Transfus Apher Sci
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Multicenter Study
Change in transfusion practice in massively bleeding patients.
This retrospective study evaluates changes in transfusion practice and modified blood product utilisation that occurred over the course of eleven years in patients receiving massive transfusion. The mean number of fresh frozen plasma units transfused increased from 9.0 ± 7.9 in 1998 to 11.3 ± 6.7 in 2008 (p=0.03). ⋯ The proportion of cryoprecipitate increased from 0.03 ± 0.19 in 1998 to 1.3 ± 1.6 in 2008 (p=0.001). Along with these changes was a trend toward decreased mortality (p=0.05).
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Case Reports
Treatment of status epilepticus with plasmapheresis in a patient with thrombotic thrombocytopenic purpura.
Thrombotic thrombocytopenic purpura (TTP) is a syndrome with numerous neurological manifestations including altered mental status and seizures. However, status epilepticus (SE) has rarely been reported in this condition. Signs may be transient or fluctuate; however, permanent deficits do occur. ⋯ Since the introduction of plasma infusions and exchanges, the prognosis of the disease has improved dramatically; remissions now occur in 80-90% of patients. Altered mental status in TTP often resolves with plasmapheresis. Likewise, we successfully treated a patient with thrombotic thrombocytopenic purpura (TTP) with pronounced clinical effects of status epilepticus with plasmapheresis and steroid treatment.