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https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#1
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28070916/non-invasive-assessment-of-muscle-oxygenation-may-aid-in-optimising-transfusion-threshold-decisions-in-ambulatory-paediatric-patients
#2
K A Schenkman, D S Hawkins, W A Ciesielski, M Delaney, L S L Arakaki
OBJECTIVE: To assess the potential utility of a novel non-invasive muscle oxygen measurement to determine the presence of muscle hypoxia in patients with anaemia. BACKGROUND: Recent assessment of the risk/benefit ratio of blood transfusion has led to clinical strategies optimising transfusion decisions. These decisions are primarily based on haematocrit (Hct) but not oxygen delivery, the primary function of red blood cells (RBCs). We hypothesised that muscle oxygenation (MOx) would correlate with Hct in patients with anaemia and may be a physiologically relevant determinant of the transfusion threshold...
January 10, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28058524/determination-of-residual-dimethylsulfoxide-in-cryopreserved-cardiovascular-allografts
#3
R Díaz Rodríguez, B Van Hoeck, S De Gelas, F Blancke, R Ngakam, K Bogaerts, R Jashari
Dimethylsulfoxide (DMSO) is a solvent which protects the structure of allografts during the cryopreservation and thawing process. However, several toxic effects of DMSO in patients after transplantation of cryopreserved allografts have been described. The aim of this study is to determine the residual DMSO in the cardiovascular allografts after thawing and preparation of cryopreserved allografts for clinical application following guidelines of the European Pharmacopoeia for DMSO detection. Four types of EHB allografts (aortic valve-AV, pulmonary valve-PV, descending thoracic aorta-DA, and femoral artery-FA) are cryopreserved using as cryoprotecting solution a 10% of DMSO in medium 199...
January 5, 2017: Cell and Tissue Banking
https://www.readbyqxmd.com/read/28057057/is-platelet-transfusion-associated-with-hospital-acquired-infections-in-critically-ill-patients
#4
Cécile Aubron, Andrew W Flint, Michael Bailey, David Pilcher, Allen C Cheng, Colin Hegarty, Antony Martinelli, Michael C Reade, Rinaldo Bellomo, Zoe McQuilten
BACKGROUND: Platelets are commonly transfused to critically ill patients. Reports suggest an association between platelet transfusion and infection. However, there is no large study to have determined whether platelet transfusion in critically ill patients is associated with hospital-acquired infection. METHODS: We conducted a multi-centre study using prospectively maintained databases of two large academic intensive care units (ICUs) in Australia. Characteristics of patients who received platelets in ICUs between 2008 and 2014 were compared to those of patients who did not receive platelets...
January 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28029503/iron-deficiency-and-iron-deficiency-anaemia-in-women
#5
REVIEW
Laura Percy, Diana Mansour, Ian Fraser
Iron deficiency (ID) is the most common micronutrient deficiency worldwide with >20% of women experiencing it during their reproductive lives. Hepcidin, a peptide hormone mostly produced by the liver, controls the absorption and regulation of iron. Understanding iron metabolism is pivotal in the successful management of ID and iron deficiency anaemia (IDA) using oral preparations, parenteral iron or blood transfusion. Oral preparations vary in their iron content and can result in gastrointestinal side effects...
October 1, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28026130/efficacy-and-safety-of-a-vwf-fviii-concentrate-wilate-%C3%A2-in-inherited-von-willebrand-disease-patients-undergoing-surgical-procedures
#6
A Srivastava, M Serban, S Werner, B A Schwartz, C M Kessler
INTRODUCTION: Surgical procedures in von Willebrand disease (VWD) patients may require prophylactic treatment with exogenous von Willebrand factor (VWF) and coagulation factor VIII (FVIII) to prevent excessive bleeding. Wilate(®) is a plasma-derived, double virus-inactivated, highly purified, freeze-dried VWF/FVIII concentrate, containing both factors in a physiological activity ratio of 1:1. AIM: To investigate the efficacy and safety of wilate(®) in maintaining haemostasis in VWD patients undergoing surgical procedures...
December 27, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28024915/how-do-megakaryocytic-microparticles-target-and-deliver-cargo-to-alter-the-fate-of-hematopoietic-stem-cells
#7
Jinlin Jiang, Chen-Yuan Kao, Eleftherios T Papoutsakis
Megakaryocytic microparticles (MkMPs), the most abundant MPs in circulation, can induce the differentiation of hematopoietic stem and progenitor cells (HSPCs) into functional megakaryocytes. This MkMP capability could be explored for applications in transfusion medicine but also for delivery of nucleic acids and other molecules to HSPCs for targeted molecular therapy. Understanding how MkMPs target, deliver cargo and alter the fate of HSPCs is important for exploring such applications. We show that MkMPs, which are distinct from Mk exosomes (MkExos), target HSPCs with high specificity since they have no effect on other ontologically or physiologically related cells, namely mesenchymal stem cells, endothelial cells or granulocytes...
