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Cryoprecipitate

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https://www.readbyqxmd.com/read/29198634/intraoperative-administration-of-4-factor-prothrombin-complex-concentrate-reduces-blood-requirements-in-cardiac-transplantation
#1
Gina H Sun, Visal Patel, Ingrid Moreno-Duarte, Farhad Zahedi, Eric Ursprung, Greg Couper, Fred Y Chen, Ian J Welsby, Raymond Comenzo, Grace Kao, Frederick C Cobey
OBJECTIVE: Assessing the efficacy of intraoperative 4-factor prothrombin complex concentrate (4F-PCC) use in blood product utilization, time to chest closure, intensive care unit (ICU) and hospital length of stay (LOS), thromboembolic complications, renal injury and mortality in left ventricular assist device (LVAD) patients on home anticoagulation therapy with warfarin, undergoing orthotopic heart transplantation (OHT). DESIGN: Retrospective analysis of OHT patients at Tufts Medical Center from May 2013 to October 2016...
August 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29180179/preoperative-thrombelastography-maximum-amplitude-predicts-massive-transfusion-in-liver-transplantation
#2
Peter J Lawson, Hunter B Moore, Ernest E Moore, Gregory R Stettler, Thomas J Pshak, Igal Kam, Christopher C Silliman, Trevor L Nydam
BACKGROUND: Massive transfusion (MT) is frequently required during liver transplantation. Risk stratification of transplant patients at risk for MT is an appealing concept but remains poorly developed. Thrombelastography (TEG) has recently been shown to reduce mortality when used for trauma resuscitation. We hypothesize that preoperative TEG can be used to risk stratify patients for MT. MATERIAL AND METHODS: Liver transplant patients had blood drawn before surgical incision and assayed via TEG...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29112541/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-cardiovascular-and-thoracic-surgery
#3
Aamer B Ahmed, Andreas Koster, Marcus Lance, David Faraoni
: None of the predictive models for venous thromboembolism (VTE) prophylaxis have been designed for and validated in patients undergoing cardiothoracic and vascular surgery. The presence of one or more risk factors [age over 70 years old, transfusion of more than 4 U of red blood cells/fresh frozen plasma/cryoprecipitate, mechanical ventilation lasting more than 24 h, postoperative complication (e.g. acute kidney injury, infection/sepsis, neurological complication)] should place the cardiac population at high risk for VTE...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29106354/characteristics-of-thawed-pooled-cryoprecipitate-stored-at-refrigerated-temperature-for-24-hours
#4
Esther P Soundar, Meredith Reyes, Laura Korte, Arthur Bracey
BACKGROUND: The need for thawed cryoprecipitate is growing. However, according to current guidelines, the shelf-life of pooled thawed cryoprecipitate at room temperature is limited because of possible bacterial contamination and loss of clotting factor activity. Here we assessed microbial growth and retention of clotting activity in cryoprecipitate stored at 4 °C after thawing to see whether its shelf life could be safely extended. MATERIALS AND METHODS: Pooled thawed cryoprecipitate units (n=10) were maintained at room temperature for 6 hours and then placed at 1-6 °C for 18 hours after thawing...
October 30, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29099345/coagulation-management-during-liver-transplantation-use-of-fibrinogen-concentrate-recombinant-activated-factor-vii-prothrombin-complex-concentrate-and-antifibrinolytics
#5
Jonathan H Chow, Khang Lee, Ezeldeen Abuelkasem, Obi R Udekwu, Kenichi A Tanaka
Coagulation management, and transfusion practice in liver transplantation (LT) have been evolving in the recent years due to better understanding of coagulation abnormalities in end-stage liver disease, and clinical management of LT patients. Avoidance of allogeneic blood components is feasible in some patients, but multi-modal coagulation therapies may be necessary in others who develop complex coagulopathy due to hemorrhage, hemodilution, hypothermia, and acid-base disturbances. Transfusions of plasma and cryoprecipitate remain to be the mainstay therapy for procoagulant factor replacement during LT...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29078926/evaluation-and-management-of-congenital-bleeding-disorders
#6
REVIEW
Rahul Bhat, Whitney Cabey
Patients presenting to the emergency department with acute bleeding and a history of clotting or platelet disorder present a unique challenge to the emergency physician. The severity of bleeding presentation is based on mechanism as well as factor levels: patients with factor levels greater than 5% can respond to most minor hemostatic challenges, whereas those with factor levels less than 1% bleed with minor trauma or even spontaneously. Treatment should be initiated in consultation with the patient's hematologist using medications and specific factor replacement, except in rare, life-threatening, resource-poor situations, when cryoprecipitate or activated prothrombin complex may be considerations...
