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https://www.readbyqxmd.com/read/29208320/efficacy-of-a-massive-transfusion-protocol-for-hemorrhagic-trauma-resuscitation
#1
George Lim, Katrina Harper-Kirksey, Ram Parekh, Alex F Manini
OBJECTIVES: New paradigm shifts in trauma resuscitation recommend that early reconstitution of whole blood ratios with massive transfusion protocols (MTP) may be associated with improved survival. We performed a preliminary study on the efficacy of MTP at an urban, Level 1 trauma center and its impact on resuscitation goals. METHODS: A case-control study was performed on consecutive critically-ill trauma patients over the course of 1 year. The trauma captain designated patients as either MTP activation (cases) or routine care without MTP (controls) in matched, non-randomized fashion...
November 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29205497/the-use-of-preoperative-aspirin-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#2
REVIEW
Sleiman Sebastian Aboul-Hassan, Tomasz Stankowski, Jakub Marczak, Maciej Peksa, Marcin Nawotka, Ryszard Stanislawski, Bartosz Kryszkowski, Romuald Cichon
BACKGROUND: Despite the fact that aspirin is of benefit to patients following coronary artery bypass grafting (CABG), continuation or administration of preoperative aspirin before CABG or any cardiac surgical procedure remains controversial. Therefore, we performed a systematic review and meta-analysis to assess the influence of preoperative aspirin administration on patients undergoing cardiac surgery. MATERIALS AND METHODS: Medline database was searched using OVID SP interface...
December 3, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29203201/combat-related-acetabular-fractures-outcomes-of-open-versus-closed-injuries
#3
Richard L Purcell, Michael A Donohue, Sameer K Saxena, Wade T Gordon, Louis L Lewandowski
INTRODUCTION: Since the onset of the Global War on Terror close to 50,000 United States service members have been injured in combat, many of these injuries would have previously been fatal. Among these injuries, open acetabular fractures are at an increased number due to the high percentage of penetrating injuries such as high velocity gunshot wounds and blast injuries. These injuries lead to a greater degree of contamination, and more severe associated injuries. There is a significantly smaller proportion of the classic blunt trauma mechanism typically seen in civilian trauma...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29189567/transfusion-of-red-blood-cells-stored-more-than-28-days-is-associated-with-increased-morbidity-following-spine-surgery
#4
Taylor E Purvis, C Rory Goodwin, Camilo A Molina, Steven M Frank, Daniel M Sciubba
STUDY DESIGN: Retrospective study. OBJECTIVE: To describe the association between storage duration of packed red blood cells (PRBCs) and perioperative adverse events in patients undergoing spine surgery at a tertiary care center. SUMMARY OF BACKGROUND DATA: Despite retrospective studies that have shown that longer PRBC storage duration worsens patient outcomes, randomized clinical trials have found no difference in outcomes. However, no studies have examined the impact of giving the oldest blood (28 days-old or more) on morbidity within spine surgery...
November 17, 2017: Spine
https://www.readbyqxmd.com/read/29176013/transfusion-associated-necrotizing-enterocolitis-in-preterm-infants-an-updated-meta-analysis-of-observational-data
#5
Parvesh Garg, Rachel Pinotti, C Vivek Lal, Ariel A Salas
BACKGROUND: The number of observational studies that report an association between packed red blood cell (PRBC) transfusions and necrotizing enterocolitis (NEC) has increased. The primary objective of this study was to evaluate the association between PRBC transfusions and NEC in observational studies. METHODS: Medline, Embase and Cochrane Library databases as well as the Pediatrics Academic Societies abstract archives were systematically searched to identify observational studies that investigated the association between PRBC transfusions and NEC...
