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https://www.readbyqxmd.com/read/29443862/red-tides-mass-casualty-and-whole-blood-at-sea-red-tides
#1
Benjamin T Miller, Andrew H Lin, Susan C Clark, Andrew P Cap, Joseph J Dubose
BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP)...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29443859/over-resuscitation-with-plasma-is-associated-with-sustained-fibrinolysis-shutdown-and-death-in-pediatric-traumatic-brain-injury
#2
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29433864/leukoreduction-of-packed-red-blood-cells-attenuates-proinflammatory-properties-of-storage-derived-microvesicles
#3
Jillian R Richter, Jeffrey M Sutton, Phillip Hexley, Taylor A Johannigman, Alex B Lentsch, Timothy A Pritts
BACKGROUND: Leukoreduction prior to packed red blood cell (pRBC) storage is not a universally accepted practice. Our laboratory has previously shown that microvesicles (MVs) accumulate in pRBC units during storage and play an important role in lung injury after resuscitation. Currently, the effect of leukoreduction on MV formation in stored pRBC units is unknown. In the present study, we investigated the hypothesis that leukoreduction of pRBC units prior to storage would attenuate the production of MVs and decrease pulmonary inflammation after hemorrhage and resuscitation...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29432891/estimation-of-achievable-oxygen-consumption-following-transfusion-with-rejuvenated-red-blood-cells
#4
Amudan J Srinivasan, Kyle Kausch, Collin Inglut, Alan Gray, Matthew Landrigan, Jessica L Poisson, Jacob N Schroder, Ian J Welsby
OBJECTIVE: Erythrocyte storage induces a non-physiological increase in hemoglobin-oxygen affinity (quantified by low p50, the oxygen tension at 50% hemoglobin saturation), which can be restored through biochemical rejuvenation. The objective was to mathematically model the impact of transfusing up to three standard allogeneic units or rejuvenated units on oxygen delivery (DO 2 ) and oxygen consumption (VO 2 ). METHODS: Oxygen dissociation curves were generated from AS-1 RBC leukoreduced units (n = 7) before and after rejuvenation following manufacturer's instructions...
February 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29408558/outcomes-of-endoscopic-intervention-for-overt-gastrointestinal-bleeding-in-severe-thrombocytopenia
#5
Guilherme Piovezani Ramos, Moritz Binder, Paul Hampel, Manuel Bonfim Braga Neto, Dharma Sunjaya, Badr Al Bawardy, Barham K Abu Dayyeh, Navtej S Buttar, David H Bruining, Nayantara Coelho-Prabhu, Mark V Larson, Louis M Wong Kee Song, Elizabeth Rajan
BACKGROUND AND AIMS: Gastrointestinal bleeding (GIB) in the setting of thrombocytopenia raises concerns about endoscopic procedure risk. We aimed to assess the safety and outcomes of endoscopy for overt GIB in the setting of severe thrombocytopenia in liver cirrhosis (LC) and non-liver cirrhosis (NLC). METHODS: Retrospective study on inpatients who underwent endoscopy within 24-hours of presentation for overt GIB with a platelet count (PC) of 20 to <50 x 103/mL...
February 1, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29402623/association-of-red-blood-cell-transfusion-and-short-and-longer-term-mortality-after-coronary-artery-bypass-graft-surgery
#6
Hossam Tantawy, Alice Li, Feng Dai, Mohamed Elgammal, Nitin Sukumar, John Elefteriades, Shamsuddin Akhtar
OBJECTIVE: Red blood cell (RBC) transfusion has been linked to increased morbidity and mortality. However, strict RBC transfusion recommendations recently have been questioned. The aim of this study was to investigate the short- and long-term mortality outcomes after RBC transfusion in patients undergoing coronary artery bypass graft surgery (CABG). DESIGN: This was a retrospective medical record review. SETTING: Tertiary care academic medical center...
December 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29382561/optimal-timing-of-initiation-of-thromboprophylaxis-after-nonoperative-blunt-spinal-trauma-a-propensity-matched-analysis
#7
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Mohammad Hamidi, Michael Truitt, Muhammad Zeeshan, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: Patients with spinal trauma have the highest risk of a venous thromboembolism. While anticoagulation is recommended, its optimal timing is not well-defined. We aimed to assess the impact of early initiation of thromboprophylaxis in spinal trauma patients who were managed non-operatively. STUDY DESIGN: A 2-year (2013-2014) analysis of all isolated spinal-trauma patients managed non-operatively who received thromboprophylaxis in the TQIP. Patients were divided into two groups based on timing of initiation of thromboprophylaxis: Early (<48hours) and Late (≥48hours), and were matched in a 1:1 ratio using propensity score matching for demographics, admission vitals, injury severity, level of spine-injury and type of prophylaxis...