December 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29064153/comparison-of-albumin-colloid-osmotic-pressure-von-willebrand-factor-and-coagulation-factors-in-canine-cryopoor-plasma-cryoprecipitate-and-fresh-frozen-plasma
#7
Christine A Culler, Cristina Iazbik, Julien Guillaumin
OBJECTIVE: To compare albumin concentrations, coagulation factors activity, and colloid osmotic pressure (COP) of cryoprecipitate (CRYO) and cryopoor plasma (CPP) to that of source fresh frozen plasma (FFP). DESIGN: Prospective in vitro study. SETTING: University teaching hospital. ANIMALS: Ten healthy, non-Greyhound dogs enrolled in an academic teaching hospital blood donor program. INTERVENTIONS: Fresh blood was obtained from canine blood donors and separated into FFP and packed red blood cells...
October 24, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29055918/rotational-thromboelastometry-or-conventional-coagulation-tests-in-liver-transplantation-comparing-blood-loss-transfusions-and-cost
#8
Laura Smart, Khalid Mumtaz, Danielle Scharpf, Nicole O'Bleness Gray, Daniel Traetow, Sylvester Black, Anthony J Michaels, Elmahdi Elkhammas, Robert Kirkpatrick, A James Hanje
INTRODUCTION: Orthotopic liver transplantation (OLT) can be associated with significant bleeding requiring multiple blood product transfusions. Rotational thromboelastometry (ROTEM) is a point-of-care device that has been used to monitor coagulation during OLT. Whether it reduces blood loss/transfusions during OLT remains controversial. MATERIALS AND METHODS: We aim to compare ROTEM with conventional coagulation tests (aPTT, PT, INR, platelet count, fibrinogen) to guide transfusion of platelets, cryoprecipitate, and fresh frozen plasma (FFP) during OLT over 3 years...
October 16, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29035661/outcome-of-laparoscopic-ovariohysterectomy-or-ovariectomy-in-dogs-with-von-willebrand-disease-or-factor-vii-deficiency-20-cases-2012-2014
#9
Thomas P Keeshen, J Brad Case, Jeffrey J Runge, Ameet Singh, Philipp D Mayhew, Michele A Steffey, William T N Culp
OBJECTIVE To describe surgical techniques and perioperative management of dogs with von Willebrand disease (VWD) or factor VII (FVII) deficiency undergoing laparoscopic ovariohysterectomy or ovariectomy and evaluate outcomes. DESIGN Retrospective case series. ANIMALS 20 client-owned dogs with VWD (n = 16) or FVII deficiency (4). PROCEDURES Dogs with VWD or FVII deficiency that underwent laparoscopic ovariohysterectomy or ovariectomy between 2012 and 2014 were retrospectively identified via a multi-institutional review of medical records...
November 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29018838/adverse-post-operative-outcomes-in-jehovah-s-witnesses-with-gynecologic-cancer-within-30%C3%A2-days-of-surgery-a-single-institution-review-of-36-cases
#10
Laura J Moulton, Peter G Rose, Haider Mahdi
Rates of blood transfusion are reported as high as 32% in women undergoing major gynecologic cancer surgery. Therefore, care of the gynecologic oncology patient who refuses blood products, such as Jehovah's witnesses, can pose a unique challenge. The objective of this study was to determine rate of adverse post-operative outcomes within 30 days of surgery in Jehovah's witnesses with gynecologic cancer. This was a retrospective cohort study of Jehovah's witnesses undergoing laparotomy or minimally invasive surgery (MIS) for gynecologic cancer at a single institution...
November 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28981194/elevated-preoperative-von-willebrand-factor-is-associated-with-perioperative-thrombosis-in-infants-and-neonates-with-congenital-heart-disease
#11
Ryan Hunt, Corey M Hoffman, Sirisha Emani, Cameron C Trenor, Sitaram M Emani, David Faraoni, Chava Kimchi-Sarfaty, Juan C Ibla
BACKGROUND: The surgical repair of congenital heart lesions is frequently complicated by perioperative thrombosis of unclear etiology. An imbalance between von Willebrand Factor (VWF) and ADAMTS-13 is an emerging variable in thrombosis. OBJECTIVES: To describe perioperative changes to VWF, ADAMTS-13 and NETosis and evaluate clinical and biochemical associations with postoperative thrombosis. METHODS: Neonates and infants undergoing palliation or definitive repair of congenital heart disease (CHD) were recruited (n =133)...
October 5, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28978859/patient-blood-management-and-transfusion-therapy-for-hemostasis
#12
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/28971741/prognostic-value-of-cryoglobulins-protein-electrophoresis-and-serum-immunoglobulins-for-lymphoma-development-in-patients-with-sj%C3%A3-gren-s-syndrome-a-retrospective-cohort-study
#13
Jesse Kimman, Xavier Bossuyt, Daniel Blockmans
BACKGROUND: Patients with Sjögren's syndrome (SS) have a considerable higher risk of lymphoma development. OBJECTIVES: To determine the incidence of lymphoma and the value of biomarkers to predict lymphoma development in patients with SS. METHODS: Clinical files of all patients with a presumed diagnosis of SS between 1991 and 2016 were retrospectively reviewed for the development of lymphoma. Biochemical data were plotted as a function of the relative time before and after the lymphoma diagnosis (for patients who developed lymphoma) or before the last available blood test (for patients who did not develop lymphoma)...
