Current opinion in hematology
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Curr. Opin. Hematol. · Nov 2005
ReviewPretransfusion trigger platelet counts and dose for prophylactic platelet transfusions.
To assess critically both the blood platelet counts that prompt a platelet transfusion (i.e. trigger) in various clinical settings in patients with thrombocytopenia caused by marrow failure and the dose of platelets infused (i.e. number per each transfusion) for optimal hemostasis, feasibility, and safety. ⋯ Reasonable clinical practice, until more definitive data become available, is to transfuse enough platelets per each transfusion to maintain the blood platelet count >10 x 10/L in stable nonbleeding patients, >20 x 10(9)/L in unstable nonbleeding patients, and >50 x 10(9)/L in bleeding patients or in those undergoing invasive procedures.
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Transfusion-related acute lung injury is an uncommon complication of blood transfusion typically manifested by shortness of breath, fever, and hypotension. Transfusion-related acute lung injury is an important cause of transfusion-related morbidity and mortality. ⋯ In this report, what is known about transfusion-related acute lung injury is summarized with particular emphasis on recent studies. Some of the areas in which knowledge and/or consensus are currently lacking are identified.
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Massive blood transfusion saves the lives of thousands of severely injured patients each year, but it does so in the context of the evolving epidemiology of injury, of trauma centers and trauma systems, and of blood safety and new technologies for hemorrhage control. This article reviews recent knowledge and advances that impact on the use and effectiveness of massive transfusion. ⋯ Injury is a major public health and medical system problem. Progress in basic science, clinical care, and the development of better hemorrhage control devices are all improving outcome for massively transfused patients. Investment in trauma care and supporting blood supply systems is highly cost effective.