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https://www.readbyqxmd.com/read/28426586/predictive-modeling-of-massive-transfusion-requirements-during-liver-transplantation-and-its-potential-to-reduce-utilization-of-blood-bank-resources
#1
Aliaksei Pustavoitau, Maggie Lesley, Promise Ariyo, Asad Latif, April J Villamayor, Steven M Frank, Nicole Rizkalla, William Merritt, Andrew Cameron, Nabil Dagher, Benjamin Philosophe, Ahmet Gurakar, Allan Gottschalk
BACKGROUND: Patients undergoing liver transplantation frequently but inconsistently require massive blood transfusion. The ability to predict massive transfusion (MT) could reduce the impact on blood bank resources through customization of the blood order schedule. Current predictive models of MT for blood product utilization during liver transplantation are not generally applicable to individual institutions owing to variability in patient population, intraoperative management, and definitions of MT...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28424137/improvement-of-treatment-outcomes-after-implementation-of-a-massive-transfusion-protocol-a-level-i-trauma-center-experience
#2
Andrew Nunn, Peter Fischer, Ronald Sing, Megan Templin, Michael Avery, A Britton Christmas
We assessed the effectiveness of the implementation of an institutional massive transfusion protocol (MTP) for resuscitation with a 1:1:1 transfusion ratio of packed red blood cell (PRBC), fresh frozen plasma, and platelet units. In a Level I trauma center database, all trauma admissions (2004-2012) that received massive transfusions (≥10 units PRBCs in the first 24 hours) were reviewed retrospectively. Demographic data, transfusion ratios, and outcomes were compared before (PRE) and after (POST) MTP implementation in May 2008...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28400306/-can-3d-power-doppler-indices-improve-the-prenatal-diagnosis-of-a-potentially-morbidly-adherent-placenta-in-patients-with-placenta-previa
#3
Ziad A Haidar, Ramesha Papanna, Baha M Sibai, Nina Tatevian, Oscar A Viteri, Patricia C Vowels, Sean C Blackwell, Kenneth J Moise
BACKGROUND: Traditionally, 2D ultrasound parameters have been used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques have not been well studied yet. OBJECTIVE: To determine the ability of prenatal 3D power Doppler analysis of flow and vascular indices to predict the morbidly adherent placenta (MAP) objectively. METHODS: Prospective cohort study was performed in women between 28-32 weeks with known placenta previa...
April 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28392864/traumatic-abdominal-solid-organ-injury-patients-might-benefit-from-thromboelastography-guided-blood-component-therapy
#4
Hao Wang, Richard D Robinson, Jessica L Phillips, Andrew Ryon, Scott Simpson, Jonathan R Ford, Johnbosco Umejiego, Therese M Duane, Bradley Putty, Nestor R Zenarosa
BACKGROUND: Thromboelastography (TEG) has been utilized for the guidance of blood component therapy (BCT). We aimed to investigate the association between emergent TEG-guided BCT and clinical outcomes in patients with traumatic abdominal solid organ (liver and/or spleen) injuries. METHODS: A single center retrospective study of patients who sustained traumatic liver and/or spleen injuries receiving emergent BCT was conducted. TEG was ordered in all these patients...
May 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28362411/continuous-manual-exchange-transfusion-for-patients-with-sickle-cell-disease-an-efficient-method-to-avoid-iron-overload
#5
Bérengère Koehl, Florence Missud, Laurent Holvoet, Ghislaine Ithier, Oliver Sakalian-Black, Zinedine Haouari, Emmanuelle Lesprit, André Baruchel, Malika Benkerrou
Children with sickle cell anemia (SCA) may be at risk of cerebral vasculopathy and strokes, which can be prevented by chronic transfusion programs. Repeated transfusions of packed red blood cells (PRBCs) is currently the simplest and most used technique for chronic transfusion programs. However, iron overload is one of the major side effects of this therapy. More developed methods exist, notably the apheresis of RBC (erythrapheresis), which is currently the safest and most efficient method. However, it is costly, complicated, and cannot be implemented everywhere, nor is it suitable for all patients...
March 14, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28338598/characterization-of-distinct-coagulopathic-phenotypes-in-injury-pathway-specific-drivers-and-implications-for-individualized-treatment
#6
S Ariane Christie, Lucy Z Kornblith, Benjamin M Howard, Amanda S Conroy, Ryan C Kunitake, Mary F Nelson, Carolyn M Hendrickson, Carolyn S Calfee, Rachael A Callcut, Mitchell Jay Cohen
BACKGROUND: International normalized ratio (INR) and partial thromboplastin time (PTT) are used interchangeably to diagnose acute traumatic coagulopathy (ATC) but reflect disparate activation pathways. In this study we identified injury/patient characteristics and coagulation factors that drive contact pathway, tissue factor pathway (TF), and common pathway dysfunction by examining injured patients with discordant coagulopathies. We hypothesized that patients with INR/PTT discordance reflect differing phenotypes representing contact vs...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28334418/rbc-transfusion-is-associated-with-increased-risk-of-respiratory-failure-after-pneumonectomy
#7
Biniam Kidane, Madelaine Plourde, Larissa Leydier, Sami A Chadi, Kathleen Eckert, Sadeesh Srinathan, Dalilah Fortin, Eric Frechette, Richard I Inculet, Richard A Malthaner
BACKGROUND AND OBJECTIVES: Pneumonectomy is associated with high risk of respiratory complications. Our objective was to determine if transfusions are associated with increased rate of ARDS and respiratory failure in adults undergoing elective pneumonectomy. METHODS: Retrospective cohort study of consecutive pneumonectomies undertaken at a tertiary hospital (2003-2013). Multivariable logistic regression was performed to adjust for confounding factors. RESULTS: ARDS and respiratory failure occurred in 12...