October 3, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28970688/transfusion-related-adverse-reactions-in-pediatric-and-surgical-patients-at-a-tertiary-care-teaching-hospital-in-india
#14
Kunal J Ghataliya, Jigar D Kapadia, Mira K Desai, K M Mehariya, G H Rathod, Nidhi Bhatnagar, M D Gajjar
BACKGROUND: Use of blood and its components is lifesaving. However, their use is often associated with adverse events. OBJECTIVE: To analyze the pattern of adverse reactions associated with transfusion of blood and its components in pediatric and surgical patients at a tertiary care teaching hospital. MATERIALS AND METHODS: Patients receiving transfusion of blood or its components in a randomly selected unit each from Departments of Pediatrics, including thalassemia OPD and surgery, were monitored intensively for a period of 6 months...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28969312/viscoelastometric-guided-early-fibrinogen-concentrate-replacement-during-postpartum-haemorrhage-obs2-a-double-blind-randomized-controlled-trial
#15
P W Collins, R Cannings-John, D Bruynseels, S Mallaiah, J Dick, C Elton, A D Weeks, J Sanders, N Aawar, J Townson, K Hood, J E Hall, R E Collis
Background: Postpartum haemorrhage (PPH) can be exacerbated by haemostatic failure. We hypothesized that early fibrinogen replacement, guided by viscoelastometric testing, reduces blood product usage and bleed size. Methods: Women with PPH 1000-1500 ml were enrolled. If Fibtem A5 was ≤15 mm and bleeding continued, subjects were randomized to fibrinogen concentrate or placebo. The primary outcome compared the number of units of red blood cells, plasma, cryoprecipitate and platelets transfused...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28963906/abo-identical-and-washed-blood-transfusions-as-candidate-strategies-to-reduce-early-mortality-in-acute-promyelocytic-leukemia
#16
Tanmay Sahai, Kelly Henrichs, Majed Refaai, Joanna M Heal, Scott A Kirkley, Amy E Schmidt, Jason H Mendler, Debra Masel, Jane Liesveld, Christopher Aquina, Neil Blumberg
BACKGROUND: Despite dramatically improved long term outcomes seen with all-trans retinoic acid therapy, and now arsenic trioxide, in acute promyelocytic leukemia (APL), early mortality remains a substantial challenge. Recent data from a single center study and the Surveillance, Epidemiology and End Results (SEER) registry report 30day mortality rates of 26% (n=18 of 70) and 17% (n=238 of 1400), respectively. Early deaths are predominately due to hemorrhage. Patients with APL invariably have abnormal laboratory hemostasis tests...
November 2017: Leukemia Research
https://www.readbyqxmd.com/read/28952919/noninfectious-and-infectious-complications-and-their-related-characteristics-in-heart-transplant-recipients-at-a-national-institute
#17
Christian Rojas-Contreras, Gabriel De la Cruz-Ku, Bryan Valcarcel-Valdivia
OBJECTIVES: Complications, which affect the morbidity and mortality of patients after heart transplant, can be divided into infectious and noninfections com-plications. Here, we analyzed both infectious and noninfectious complications and their relation to clinical, laboratory, and surgical characteristics in a Latin American heart transplant population. MATERIALS AND METHODS: Data were obtained from records of 35 heart transplant patients in the period from 2010 to 2015...
September 26, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28952916/noninfectious-and-infectious-complications-and-their-related-characteristics-in-heart-transplant-recipients-at-a-national-institute
#18
Christian Rojas-Contreras, Gabriel De la Cruz-Ku, Bryan Valcarcel-Valdivia
OBJECTIVES: Complications, which affect the morbidity and mortality of patients after heart transplant, can be divided into infectious and noninfections com-plications. Here, we analyzed both infectious and noninfectious complications and their relation to clinical, laboratory, and surgical characteristics in a Latin American heart transplant population. MATERIALS AND METHODS: Data were obtained from records of 35 heart transplant patients in the period from 2010 to 2015...
September 26, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28930957/clot-dynamics-and-mortality-the-ma-r-ratio
#19
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/28914279/blood-products-provided-to-patients-receiving-futile-critical-care
#20
Thanh H Neville, Alyssa Ziman, Neil S Wenger
The number of hospitalized patients receiving treatment perceived to be futile is not insignificant. Blood products are valuable resources that are donated to help others in need. We aimed to quantify the amount of blood transfused into patients who were receiving treatment that the critical care physician treating them perceived to be futile. During a 3-month period, critical care physicians in 5 adult intensive care units completed a daily questionnaire to identify patients perceived as receiving futile treatment...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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