend one observes in critical care with respect to various treatment modalities i...
April 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29721496/the-role-of-plasma-transfusion-in-massive-bleeding-protecting-the-endothelial-glycocalyx
#4
REVIEW
Stefano Barelli, Lorenzo Alberio
Massive hemorrhage is a leading cause of death worldwide. During the last decade several retrospective and some prospective clinical studies have suggested a beneficial effect of early plasma-based resuscitation on survival in trauma patients. The underlying mechanisms are unknown but appear to involve the ability of plasma to preserve the endothelial glycocalyx. In this mini-review, we summarize current knowledge on glycocalyx structure and function, and present data describing the impact of hemorrhagic shock and resuscitation fluids on glycocalyx...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29714029/a-data-driven-patient-blood-management-strategy-in-liver-transplantation
#5
R A Metcalf, M B Pagano, J R Hess, J Reyes, J D Perkins, M I Montenovo
BACKGROUND AND OBJECTIVES: Blood utilization during liver transplant has decreased, but remains highly variable due to many complex surgical and physiologic factors. Previous models attempted to predict utilization using preoperative variables to stratify cases into two usage groups, usually using entire blood units for measurement. We sought to develop a practical predictive model using specific transfusion volumes (in ml) to develop a data-driven patient blood management strategy. MATERIALS AND METHODS: This is a retrospective evaluation of primary liver transplants at a single institution from 2013 to 2015...
May 1, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29706495/effect-of-red-blood-cell-storage-duration-on-outcome-after-paediatric-cardiac-surgery-a-prospective-observational-study
#6
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Chandrasekaran Ananthanarayanan, Ritesh Shah, Atul Solanki, Himani Pandya, Sanjay Patel
BACKGROUND: Retrospective reviews have found the use of stored packed red blood cells (PRBCs) in priming to be associated with increased risk of postoperative complications. The purpose of study was to prospectively investigate the influence of duration of storage of PRBCs used in priming the cardiopulmonary bypass (CPB) circuit on the metabolic profile of the patients, and postoperative outcome after paediatric cardiac surgery. METHODS: Between January 2015 and December 2015, 198 consecutive children operated for cardiac surgery using CPB and received blood for priming the circuit were included...
March 31, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29706249/isolated-traumatic-brain-injury-results-in-significant-pre-hospital-derangement-of-cardiovascular-physiology
#7
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29683829/harmful-or-physiologic-diagnosing-fibrinolysis-shutdown-in-a-trauma-cohort-with-rotational-thromboelastometry
#8
J Carolina Gomez-Builes, Sergio A Acuna, Bartolomeu Nascimento, Fabiana Madotto, Sandro B Rizoli
BACKGROUND: Despite its central role in early trauma coagulopathy, abnormal fibrinolysis continues to be poorly understood. Excessive fibrinolysis is a known contributor to mortality. Recent studies with thromboelastography (TEG) suggest decreased fibrinolysis (or shutdown) may be just as harmful. Considering the broad use of 2 different viscoelastic assays, which are not interchangeable, we proposed for the first time to define and characterize fibrinolysis shutdown using rotational thromboelastometry (ROTEM)...
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29664514/-damage-control-resuscitation-in-pediatric-severe-trauma
#9
Adriana Wegner Araya
INTRODUCTION: Trauma is an important cause of morbidity and mortality in the pediatric population. It has the first place in mortality in our country without considering perinatal pathologies and congenital malformations. An important percentage of early and late deaths secondary to this cau se, as well as its sequelae, could be prevented with optimal and timely resuscitation. OBJECTIVE: To review the applicability of damage control resuscitation (DCR) in severe pediatric trauma, with emphasis on medical management...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29627883/platelet-transfusion-increases-risk-for-acute-respiratory-distress-syndrome-in-non-massively-transfused-blunt-trauma-patients
#10
George Kasotakis, Nichole Starr, Erek Nelson, Bedabrata Sarkar, Peter Ashley Burke, Daniel George Remick, Ronald Gary Tompkins
PURPOSE: While damage control resuscitation is known to confer a survival advantage in severely injured patients, high-ratio blood component therapy should be initiated only in carefully selected trauma patients, due to the morbidity associated with blood product use. With this project, we aim to identify the effect of platelet transfusion in non-massively transfused bluntly injured patients. METHODS: The Glue Grant database was retrospectively queried and severely injured blunt trauma patients who underwent non-massive transfusion were identified...