December 24, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/27998318/management-of-severe-dengue-hemorrhagic-fever-and-bleeding-complications-in-a-primigravida%C3%A2-patient-a-case-report
#8
Hori Hariyanto, Corry Quando Yahya, Primartanto Wibowo, Oloan E Tampubolon
BACKGROUND: The incidence of dengue hemorrhagic fever is increasing among the adult population living in endemic areas. The disease carries a 0.73% fatality rate for the general population, but what happens when the disease strikes a special subpopulation group, the obstetrics? Perhaps the important question specific to this special subpopulation revolves around the right time and mode of delivery under severe coagulopathy and plasma leakage in conditions of imminent delivery. CASE PRESENTATION: A 24-year-old primigravid Sundanese woman presented to our intensive care unit due to acute pulmonary edema secondary to massive plasma leakage caused by severe dengue...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27935625/comparison-of-established-and-novel-methods-for-the-detection-and-enumeration-of-microparticles-in-canine-stored-erythrocyte-concentrates-for-transfusion
#9
Meredeth C McEntire, K Jane Wardrop, William C Davis
BACKGROUND: Microparticles (MP) are submicron, phosphatidylserine (PS)-bearing lipid vesicles with physiologic and pathologic roles in coagulation and inflammation. Microparticles accumulate in packed RBC (pRBC) stored for transfusion, potentially increasing recipient morbidity. Historically, canine MP have been detected with the PS label annexin V in supernatant samples. Other detection methods are available but have not been evaluated in dogs. OBJECTIVES: The purpose of the study was to detect and enumerate MP in canine pRBC using annexin V, lactadherin, and bio-maleimide to compare label performance and assess microparticle accumulation under standard storage conditions...
December 9, 2016: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/27931652/red-blood-cell-transfusion-and-its-effect-on-microvascular-dysfunction-in-shock-states
#10
REVIEW
Jordan A Weinberg, Rakesh P Patel
Among critically ill patients, red blood cell (RBC) transfusion is often prescribed for anemia in the absence of active or recent bleeding. The failure of RBC transfusion to improve physiological parameters and clinical outcomes in this setting may be explained by current understanding of the relationship between the RBCs and the microcirculation. It is now evident that the circulating RBCs contribute to microcirculatory hypoxic vasodilation by regulated nitric oxide (NO)-dependent vasodilation, thereby facilitating delivery of oxygen to oxygen-deprived tissue...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27927658/aneurysmal-subarachnoid-hemorrhage-red-blood-cell-transfusion-and-outcome-sahara-a-pilot-randomised-controlled-trial-protocol
#11
Shane W English, D Fergusson, M Chassé, A F Turgeon, F Lauzier, D Griesdale, A Algird, A Kramer, A Tinmouth, C Lum, J Sinclair, S Marshall, D Dowlatshahi, A Boutin, G Pagliarello, L A McIntyre
INTRODUCTION: Anaemia is common in aneurysmal subarachnoid haemorrhage (aSAH) and is a potential critical modifiable factor affecting secondary injury. Despite physiological evidence and management guidelines that support maintaining a higher haemoglobin level in patients with aSAH, current practice is one of a more restrictive approach to transfusion. The goal of this multicentre pilot trial is to determine the feasibility of successfully conducting a red blood cell (RBC) transfusion trial in adult patients with acute aSAH and anaemia (Hb ≤100 g/L), comparing a liberal transfusion strategy (Hb ≤100 g/L) with a restrictive strategy (Hb ≤80 g/L) on the combined rate of death and severe disability at 12 months...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27925235/quantification-of-operational-learning-in-minimal-invasive-extracorporeal-circulation
#12
Kyriakos Anastasiadis, Polychronis Antonitsis, Christos Asteriou, Helena Argiriadou, Apostolos Deliopoulos, Dimitrios Konstantinou, Vassilios Grosomanidis, Paschalis Tossios
Minimal invasive extracorporeal circulation (MiECC) has initiated important new efforts within science and technology towards a more physiologic perfusion. In this study, we aim to investigate the learning curve of our center regarding MiECC. We studied a series of 150 consecutive patients who underwent elective coronary artery bypass grafting by the same surgical team during the initial phase of MiECC application. Patients were randomly assigned into two groups. Group A (n = 75) included patients operated on MiECC, while group B (n = 75) included patients operated with conventional cardiopulmonary bypass (cCPB)...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27919118/preeclampsia-and-the-risk-of-bronchopulmonary-dysplasia-in-preterm-infants-less-than-32-weeks-gestation
#13
Nancy Soliman, Kathleen Chaput, Belal Alshaikh, Kamran Yusuf
Objective Angiogenesis is essential for normal lung development. The objective of our study was to test the hypothesis that preeclampsia, an antiangiogenic state, is a risk factor for bronchopulmonary dysplasia (BPD). Design Prospective cohort study of infants less than 32 weeks' gestation born to mothers with preeclampsia between January 2007 and June 2010 at a single tertiary care center. Their BPD outcome was compared with infants born to the next two normotensive mothers with a ± 1 week gestational age difference...
