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Joyce Mendes Soares, Athos Gabriel Vilela Queiroz, Vaniely Kaliny Pinheiro de Queiroz, Ana Rodrigues Falbo, Marcelo Neves Silva, Tania Cursino de Menezes Couceiro, Luciana Cavalcanti Lima
INTRODUCTION: Blood is an important resource in several lifesaving interventions, such as anemia correction and improvement of oxygen transport capacity. Despite advances, packed red blood cell (PRBC) transfusion still involves risks. The aim of this study was to describe the knowledge of anesthesiologists about the indications, adverse effects, and alternatives to red blood cell transfusion intraoperatively. METHOD: Cross-sectional study using a questionnaire containing multiple choice questions and clinical cases related to relevant factors on the decision whether to perform PRBC transfusion, its adverse effects, hemoglobin triggers, preventive measures, and blood conservation strategies...
October 10, 2016: Revista Brasileira de Anestesiologia
Madhuradhar Chegondi, Jun Sasaki, André Raszynski, Balagangadhar R Totapally
OBJECTIVE: To evaluate the hemoglobin threshold for red cell transfusion in children admitted to a pediatric intensive care unit (PICU). METHODS: Retrospective chart review study. Tertiary care PICU. Critically ill pediatric patients requiring blood transfusion. No intervention. RESULTS: We analyzed the charts of all children between 1 month and 21 years of age who received packed red blood cell (PRBC) transfusions during a 2-year period. The target patients were identified from our blood bank database...
July 2016: Transfusion Medicine and Hemotherapy
Joana Marques, Juan José Valle-Delgado, Patricia Urbán, Elisabet Baró, Rafel Prohens, Alfredo Mayor, Pau Cisteró, Michael Delves, Robert E Sinden, Christian Grandfils, José L de Paz, José A García-Salcedo, Xavier Fernàndez-Busquets
The adaptation of existing antimalarial nanocarriers to new Plasmodium stages, drugs, targeting molecules, or encapsulating structures is a strategy that can provide new nanotechnology-based, cost-efficient therapies against malaria. We have explored the modification of different liposome prototypes that had been developed in our group for the targeted delivery of antimalarial drugs to Plasmodium-infected red blood cells (pRBCs). These new models include: (i) immunoliposome-mediated release of new lipid-based antimalarials; (ii) liposomes targeted to pRBCs with covalently linked heparin to reduce anticoagulation risks; (iii) adaptation of heparin to pRBC targeting of chitosan nanoparticles; (iv) use of heparin for the targeting of Plasmodium stages in the mosquito vector; and (v) use of the non-anticoagulant glycosaminoglycan chondroitin 4-sulfate as an heparin surrogate for pRBC targeting...
October 5, 2016: Nanomedicine: Nanotechnology, Biology, and Medicine
Sleiman Sebastian Aboul-Hassan, Tomasz Stankowski, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether continuation of administration of preoperative aspirin until the day of coronary artery bypass grafting (CABG) could minimize postoperative mortality, prevalence of postoperative myocardial infarction (MI) with or without influence on postoperative bleeding, packed red blood cell (PRBC) transfusion and reoperation for bleeding. Altogether, 662 papers were found using the reported search, 7 of which represented the best evidence to answer the clinical question...
October 4, 2016: Interactive Cardiovascular and Thoracic Surgery
Gaya Spolverato, Fabio Bagante, Matthew Weiss, Jin He, Christopher L Wolfgang, Fabian Johnston, Martin A Makary, Will Yang, Steven M Frank, Timothy M Pawlik
BACKGROUND: Delta hemoglobin (ΔHb) is defined as the difference between the preoperative Hb and the lowest post-operative Hb level. We sought to define the impact of ΔHb relative to nadir Hb levels on the likelihood of transfusion, as well as characterize the impact of ΔHb and nadir Hb on morbidity among a large cohort of patients undergoing complex hepatopancreatobiliary (HPB) surgery. METHODS: Patients who underwent pancreatic or hepatic resection between January 1, 2009 and June 30, 2015 at Johns Hopkins Hospital were identified...
September 30, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ernest Moles, Kirsten Moll, Jun-Hong Ch'ng, Paolo Parini, Mats Wahlgren, Xavier Fernàndez-Busquets
Parasite proteins exported to the surface of Plasmodium falciparum-parasitized red blood cells (pRBCs) have a major role in severe malaria clinical manifestation, where pRBC cytoadhesion and rosetting processes have been strongly linked with microvascular sequestration while avoiding both spleen filtration and immune surveillance. The parasite-derived and pRBC surface-exposed PfEMP1 protein has been identified as one of the responsible elements for rosetting and, therefore, considered as a promising vaccine candidate for the generation of rosette-disrupting antibodies against severe malaria...