April 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29621120/absences-of-endothelial-microvesicle-changes-in-the-presence-of-the-endotheliopathy-of-trauma
#11
Charles E Wade, Nena Matijevic, Yao-Wei W Wang, Erika Gonzalez Rodriguez, Ernesto Lopez, Sisse R Ostrowski, Jessica C Cardenas, Lisa A Baer, Tzu-An Chen, Jeffrey S Tomasek, Hanne H Henriksen, Jakob Stensballe, Bryan A Cotton, John B Holcomb, Pär I Johansson
INTRODUCTION: Severe trauma is accompanied by endothelial glycocalyx disruption, which drives coagulopathy, increasing transfusion requirements and death. This syndrome has been termed traumatic endotheliopathy (EOT). Some have suggested EOT results from endothelial cellular damage and apoptosis. Endothelial microvesicles (EMVs) represent cellular damage. We hypothesized that EOT is associated with endothelial damage and apoptosis resulting in an increase in circulating EMVs. METHODS: Prospective, observational study enrolling severely injured patients...
April 4, 2018: Shock
https://www.readbyqxmd.com/read/29606481/frequency-and-risk-factors-for-subsyndromal-delirium-in-an-intensive-care-unit
#12
Chikayo Yamada, Yoko Iwawaki, Kiyomi Harada, Michihiko Fukui, Masafumi Morimoto, Ryuya Yamanaka
OBJECTIVE: Delirium and subsyndromal delirium in critically ill patients are important determinants of long-term functional disability and cognitive impairment. However, few outcome studies on sub-syndromal delirium have been reported. Thus, this study aimed to evaluate the incidence of delirium and sub-syndromal delirium as well as the risk factors and progression to delirium. DESIGN: A prospective cohort study. SETTING: Six bed medical and surgical intensive care unit in Otsu Municipal Hospital in Japan...
March 29, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29603246/elevated-free-hemoglobin-and-decreased-haptoglobin-levels-are-associated-with-adverse-clinical-outcomes-unfavorable-physiologic-measures-and-altered-inflammatory-markers-in-pediatric-cardiac-surgery-patients
#13
Jill M Cholette, Anthony P Pietropaoli, Kelly F Henrichs, George M Alfieris, Karen S Powers, Francisco Gensini, Jeffrey S Rubenstein, Dawn Sweeney, Richard Phipps, Sherry L Spinelli, Majed A Refaai, Michael P Eaton, Neil Blumberg
BACKGROUND: There are data suggesting that free hemoglobin (Hb), heme, and iron contribute to infection, thrombosis, multiorgan failure, and death in critically ill patients. These outcomes may be mitigated by haptoglobin. STUDY DESIGN AND METHODS: 164 consecutively treated children undergoing surgery for congenital heart disease were evaluated for associations between free Hb and haptoglobin and clinical outcomes, physiologic metrics, and biomarkers of inflammation RESULTS: Higher perioperative free Hb levels (and lower haptoglobin levels) were associated with mortality, nosocomial infection, thrombosis, hours of intubation and inotropes, increased interleukin-6, peak serum lactate levels, and lower nadir mean arterial pressures...
March 30, 2018: Transfusion
https://www.readbyqxmd.com/read/29595346/a-proteomic-approach-reveals-the-variation-in-human-platelet-protein-composition-after-storage-at-different-temperatures
#14
Shichun Wang, Tianlun Jiang, Yahan Fan, Shuming Zhao
Cryopreservation can slow down the metabolism and decrease the risk of bacterial contamination. But, chilled platelets (PLTs) show a reduced period in circulation due to the rapid clearance by hepatic cells or spleen macrophages after transfusion. The deleterious changes that PLTs undergo are mainly considered the result of PLT protein variation. However, the basis for proteomic variation of stored PLTs remains poorly understood. Besides count, activation markers (CD62P and Annexin V), and aggregation, we used quantitative mass spectrometry to create the first comprehensive and quantitative human PLT proteome of samples stored at different temperatures (22°C, 10°C and -80°C)...