January 27, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29380052/immune-challenges-decrease-biliverdin-concentration-in-the-spleen-of-northern-bobwhite-quail-colinus-virginianus
#8
Melissa P Homsher, Michael T Astor, Justin K Hines, Michael W Butler
Most antioxidants have multiple functions; in addition to minimizing oxidative damage, many antioxidants have immune-modulating properties. For example, biliverdin is produced in the liver and spleen from the breakdown of heme, and has putative immune-suppressing and antioxidant properties. However, the majority of these properties have been investigated in vitro or in mammalian models, in which biliverdin reductase converts virtually all biliverdin to bilirubin. Thus, biliverdin's physiological roles remain largely untested...
January 29, 2018: Journal of Comparative Physiology. B, Biochemical, Systemic, and Environmental Physiology
https://www.readbyqxmd.com/read/29376251/-current-advance-in-cerebral-malaria
#9
Jian-Liang Li, Kai Li, Yuan Guo, Zheng Zhao, Li-Na Chen, Xiao-Hui Jiang, Yu-Jie Li, Ya Tu, Xiao-Jun Zheng
Cerebral malaria (CM), a severe neurological syndrome caused by Plasmodium falciparum infection, is a serious life-threatening disease with a high mortality. Survivors' persistent brain injury is manifested as long-term neurocognitive disorders. The main neuropathological feature of CM is the sequestration of parasited red blood cells (pRBCs) in cerebral microvessels. Other neuropathological features of CM include petechial hemorrhage in the brain parenchyma, annular hemorrhage, extensive brain endothelial cell activation, and focal endothelial cell injury and necrosis...
December 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29369239/rising-events-and-improved-outcomes-of-gastrointestinal-bleed-with-shock-in-usa-a-12-year-national-analysis
#10
Nauman S Siddiqui, Suman Paul, Zubair Khan, Toseef Javaid, Syed S Hasan, Zarmina Khan, Jamal Saleh, Douglas J Federman, Sadik Khuder, Ali Nawras
OBJECTIVE: Limited information is available based on single-center studies on trends of incidence and outcomes in gastrointestinal (GI) bleed with shock. METHODS: We analyzed data from 2002 to 2013 National Inpatient Sample. Using ICD-9 codes we identified 6.4 million hospital discharges of GI bleed from National Inpatient Sample database. Events were analyzed based on type of GI bleed, in-hospital mortality, hemodynamic status, and use of blood products. RESULTS: GI bleed with shock results in higher hospital mortality (20...
January 23, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29351595/propensity-matched-comparison-between-minimally-invasive-and-conventional-sternotomy-in-aortic-valve-resuspension
#11
Nadejda Monsefi, Petar Risteski, Aleksandra Miskovic, Andreas Zierer, Anton Moritz
OBJECTIVES: The aim of the study was to compare the results of David procedure through conventional or minimally invasive approach. METHODS: A propensity-matched comparison in patients undergoing a minimally invasive (partial upper sternotomy, n = 103) or complete sternotomy (n = 103) David procedure from 1991 to 2016 was performed. Patients were 57 ± 14 years old on average in both groups. The David technique was modified by generating a neosinus (P < 0...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29350594/determinants-of-perioperative-transfusion-risk-in-patients-with-adult-spinal-deformity
#12
Varun Puvanesarajah, Sandesh S Rao, Hamid Hassanzadeh, Khaled M Kebaish
OBJECTIVE To determine predictors of perioperative allogeneic packed red blood cell (pRBC) transfusion requirement (total units transfused) in patients with adult spinal deformity (ASD). METHODS The authors retrospectively analyzed records of patients aged 18 years or older who underwent surgical correction of ASD that involved 4 or more spinal levels by the same spine surgeon between 2010 and 2016. Data regarding patient characteristics, comorbidities, surgical factors, and perioperative transfusions (up to 10 days after surgery) were analyzed using a linear regression model...
January 19, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29349622/transfusion-practice-patterns-in-patients-with-anemia-receiving-myelosuppressive-chemotherapy-for-nonmyeloid-cancer-results-from-a-prospective-observational-study
#13
James Granfortuna, Kaye Shoffner, Stephen E DePasquale, Sejal Badre, Chet Bohac, Cisio De Oliveira Brandao
PURPOSE: The decision to prescribe packed red blood cell (PRBC) transfusions in patients with chemotherapy-induced anemia (CIA) includes assessment of clinical features such as the patient's cancer type and treatment regimen, severity of anemia symptoms, and presence of comorbidities. We examined contemporary transfusion practices in patients with nonmyeloid cancer and CIA. METHODS: Key inclusion criteria were age ≥ 18 years with nonmyeloid cancer, receiving first/second-line myelosuppressive chemotherapy, baseline hemoglobin (Hb) ≤ 10...
January 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29323760/donor-cd163-and-nestin-positive-cells-predict-graft-function-in-living-donor-liver-transplant
#14
Neha Nigam, Chhagan Bihari, Deepika Lal, Archana Rastogi, Senthil Kumar, Viniyendra Pamecha, Savneet Kaur, Anupam Kumar, Shiv K Sarin
AIMS: To evaluate the effect of donor liver resident mesenchymal cells, M2 macrophages on liver graft outcome after living donor liver transplantation. MATERIALS AND METHODS: 70 donor biopsies were included in the study. Outcomes at day 3, 7, 30 and 180 post liver transplantation were assessed. Mesenchymal stem cells and M2 macrophages in donor liver biopsies were evaluated. RESULTS: Mean age of recipients was 40.9 ± 13.6 years. Sex mismatched transplants were 44 (M→F=9; F→M=35)...