November 10, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Bikram Shrestha, Bernard Kim, Alison Huffstetler
MALT: Mucosa-associated lymphoid tissue (MALT)-type lymphoma is a relatively rare disease; nevertheless, it is the third most common lymphoma type, accounting for 5-7% of all non-Hodgkin lymphomas. Case series and retrospective analysis published in the literature have suggested that extra gastrointestinal (GI) MALT-type lymphoma can occur simultaneously with MALT-type lymphoma involving the GI tract. We report the case of a healthy, 64-year-old Caucasian male who presented with progressive fatigue, non-productive cough, and worsening exertional shortness of breath for 3 months who was subsequently diagnosed with gastric extra-nodal marginal zone B-cell lymphoma or MALToma with simultaneous metastasis to the lung (bronchi) based on biopsy reports...
2016: Journal of Community Hospital Internal Medicine Perspectives
Mathew D Schur, Gideon W Blumstein, Derek A Seehausen, Patrick A Ross, Lindsay M Andras, David L Skaggs
BACKGROUND: Intraoperative hypothermia may be associated with increased blood loss due to the effects of temperature on clotting but this has not been evaluated in the setting of pediatric posterior spinal fusion (PSF). The purpose of this study was to determine if a correlation exists between intraoperative hypothermia and estimated blood loss (EBL) or transfusion requirements in pediatric patients undergoing PSF. METHODS: A retrospective review of consecutive patients undergoing PSF for scoliosis at a single institution between 6/2004 and 3/2012 was performed...
September 3, 2016: Journal of Pediatric Orthopedics
Brandon W Godfrey, Ashley Martin, Paul J Chestovich, Gordon H Lee, Nichole K Ingalls, Vilas Saldanha
INTRODUCTION: Improvised Explosive Devices (IED) are the primary wounding mechanism for casualties in Operation Enduring Freedom. Patients can sustain devastating traumatic amputations, which are unlike injuries seen in the civilian trauma sector. This is a database analysis of the largest patient registry of multiple traumatic amputations. METHODS: The Joint Theater Trauma Registry was queried for patients with a traumatic amputation from 2009 to 2012. Data obtained included the Injury Severity Score (ISS), Glasgow Coma Score (GCS), blood products, transfer from theatre, and complications including DVT, PE, infection (Acinetobacter and fungal), acute renal failure, and rhabdomyolysis...
August 17, 2016: Injury
Shannon N Acker, Brianne Hall, Lauren Hill, David A Partrick, Denis D Bensard
Introduction In the adult population, assessment of blood consumption (ABC) score [penetrating mechanism, positive focused assessment sonography for trauma (FAST), systolic blood pressure < 90, and heart rate (HR) > 120] ≥2 identifies trauma patients who require massive transfusion (MT) with sensitivity and specificity of 75 and 86%. We hypothesized that the adult criteria cannot be applied to children, as the vital sign cut-offs are not age-adjusted. We aimed to determine if the use of a shock index, pediatric age-adjusted (SIPA) would improve the discriminate ability of the ABC score in children...
August 17, 2016: European Journal of Pediatric Surgery
Maria Del Pilar Quintana, Davide Angeletti, Kirsten Moll, Qijun Chen, Mats Wahlgren
BACKGROUND: Individuals living in endemic areas gradually acquire natural immunity to clinical malaria, largely dependent on antibodies against parasite antigens. There are many studies indicating that the variant antigen PfEMP1 at the surface of the parasitized red blood cell (pRBC) is one of the major targets of the immune response. It is believed that antibodies against PfEMP1 confer protection by blocking sequestration (rosetting and cytoadherence), inducing antibody-dependent cellular-inhibitory effect and opsonizing pRBCs for phagocytosis...
2016: Malaria Journal
Petra M Meier, David Zurakowski, Susan M Goobie, Mark R Proctor, John G Meara, Vanessa J Young, Gary F Rogers, James A DiNardo
BACKGROUND: Operative treatment of craniosynostosis is associated with substantial blood loss, often requiring transfusion of packed red blood cells (PRBC) and coagulation products. AIMS: The aim of this prospective study was to analyze thromboelastographic (TEG) parameters and platelet fibrinogen product to determine predictors of substantial blood loss, and the need for PRBC transfusion and coagulation products. METHODS: With IRB approval, we enrolled 120 children undergoing craniosynostosis repair with a standardized anesthetic, fluid management, and TEG measurements at predefined times...
October 2016: Paediatric Anaesthesia
Jorge Mena-Munoz, Udayan Srivastava, Christian Martin-Gill, Brian Suffoletto, Clifton W Callaway, Francis X Guyette
BACKGROUND: Civilian out-of-hospital transfusions have not been adequately studied. This study seeks to characterize patients receiving out-of-hospital blood product transfusion during critical care transport. STUDY DESIGN AND METHODS: We studied patients transported by a regional critical care air-medical service who received blood products during transport. This service carries two units of uncrossmatched packed Red Blood Cells (pRBCs) on every transport in addition to blood obtained from referring facilities...
