Transfusion
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In January 2005, the Cord Blood Bank (CBB) at the Mexican Institute of Social Security initiated activities. Herein, we describe the experience generated during this period (January 1, 2005-December 31, 2009). ⋯ Although the experience presented herein is still limited and the period of analysis is still short, the results obtained during these 5 years are encouraging.
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Comparative Study
Comparison of platelet transfusion as fresh whole blood versus apheresis platelets for massively transfused combat trauma patients (CME).
At major combat hospitals, the military is able to provide blood products to include apheresis platelets (aPLT), but also has extensive experience using fresh whole blood (FWB). In massively transfused trauma patients, we compared outcomes of patients receiving FWB to those receiving aPLT. ⋯ Survival for massively transfused trauma patients receiving FWB appears to be similar to patients resuscitated with aPLT. Prospective trials will be necessary before consideration of FWB in the routine management of civilian trauma. However, in austere environments where standard blood products are unavailable, FWB is a feasible alternative.
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Transfusion-associated circulatory overload (TACO) is a frequent complication of blood transfusion. Investigations identifying risk factors for TACO in critically ill patients are lacking. ⋯ Volume of transfused plasma and the rate of transfusion were identified as transfusion-specific risk factors for TACO. Left ventricular dysfunction and fresh-frozen plasma ordered for the reversal of anticoagulant were strong predictors of TACO before the onset of transfusion.
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Electrolyte disturbances are common in patients with critical bleeding requiring massive transfusion. The risk factors and outcome associated with the occurrence of hypomagnesemia in massive transfusion remain uncertain. ⋯ Hypomagnesemia was common and associated with hypocalcemia in massive transfusion, but serum magnesium concentrations had no independent effect or interactive effect with hypocalcemia on mortality of patients requiring massive transfusion.