January 11, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29314246/balanced-blood-product-transfusion-during-liver-transplantation
#15
Rachel Hogen, Kiran Dhanireddy, Damon Clark, Subarna Biswas, Joseph DiNorcia, Niquelle Brown, Jonson Yee, J Perren Cobb, Aaron Strumwasser
INTRODUCTION: This study was conducted to determine whether an intra-operative ratio of at least 1:1:2 of fresh frozen plasma(FFP):platelets(PLTs):packed red blood cells (pRBCs) improves outcomes in orthotopic liver transplantation (OLT). METHODS: A single-center, retrospective study of deceased donor OLT recipients (MELD≥15) requiring intra-operative pRBC transfusion (years 2013-2016). Patients were grouped into those receiving an intra-operative ratio of ≥1:1:2 of FFP:PLTs:pRBCs versus ratios <1:1:2...
January 4, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29300196/mesenteric-oxygenation-changes-associated-with-necrotizing-enterocolitis-and-pneumoperitoneum-after-multiple-blood-transfusions-a-case-report
#16
Terri Marin, James E Moore
BACKGROUND: The multifactorial pathology and broad clinical presentation of necrotizing enterocolitis (NEC) development in premature infants make prediction of disease onset extremely challenging. Over the past decade, packed red blood cell (PRBC) transfusions have been temporally linked to the development of NEC in severely anemic preterm infants, although this issue is highly controversial. PURPOSE: In this case study, we describe events of an extremely low birth-weight infant who developed NEC complicated by pneumoperitoneum after receiving multiple PRBC transfusions...
January 3, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29298240/increased-risk-of-fibrinolysis-shutdown-among-severely-injured-trauma-patients-receiving-tranexamic-acid
#17
Jonathan P Meizoso, Roman Dudaryk, Michelle B Mulder, Juliet J Ray, Charles A Karcutskie, Sarah A Eidelson, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: The association between tranexamic acid (TXA) and fibrinolysis shutdown is unknown. We hypothesize that TXA is associated with fibrinolysis shutdown in critically injured trauma patients. METHODS: 218 critically injured adults admitted to the intensive care unit (ICU) at an urban level 1 trauma center from 08/2011-01/2015 who had thromboelastography performed upon ICU admission were reviewed. Groups were stratified based on fibrinolysis shutdown, which was defined as LY30<0...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29290073/implementation-of-trauma-center-and-massive-transfusion-protocol-improves-outcomes-for-major-trauma-patients-a-study-at-a-single-institution-in-korea
#18
Kyungjin Hwang, Junsik Kwon, Jayun Cho, Yunjung Heo, John Cook-Jong Lee, Kyoungwon Jung
BACKGROUND: This study evaluated the effectiveness and clinical outcomes of the implementation of a trauma center and massive transfusion protocol (TCMTP) in a developing country without a well-established trauma system. METHODS: We included patients (1) aged >15 years, (2) with an Injury Severity Score >15, (3) who received ≥10 units of packed red blood cells (PRBCs) within 24 h, (4) who directly visited our institution from 2010 to 2016, and (5) who survived for ≥24 h...
December 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29274443/gynecologic-bleeding-complications-in-post-menarchal-adolescent-females-on-anti-thrombotic-medications
#19
Heather Soni, Jennifer Kurkowski, Danielle Guffey, Jennifer E Dietrich, Lakshmi V Srivaths
INTRODUCTION: The prevalence, clinical features and management of gynecologic bleeding complications and health care provider awareness of these in post-menarchal adolescents on anti-thrombotic medications has rarely been addressed in the literature. We sought to review our experience in a pediatric tertiary care center addressing these issues. MATERIALS AND METHODS: A retrospective chart review was conducted with Institutional Review Board approval from 2004-2014, on eligible post-menarchal adolescents on antithrombotic medications...
December 20, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29261590/use-of-open-and-endovascular-surgical-techniques-to-manage-vascular-injuries-in-the-trauma-setting-a-review-of-the-aast-proovit-registry
#20
Edwin R Faulconer, Bernardino C Branco, Melissa N Loja, Kevin Grayson, James Sampson, Timothy C Fabian, John B Holcomb, Thomas Scalea, David Skarupa, Kenji Inaba, Nathaniel Poulin, Todd E Rasmussen, Joseph J Dubose
INTRODUCTION: Vascular trauma data have been submitted to the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Trial (PROOVIT) database since 2013. We present data to describe current use of endovascular surgery in vascular trauma. METHODS: Registry data from March 2013 to December 2016 were reviewed. All trauma patients who had an injury to a named artery, except the forearm and lower leg, were included. Arteries were grouped into anatomic regions and by compressible and non-compressible region for analysis...
December 20, 2017: Journal of Trauma and Acute Care Surgery
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