Transfusion
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, blinded trial comparing the hemostatic effects of pentastarch versus hetastarch.
HES solutions provide a sterile, alternative colloidal fluid to albumin solutions and/or plasma in the management of patients who need plasma volume expansion. Solutions of HES are widely accepted internationally but are used only modestly in the United States, largely because of concerns over hemostasis. ⋯ Solutions of hetastarch produce significant abnormalities of some hemostasis laboratory results when infused at clinically relevant doses, but it is unlikely that the modest hemostatic abnormalities produced at these doses per se would lead to clinical bleeding. Hetastarch causes greater hemostatic abnormalities than pentastarch, and because both HES solutions have comparable plasma volume-expanding effects, it is reasonable to prefer pentastarch as a plasma volume expander.
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Review Multicenter Study
Clinical significance of RBC alloantibodies and autoantibodies in sickle cell patients who received transfusions.
The clinical significance of alloimmunization to RBC antigens in sickle cell patients was analyzed by a retrospective review of the records of pediatric and adult sickle cell patients who received transfusions and who were followed over a 10-year period. ⋯ The alloimmunization rate is 29 percent in pediatric and 47 percent in adult sickle cell patients when partial or extended RBC antigen match is not performed. However, the delayed serologic and/or hemolytic transfusion reactions did not result in severe clinical outcome in most instances. The most important adverse event was hyperhemolysis, which may be triggered by a transfusion, but was not prevented by matching for RBC antigens. In most instances, the cause of hyperhemolysis was multifactorial.
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A relationship may exist between the immunomodulatory effects of allogeneic blood transfusion and the volume of transfused allogeneic plasma and/or the number of transfused plasma-containing units. ⋯ A relationship between the exposure to allogeneic plasma and the risk of postoperative pneumonia and/or wound infection was not detected in this study population.