December 5, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#14
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27827796/effect-of-body-position-and-ventilation-on-umbilical-artery-and-venous-blood-flows-during-delayed-umbilical-cord-clamping-in-preterm-lambs
#15
Stuart B Hooper, Kelly J Crossley, Valerie A Zahra, Jeroen van Vonderen, Alison Moxham, Andrew W Gill, Martin Kluckow, Arjan B Te Pas, Euan M Wallace, Graeme R Polglase
OBJECTIVE: While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. METHODS: Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows...
November 8, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27792859/emerging-cellular-and-gene-therapies-for-congenital-anemias
#16
REVIEW
Leif S Ludwig, Rajiv K Khajuria, Vijay G Sankaran
Congenital anemias comprise a group of blood disorders characterized by a reduction in the number of peripherally circulating erythrocytes. Various genetic etiologies have been identified that affect diverse aspects of erythroid physiology and broadly fall into two main categories: impaired production or increased destruction of mature erythrocytes. Current therapies are largely focused on symptomatic treatment and are often based on transfusion of donor-derived erythrocytes and management of complications...
December 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/27779595/sympathoadrenal-activation-and-endotheliopathy-are-drivers-of-hypocoagulability-and-hyperfibrinolysis-in-trauma-a-prospective-observational-study-of-404-severely-injured-patients
#17
Sisse R Ostrowski, Hanne H Henriksen, Jakob Stensballe, Mikkel Gybel-Brask, Jessica C Cardenas, Lisa A Baer, Bryan A Cotton, John B Holcomb, Charles E Wade, Pär I Johansson
BACKGROUND: One third of severely injured patients present with a laboratory based diagnosis of coagulopathy. This study investigated clinical and biomarker profile of patients with rapid TEG (rTEG) coagulopathy hypothesizing that sympathoadrenal activation and endothelial damage were drivers of this condition. METHODS: Prospective observational study of 404 trauma patients admitted to a Level 1 US Trauma Center. Patients with admission rTEG and plasma measurements of catecholamines (adrenaline, noradrenaline) and biomarkers reflecting endothelial activation/damage (syndecan-1, thrombomodulin, sE-selectin, sVE-cadherin, nucleosomes) were included...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27767984/the-optimum-hematocrit
#18
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27757915/the-impact-of-red-blood-cell-transfusion-on-cerebral-tissue-oxygen-saturation-in-severe-traumatic-brain-injury
#19
Victoria A McCredie, Simone Piva, Marlene Santos, Wei Xiong, Airton Leonardo de Oliveira Manoel, Andrea Rigamonti, Gregory M T Hare, Martin G Chapman, Andrew J Baker
BACKGROUND: There are a range of opinions on the benefits and thresholds for the transfusion of red blood cells in critically ill patients with traumatic brain injury (TBI) and an urgent need to understand the neurophysiologic effects. The aim of this study was to examine the influence of red blood cell transfusions on cerebral tissue oxygenation (SctO2) in critically ill TBI patients. METHODS: This prospective observational study enrolled consecutive TBI patients with anemia requiring transfusion...
October 18, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27746547/a-comparative-study-of-sterofundin-and-ringer-lactate-based-infusion-protocol-in-scoliosis-correction-surgery
#20
Ashima Sharma, Monu Yadav, B Rajesh Kumar, P Sai Lakshman, Raju Iyenger, Gopinath Ramchandran
BACKGROUND: A major change in anesthesia practice as regards to intraoperative infusion therapy is the present requirement. Switching over to balanced fluids can substantially decrease the incidence of lactic acidosis and hyperchloremic acidosis. The deleterious effects of unbalanced fluids are more recognizable during major surgeries. We prospectively studied the influence of Sterofundin (SF) and Ringer lactate (RL) on acid-base changes, hemodynamics, and readiness for extubation during scoliosis surgery...
September 2016: Anesthesia, Essays and Researches
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