March 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28292321/prothrombin-time-is-predictive-of-low-plasma-prothrombin-concentration-and-clinical-outcome-in-patients-with-trauma-hemorrhage-analyses-of-prospective-observational-cohort-studies
#8
Clare A Balendran, Ann Lövgren, Kenny M Hansson, Karin Nelander, Marita Olsson, Karin J Johansson, Karim Brohi, Dietmar Fries, Anders Berggren
BACKGROUND: Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outcome is unknown. METHODS: We have utilized two trauma patient databases (database 1 n = 358 and database 2 n = 331) to investigate the relationship of plasma prothrombin concentration on clinical outcome and coagulation status. Database 1 has been used to assess the relationship of plasma prothrombin to administered packed red blood cells (PRBC), clinical outcome and coagulation biomarkers (Prothrombin Time (PT), ROTEM EXTEM Coagulation Time (CT) and Maximum Clot Firmness (MCF))...
March 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28291703/fdp-fibrinogen-ratio-reflects-the-requirement-of-packed-red-blood-cell-transfusion-in-patients-with-blunt-trauma
#9
Shuichi Hagiwara, Makoto Aoki, Masato Murata, Minoru Kaneko, Yumi Ichikawa, Jun Nakajima, Yuta Isshiki, Yusuke Sawada, Jun'ichi Tamura, Kiyohiro Oshima
PURPOSE: To find factors that predict the requirement of packed red blood cells (pRBC) transfusion in patients with blunt trauma on arrival at the hospital. METHODS: We conducted blood tests in trauma patients whose trauma severity was suspected as being 3 and over in the Abbreviated Injury Scale. Patients were divided into the blood transfusion (BT) and control groups according to the requirement of pRBC transfusion within 24h after arrival. RESULTS: We analyzed 347 patients (BT group, n=14; control group, n=333)...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#10
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28273147/a-quantitative-brain-map-of-experimental-cerebral-malaria-pathology
#11
Patrick Strangward, Michael J Haley, Tovah N Shaw, Jean-Marc Schwartz, Rachel Greig, Aleksandr Mironov, J Brian de Souza, Sheena M Cruickshank, Alister G Craig, Danny A Milner, Stuart M Allan, Kevin N Couper
The murine model of experimental cerebral malaria (ECM) has been utilised extensively in recent years to study the pathogenesis of human cerebral malaria (HCM). However, it has been proposed that the aetiologies of ECM and HCM are distinct, and, consequently, no useful mechanistic insights into the pathogenesis of HCM can be obtained from studying the ECM model. Therefore, in order to determine the similarities and differences in the pathology of ECM and HCM, we have performed the first spatial and quantitative histopathological assessment of the ECM syndrome...
March 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28265454/fluid-resuscitation-in-haemorrhagic-shock-in-combat-casualties
#12
REVIEW
Parli R Ravi, Bipin Puri
This brief update reviews the recent literature available on fluid resuscitation from hemorrhagic shock and considers the applicability of this evidence for use in resuscitation of combat casualties in the combat casualty care (CCC) environment. A number of changes need to be incorporated in the CCC guidelines: (1) dried plasma (DP) is added as an option when other blood components or whole blood are not available; (2) the wording is clarified to emphasize that Hetastarch is a less desirable option than whole blood, blood components, or DP and should be used only when these preferred options are not available; (3) the use of blood products in certain tactical field care settings where this option might be feasible (FSC, GH) is discussed; (4) 1:1:1 damage control resuscitation (DCR) with plasma: packed red blood cells (PRBC): platelets is preferred to 1:1 DCR with plasma: PRBC when platelets are available; and (5) the 30-min wait between increments of resuscitation fluid administered to achieve clinical improvement or target blood pressure has been eliminated...
