Transfus Apher Sci
-
Ammonia concentration increases in red cell units (RBCs) during storage. We measured absolute amounts of ammonia (AA) per unit serially in stored RBCs and before and after removal of the supernatant by volume reduction (VR) or washing. ⋯ VR decreased AA 3.7-fold, whereas washing decreased it 38-fold (p<0.0001). At least for certain patients, e.g., infants receiving large volume transfusions and patients in liver failure, it may be advisable to use RBCs as fresh as possible and to limit infusion (by VR or washing) of ammonia in the supernatant.
-
Two decades of war in south-west Asia has demonstrated the essential role of primary resuscitation with blood products in the care of critically injured soldiers. This idea has been widely adopted and is being critically tested in civilian trauma centers. The need for red cells, plasma and platelets to be immediately available in remote locations creates a logistic burden that will best be eased by innovative new blood products such as longer-stored liquid RBCs, freeze-dried plasma, small-volume frozen platelets, and coagulation factor concentrates such as fibrinogen concentrates and prothrombin complex concentrates. ⋯ It also will allow treatment in other austere environments such as the hundreds of small hospitals in the US which serve as Levels 3 and 4 trauma centers but do not currently have thawed plasma or platelets available. Such small trauma centers currently care for half of all the trauma patients in the country. Proving the new generation of blood products work, will help assure their widest availability in emergencies.
-
The 7/1/2007 bridge collapse into the Mississippi River was instructional from both a disaster response and a mass casualty transfusion response perspective. It is a well cited example of how community disaster response coordination can work well, especially following systematic preparation of an integrated response network. The blood center is and should be an integral part of this disaster response and should be included in drills where appropriate. We give personal perspectives on both the hospital and transfusion service response to this particularly dramatic event.
-
Randomized Controlled Trial
Effectiveness of oral Tranexamic acid administration on blood loss after knee artroplasty: a randomized clinical trial.
Some studies have proved that Tranexamic acid infusion is associated with a decrease in blood loss during and after surgery. Due to the availability of an oral form of the drug, the rapid and complete absorption of it and ease of administration without need for specific instruments, we evaluated the effectiveness of the oral form in decreasing blood loss after total knee arthroplasty. ⋯ Prescription of oral Tranexamic acid before knee arthroplasty can cause remarkable decrease in blood loss after surgery and also less decrease in hematocrit. The advantages of the oral route of the drug versus the intravenous form is that it can be used routinely as a safe and effective way to decrease bleeding after surgery.
-
The patients' hemodynamic conditions of septic shock due to intra-abdominal infection were improved by the longer duration of direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX), reducing plasma endotoxins measured by the novel endotoxin detection method, named endotoxin scattering photometry (ESP) method; however, turbidimetric method could not detect endotoxins. We also observed the reduction in the endotoxin after passing through column by ESP method even after the longer duration of PMX. ESP method may more sensitively detect endotoxins than the ordinary turbidimetric method. Moreover, we demonstrated the ability of endotoxin adsorption in spite of the longer duration of PMX.