March 29, 2018: Platelets
https://www.readbyqxmd.com/read/29594527/matched-cohort-study-of-topical-tranexamic-acid-in-cementless-primary-total-hip-replacement
#15
Javier Sanz-Reig, Jesus Mas Martinez, Carmen Verdu Román, Manuel Morales Santias, Enrique Martínez Gimenez, David Bustamante Suarez de Puga
PURPOSE: Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. METHODS: This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement...
March 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29588551/hip-hemi-arthroplasty-vs-total-hip-replacement-for-displaced-intra-capsular-hip-fractures-retrospective-age-and-sex-matched-cohort-study
#16
Daniel Dawson, David Milligan, Fayaz Callachand, Laurence Cusick
Introduction: The Royal Victoria Hospital in Belfast is the largest volume hospital in the UK Hip Fracture Database. Management of displaced intra-capsular hip fractures is evolving in light of NICE2 and BOA guidelines3 , with more patients receiving total hip replacement (THR) over hemi-arthroplasty. With current rationing within the NHS, it is vital that principles of the 'Getting It Right First time' (GIRFT) report4 are implemented and the correct treatment choice made. Our aim was to assess Barthel scores5 , complication rate, blood transfusion rate and post op functional ability in two age and sex matched cohorts to see if our patient selection was appropriate...
January 2018: Ulster Medical Journal
https://www.readbyqxmd.com/read/29553857/a-comprehensive-proteomics-study-on-platelet-concentrates-platelet-proteome-storage-time-and-mirasol-pathogen-reduction-technology
#17
Vishal Salunkhe, Iris M De Cuyper, Petros Papadopoulos, Pieter F van der Meer, Brunette B Daal, María Villa-Fajardo, Dirk de Korte, Timo K van den Berg, Laura Gutiérrez
Platelet concentrates (PCs) represent a blood transfusion product with a major concern for safety as their storage temperature (20-24°C) allows bacterial growth, and their maximum storage time period (less than a week) precludes complete microbiological testing. Pathogen inactivation technologies (PITs) provide an additional layer of safety to the blood transfusion products from known and unknown pathogens such as bacteria, viruses, and parasites. In this context, PITs, such as Mirasol Pathogen Reduction Technology (PRT), have been developed and are implemented in many countries...
March 19, 2018: Platelets
https://www.readbyqxmd.com/read/29550819/red-blood-cell-transfusion-in-preterm-infants-current-evidence-and-controversies
#18
Claire Howarth, Jayanta Banerjee, Narendra Aladangady
The current evidence regarding the indication, advantages and risks of red blood cell transfusion (RBCT) for preterm infants is discussed. This is an important area in Neonatology to be examined given that 90% of extremely low birth weight infants receive RBCT and many controversies remain regarding when to transfuse and the risks of RBCT. The various treatment thresholds and guidelines used are presented and we compare the short-term clinical benefits of liberal and restrictive RBCT in preterm infants; the majority of these are equivocal and sadly long-term outcome data is limited...
March 16, 2018: Neonatology
https://www.readbyqxmd.com/read/29549618/transcatheter-arterial-embolization-in-lower-gastrointestinal-bleeding-ischemia-remains-a-concern-even-with-a-superselective-approach
#19
Taina Nykänen, Erno Peltola, Leena Kylänpää, Marianne Udd
PURPOSE: To evaluate the safety, efficacy, and feasibility of transcatheter arterial embolization (TAE) in the treatment of lower gastrointestinal bleeding (LGIB). METHODS: Study group comprised all patients receiving angiography for LGIB in the Helsinki University Hospital during the period of 2004-2016. Hospital medical records provided the study data. Rebleeding, complication, and mortality rates (≤ 30 days) were the primary outcomes. Secondary outcomes included need for blood transfusions, durations of intensive care unit and hospital admissions, incidence of delayed rebleeding, and long-term complications, as well as overall survival...
March 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29535993/placental-transfusion-and-cardiovascular-instability-in-the-preterm-infant
#20
REVIEW
Zbynĕk Straňák, Simona Feyereislová, Peter Korček, Eugene Dempsey
Postnatal adaptation in preterm newborn comprises complex physiological processes that involve significant changes in the circulatory and respiratory system. Increasing hemoglobin level and blood volume following placental transfusion may be of importance in enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. The European consensus on resuscitation of preterm infants recommends delayed cord clamping (DCC) for at least 60 s to promote placenta-fetal transfusion in uncompromised neonates...
2018: Frontiers in Pediatrics
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