November 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29162636/quantitative-proteomic-profiling-reveals-novel-plasmodium-falciparum-surface-antigens-and-possible-vaccine-candidates
#6
Sandra K Nilsson Bark, Rushdy Ahmad, Kathleen Dantzler, Amanda K Lukens, Mariana De Niz, Matthew J Szucs, Xiaojing Jin, Joanne Cotton, Dietmar Hoffmann, Eva Bric-Furlong, Ray Oomen, Mark Parrington, Dan Milner, Daniel E Neafsey, Steven A Carr, Dyann F Wirth, Matthias Marti
Despite recent efforts towards control and elimination, malaria remains a major public health problem worldwide. Plasmodium falciparum resistance against artemisinin, used in front line combination drugs, is on the rise, and the only approved vaccine shows limited efficacy. Combinations of novel and tailored drug and vaccine interventions are required to maintain the momentum of the current malaria elimination program. Current evidence suggests that strain-transcendent protection against malaria infection can be achieved using whole organism vaccination or with a polyvalent vaccine covering multiple antigens or epitopes...
November 21, 2017: Molecular & Cellular Proteomics: MCP
https://www.readbyqxmd.com/read/29140831/relative-efficacies-of-hboc-201-and-polyheme-to-increase-oxygen-transport-compared-to-blood-and-crystalloids-2017-military-supplement
#7
Gregory P Dubé, Arkadiy N Pitman, Colin F Mackenzie
BACKGROUND: Because total hemoglobin in circulation ([THb]) is an established predictor of clinical outcomes in anemic individuals, the relative efficacies of resuscitation fluids to increase [THb] can be used to design better hemoglobin-based oxygen carrier (HBOC) clinical trials. METHODS: Expected efficacies of HBOC-201 (13 g Hb/dL) and packed RBCs (pRBCs, 24 g Hb/dL) to increase [THb] were calculated and interpreted in the context of SAEs in the HEM-0115 phase III clinical trial...
November 14, 2017: Shock
https://www.readbyqxmd.com/read/29140548/a-phase-ib-open-label-single-arm-study-to-assess-the-safety-pharmacokinetics-and-impact-on-humoral-sensitization-of-sanguinate-infusion-in-patients-with-end-stage-renal-disease
#8
Bassam G Abu Jawdeh, E Steve Woodle, Abbie D Leino, Paul Brailey, Simon Tremblay, Tonya Dorst, Mouhamad H Abdallah, Amit Govil, Daniel Byczkowski, Hemant Misra, Abraham Abuchowski, Rita R Alloway
The endeavor to study desensitization in kidney transplantation hasn't been matched by an effort to investigate strategies to prevent sensitization. In this study (NCT02437422), we investigated the safety, impact on sensitization and pharmacokinetics of SANGUINATE (SG), a hemoglobin-based oxygen carrier, as a potential alternative to packed red blood cells (PRBC) in transplant candidates with end-stage renal disease (ESRD). Ten ESRD subjects meeting inclusion/exclusion (I/E) criteria were planned to receive 3 weekly infusions of SG (320mg/Kg)...
November 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29122112/prehospital-transfusion-for-gastrointestinal-bleeding
#9
Maile E Parker, Mohammad A Khasawneh, Cornelius A Thiels, Kathleen S Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
OBJECTIVE: Gastrointestinal (GI) bleeding is a common medical emergency with significant morbidity and mortality. Many patients are coagulopathic, which may perpetuate bleeding. Remote damage control resuscitation, including early correction of coagulopathy and anemia, may benefit exsanguinating patients with GI bleeding. METHODS: We conducted a retrospective review of patients with acute GI bleeding who received packed red blood cells (pRBC) and/or plasma during transportation to our institution between 2010 and 2014...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29099397/implementation-of-a-blood-management-program-at-a-tertiary-care-hospital-effect-on-transfusion-practices-and-clinical-outcomes-among-patients-undergoing-surgery
#10
Faiz Gani, Marcelo Cerullo, Aslam Ejaz, Pranjal B Gupta, Vincent M Demario, Fabian M Johnston, Steven M Frank, Timothy M Pawlik
BACKGROUND: Patient blood management (PBM) programs represent a perioperative bundle of care that aim to reduce or eliminate unnecessary transfusions. OBJECTIVE: To evaluate the impact of a PBM program on transfusion practices and clinical outcomes at a single surgical department at a tertiary care hospital in the United States. METHODS: This pre-post, cross-sectional study was performed using data from 17,114 patients undergoing gastrointestinal surgery between 2010 and 2013...