September 2016: Prehospital Emergency Care
Katherine Baysinger, Merry E Barnett, Mickey Ott, William Bromberg, Katherine Mcbride, Lynne Thompson, Gretchen Goodman, Eric Shaw, James Dunne
Transfusion ratios approaching 1:1:1 of packed red blood cells (PRBCs) to fresh frozen plasma (FFP) to platelet have been shown to improve outcomes in trauma. There is little data available to describe in what quantity that ratio should be delivered. We hypothesized that lowering the total volume of products delivered in each protocol round would not adversely affect outcomes in the bleeding trauma patient. A retrospective review of 9732 trauma patients admitted to a rural Level I trauma center over a 3-year period was performed...
July 2016: American Surgeon
Raphael Stehrer, Stefan Hunger, Klaus-Jürgen Schotten, Babak Parsaei, Michael Malek, Matthias Jacob, Gertraud Geiselseder, Jens Meier
BACKGROUND AND OBJECTIVES: Craniosynostosis surgery is often associated with severe perioperative bleeding especially due to venae emissariae, resulting in large transfusion amounts of packed red blood cells (PRBCs). Blood loss from venae emissariae is usually reduced by the usage of bone wax. SeraSeal is a new hemostatic agent which might help to reduce transfusion amounts if used additionally to bone wax. MATERIALS AND METHODS: This study was designed with a retrospective control group (23 children), treated only with bone wax and a consecutive prospective verum group (12 children) treated additionally with SeraSeal...
September 2016: Journal of Cranio-maxillo-facial Surgery
Gregory Barshtein, Axel R Pries, Neta Goldschmidt, Ayelet Zukerman, Ariel Orbach, Orly Zelig, Dan Arbell, Saul Yedgar
OBJECTIVE: There is growing concern regarding the risks in the transfusion of packed red blood cells (PRBC), as numerous studies have reported negative transfusion outcomes, including reduced blood perfusion. In search of this phenomenon's mechanism, the effect of PRBC deformability, a major determinant of blood flow, on transfusion outcome was explored. METHODS: The effect of PRBC deformability was examined by the transfusion-induced change in recipients' skin blood flow (∆SBF), in β-Thalassemia-Major patients, who are routinely treated with life-long frequent transfusions...
July 12, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Alex L Chang, Richard S Hoehn, Peter Jernigan, Daniel Cox, Martin Schreiber, Timothy A Pritts
BACKGROUND: During storage, packed red blood cells (pRBCs) undergo a number of biochemical, metabolic, and morphologic changes, collectively known as the "storage lesion." We aimed to determine the effect of cryopreservation on the red blood cell storage lesion compared with traditional 4°C storage. METHODS: Previously cryopreserved human pRBCs were compared with age-matched never-frozen pRBCs obtained from the local blood bank. The development of the red cell storage lesion was evaluated after 7, 14, 21, 28, and 42 days of storage at 4°C in AS-3 storage medium...
September 2016: Shock
Richard S Hoehn, Peter L Jernigan, Alex L Chang, Michael J Edwards, Charles C Caldwell, Erich Gulbins, Timothy A Pritts
BACKGROUND/AIMS: During storage, units of human red blood cells (pRBCs) experience membrane destabilization and hemolysis which may cause harm to transfusion recipients. This study investigates whether inhibition of acid sphingomyelinase could stabilize erythrocyte membranes and prevent hemolysis during storage. METHODS: Human and murine pRBCs were stored under standard blood banking conditions with and without the addition of amitriptyline, a known acid sphingomyelinase inhibitor...
2016: Cellular Physiology and Biochemistry
Helmuth Tauber, Werner Streif, Josef Fritz, Helmut Ott, Guenter Weigel, Lorin Loacker, Anneliese Heinz, Corinna Velik-Salchner
OBJECTIVE: Patients requiring extracorporeal membrane oxygenation (ECMO) have a well-known bleeding risk and the potential for experiencing possibly fatal thromboembolic complications. Risk factors and predictors of transfusion requirements during ECMO support remain uncertain. The authors hypothesized that compromised organ function immediately before ECMO support will influence transfusion requirements. DESIGN: A prospective observational study. SETTING: A tertiary, single-institutional university hospital...
June 2016: Journal of Cardiothoracic and Vascular Anesthesia
James Milligan, Anna Lee, Martin Gill, Andrew Weatherall, Chloe Tetlow, Alan A Garner
INTRODUCTION: Prehospital transfusion of packed red blood cells (PRBC) may be life saving for hypovolaemic trauma patients. PRBCs should preferably be warmed prior to administration but practical prehospital devices have only recently become available. The effectiveness of purpose designed prehospital warmers compared with previously used improvised methods of warming has not previously been described. MATERIALS AND METHODS: Expired units of PRBCs were randomly assigned to a warming method in a bench study...
August 2016: Injury
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