2017: Disaster Mil Med
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#13
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28248803/1-1-transfusion-strategies-are-right-for-the-wrong-reasons
#14
Stephanie A Savage, Ben L Zarzaur, Brian L Brewer, Garrett H Lim, Ali C Martin, Louis J Magnotti, Martin A Croce, Timothy H Pohlman
BACKGROUND: Early assessment of clot function identifies coagulopathies after injury. Abnormalities include a hypercoagulable state from excess thrombin generation, as well as an acquired coagulopathy. Efforts to address coagulopathy have resulted in earlier, aggressive use of plasma emphasizing 1:1 resuscitation. The purpose of this study was to describe coagulopathies in varying hemorrhagic profiles from a cohort of injured patients. METHODS: All injured patients who received at least one unit of packed red blood cells (PRBC) in the first 24 hours of admission from September 2013 to May 2015 were eligible for inclusion...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28193297/pre-hospital-transfusion-of-packed-red-blood-cells-in-147-patients-from-a-uk-helicopter-emergency-medical-service
#15
Richard M Lyon, Eleanor de Sausmarez, Emily McWhirter, Gary Wareham, Magnus Nelson, Ashley Matthies, Anthony Hudson, Leigh Curtis, Malcolm Q Russell
BACKGROUND: Early transfusion of packed red blood cells (PRBC) has been associated with improved survival in patients with haemorrhagic shock. This study aims to describe the characteristics of patients receiving pre-hospital blood transfusion and evaluate their subsequent need for in-hospital transfusion and surgery. METHODS: The decision to administer a pre-hospital PRBC transfusion was based on clinical judgment. All patients transfused pre-hospital PRBC between February 2013 and December 2014 were included...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28193080/inappropriate-packed-rbc-transfusion-in-a-tertiary-care-center
#16
Anahita Sadeghi, Safieh Belali, Ali Ali Asgari, Zahra Morovat, Reza Malekzadeh, Ashkan Emadi
INTRODUCTION: Transfusion of packed red blood cells (pRBC) with appropriate indications is not only important for patient safety and well-being but is also crucial for proper utilization of resources and health care-related cost reduction. We aimed to investigate the clinical appropriateness of blood transfusion in Shariati Hospital, one of the largest academic medical centers in Tehran. METHODS: In this prospective observational study, 1000 transfusions of allogenic pRBCs from April 1st to October 31st, 2015 were included...
February 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28176346/educational-interventions-encouraging-appropriate-use-of-blood-transfusions
#17
A Abelow, A Gafter-Gvili, B Tadmor, M Lahav, D Shepshelovich
BACKGROUND AND OBJECTIVES: The integration of a restrictive packed red blood cells (PRBC) transfusion strategy into daily clinical practice presents a challenge. This study describes the effect of an intervention including educational presentations and computerized alerts on PRBC utilization at a tertiary hospital. MATERIALS AND METHODS: During December 2014, lectures describing recommended PRBC transfusion indications were presented to all non-intensive care departments...
February 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28164307/how-to-quantify-microparticles-in-rbcs-a-validated-flow-cytometry-method-allows-the-detection-of-an-increase-in-microparticles-during-storage
#18
Clémentine Gamonet, Guillaume Mourey, Sophie Aupet, Sabéha Biichle, Régis Petitjean, Chrystelle Vidal, Aurore Pugin, Christian Naegelen, Pierre Tiberghien, Pascal Morel, Fanny Angelot-Delettre, Estelle Seilles, Philippe Saas, Laurent Bardiaux, Francine Garnache-Ottou
BACKGROUND: The procoagulant and proinflammatory microparticles (MPs) released during storage of packed red blood cells (pRBCs) can potentially modify transfusion benefits. A robust method to quantify MPs in pRBCs is needed to evaluate their impact in clinical trials. STUDY DESIGN AND METHODS: The objective was to validate the preanalytic conditions required to prepare pRBC supernatant as well as a method to quantify and evaluate MP variations over 42 days of pRBC storage...
March 2017: Transfusion
https://www.readbyqxmd.com/read/28156546/blood-transfusions-at-end-of-life-for-stem-cell-transplant-patients
#19
Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric Roeland
115 Background: Transfusions are an essential palliative tool in the stem cell transplant (SCT) population. Limited data exist regarding transfusion practices at end-of-life for SCT patients and whether these practices may limit enrollment in hospice. METHODS: A retrospective chart review was conducted of deceased patients with hematologic malignancies who underwent SCT at an academic medical center from 2011 to 2015. The primary objective was to determine the difference between the dates of last transfusion and death in patients enrolled and not enrolled in hospice...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28155184/blood-product-transfusion-in-emergency-department-patients-a-case-control-study-of-practice-patterns-and-impact-on-outcome
#20
Alexander Beyer, Ryan Rees, Christopher Palmer, Brian T Wessman, Brian M Fuller
BACKGROUND: Blood product transfusion occurs in a significant percentage of intensive care unit (ICU) patients. Pulmonary complications, such as acute respiratory distress syndrome (ARDS), occurring in the setting of transfusion, are associated with increased morbidity and mortality. Contrary to the ICU setting, there is little evidence describing the epidemiology of transfusion in the emergency department (ED) or its potential impact on outcome. The objectives of this study were to: (1) characterize transfusion practices in the ED with respect to patient characteristics and pre-transfusion laboratory values; and (2) investigate the effect of ED blood product transfusion on the incidence of pulmonary complications after admission...
December 2017: International Journal of Emergency Medicine
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