November 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29078906/early-thromboprophylaxis-with-low-molecular-weight-heparin-is-safe-in-patients-with-pelvic-fracture-managed-nonoperatively
#11
Faisal Jehan, Terence O'Keeffe, Muhammad Khan, Albert Chi, Andrew Tang, Narong Kulvatunyou, Lynn Gries, Bellal Joseph
INTRODUCTION: Early initiation of thromboprophylaxis is highly desired in pelvic fracture patients, but it is often delayed due to the fear of hemorrhage. Aim of our study was to assess the safety of early initiation of venous thromboprophylaxis in patients with pelvic trauma managed nonoperatively. METHODS: Three-year (2010-2012) retrospective study of trauma patients with pelvic fractures who were managed nonoperatively and received thromboprophylaxis with low-molecular-weight heparin (LMWH)...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29077977/packed-red-blood-cell-transfusion-in-older-adults-a-systematic-review
#12
Allison R Jones, Gwen McGhan, Jill Deaver
Most packed red blood cell (PRBC) transfusion research focuses on younger patient populations (younger than 65) given the complexity of care and presence of comorbidities in older adults. The purpose of the current study was to critically examine the current evidence related to PRBC transfusion among older adults (age ≥65). PubMed, CINAHL, and Embase were searched for randomized controlled trials that evaluated blood transfusion in any manner (e.g., prevention, associated outcomes). Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the search resulted in 10 studies focused on cardiac, orthopedic, and gastrointestinal surgery patients...
October 27, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29068791/transfusion-associated-necrotizing-enterocolitis-re-evaluated-a-systematic-review-and-meta-analysis
#13
Stientje Esther Rai, Amneet Kaur Sidhu, Rohin Jayaram Krishnan
CONTEXT: Significant controversy exists surrounding the possible association between recent packed red blood cell (PRBC) transfusion and the subsequent development of necrotizing enterocolitis (NEC) in infants. Previous studies and meta-analyses reporting a statistically significant association led to a practice change to withhold enteral feeds in the peri-transfusion period in many centers in an effort to prevent NEC; however, results from more recent studies do not support the existence of an association and, thus, question the validity of this practice change...
October 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29059104/transfusion-strategies-are-associated-with-epigenetic-changes-following-blunt-trauma
#14
Martin Sillesen, Yongqing Li, Hasan B Alam
INTRODUCTION: Epigenetics has been identified in multiple diseases. The effect of transfusion strategy on epigenetics is unknown. We hypothesized that expression of epigenetic regulating genes would be associated with resuscitation strategy following blunt trauma. METHODS: Retrospective study using the inflammation in host response to injury (glue grant) dataset. Volume transfused over 24 hours of packed red blood cells (PRBC), Fresh Frozen Plasma(FFP), Platelets(PLT) as well as crystalloids was extracted along with leucocyte microarray data of genes with known epigenetic modulating activity from day 1 after injury...
October 20, 2017: Shock
https://www.readbyqxmd.com/read/29050713/is-preoperative-fibrinogen-testing-associated-with-total-blood-loss-in-adolescent-idiopathic-scoliosis-correction
#15
Matthew J Geck, Devender Singh, Holly Gunn, John K Stokes, Eeric Truumees
STUDY DESIGN: Retrospective analysis. OBJECTIVE: This study sought to investigate the potential association between preoperative fibrinogen, bleeding, and transfusion requirements in adolescent idiopathic scoliosis (AIS) corrections. SUMMARY OF BACKGROUND DATA: Blood loss after major spinal reconstruction increases the risks and costs of surgery. Preoperative fibrinogen levels may predict intra- and postoperative blood loss. METHODS: Data were collected from clinic charts and hospital medical records of all 110 of a single surgeon's consecutive AIS patients undergoing greater than three-level deformity correction surgeries from January 2011 to December 2013...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29045442/a-semi-synthetic-glycosaminoglycan-analogue-inhibits-and-reverses-plasmodium-falciparum-cytoadherence
#16
Mark A Skidmore, Khairul Mohd Fadzli Mustaffa, Lynsay C Cooper, Scott E Guimond, Edwin A Yates, Alister G Craig
A feature of mature Plasmodium falciparum parasitized red blood cells is their ability to bind surface molecules of the microvascular endothelium via the parasite-derived surface protein Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1). This ligand is associated with the cytoadherence pathology observed in severe malaria. As pRBC treated with effective anti-malarial drugs are still able to cytoadhere, there is therefore a need to find an adjunct treatment that can inhibit and reverse the adhesion process...
2017: PloS One
https://www.readbyqxmd.com/read/29037202/high-prevalence-of-very-low-plasmodium-falciparum-and-plasmodium-vivax-parasitaemia-carriers-in-the-peruvian-amazon-insights-into-local-and-occupational-mobility-related-transmission
#17
Gabriel Carrasco-Escobar, Julio Miranda-Alban, Carlos Fernandez-Miñope, Kimberly C Brouwer, Katherine Torres, Maritza Calderon, Dionicia Gamboa, Alejandro Llanos-Cuentas, Joseph M Vinetz
BACKGROUND: The incidence of malaria due both to Plasmodium falciparum and Plasmodium vivax in the Peruvian Amazon has risen in the past 5 years. This study tested the hypothesis that the maintenance and emergence of malaria in hypoendemic regions such as Amazonia is determined by submicroscopic and asymptomatic Plasmodium parasitaemia carriers. The present study aimed to precisely quantify the rate of very-low parasitaemia carriers in two sites of the Peruvian Amazon in relation to transmission patterns of P...
October 16, 2017: Malaria Journal
https://www.readbyqxmd.com/read/29017765/accuracy-of-shock-index-versus-abc-score-to-predict-need-for-massive-transfusion-in-trauma-patients
#18
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/28988067/the-effect-of-resuscitation-strategy-on-the-longitudinal-immuno-inflammatory-response-to-blunt-trauma
#19
Alexander Bonde, Ask Tybjærg Nordestgaard, Rasmus Kirial, Peter Svenningsen, Martin Sillesen
INTRODUCTION: Resuscitation strategies following blunt trauma have been linked to immuno-inflammatory complications leading to systemic inflammatory syndrome (SIRS), sepsis and multiple organ failure (MOF). The effect of resuscitation strategy on longitudinal inflammation marker trajectories is, however, unknown. We hypothesized that the effect of resuscitation strategy extends beyond the trauma-related coagulopathy, perhaps affecting the longitudinal immuno-inflammatory response to injury...
September 28, 2017: Injury
https://www.readbyqxmd.com/read/28985912/patterns-of-vasopressor-utilization-during-the-resuscitation-of-massively-transfused-trauma-patients
#20
Galinos Barmparas, Navpreet K Dhillon, Eric Jt Smith, Russell Mason, Nicolas Melo, Gretchen M Thomsen, Daniel R Margulies, Eric J Ley
BACKGROUND: The use of vasopressors (VP) in the resuscitation of massively transfused trauma patients might be considered a marker of inadequate resuscitation. We sought to characterize the utilization of VP in patients receiving massive transfusion and examine the association of their use with mortality. METHODS: Trauma patients admitted from January 2011 to October 2016 receiving massive transfusion, defined as 3 units of pRBC within the first hour from admission, were selected for analysis...
September 27, 2017: Injury
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