Clin Lab
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Comparative Study Controlled Clinical Trial
Correlation between rotation thrombelastometry ROTEM analysis and standard haemostatic parameters during liver transplantation.
The determination of the correlations between simultaneously performed rotation thrombelastometry ROTEM analysis and standard haemostatic analysis during liver transplantations is indispensable for performing an adequate perioperative haemostatic monitoring. ⋯ The correlations found in the present study suggest to perform the haemoststic liver transplantation monitoring through a parallel systematic analysis of both standard and rotation thrombelastometry parameters and confirm the ROTEM method as preferable and highly informative.
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Many children receive one or more units of red blood cell (RBC) preparations during their paediatric intensive care unit (PICU) admission depending on their underlying disease course. Physicians often justify RBC transfusions in critically ill children when anaemia is present because of the assumption that by increasing the haemoglobin level the delivery of oxygen (DO2) to peripheral tissues is improved so that ultimately the oxygen utilization (VO2) can be improved. ⋯ The TRIPICU study has clearly shown that it is safe to refrain from transfusing stable critically ill children unless their Hb has dropped below 7 g/dL (4.3 mmol/L) as increasing data emphasizes that the common practice of transfusing critically ill children is not free from causing harm as shown by increased morbidity and mortality. This narrative review summarizes the current literature and discusses possible pathophysiological mechanisms.
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Comparative Study
Serum matrix Gla protein concentrations in patients with mild and severe acute pancreatitis.
Acute pancreatitis (AP) causes an increase in proinflammatory cytokine and acute phase protein levels. Our previous studies in AP showed the role of fetuin A as a negative acute phase protein. Matrix Gla protein (MGP), beside fetuin A, is one of the main inhibitors of extraosseous calcification. In the present preliminary study we evaluated the relationship between MGP, lipase, and inflammation in AP patients. ⋯ Our preliminary results indicate that the MGP level correlated negatively with all of the proinflammatory cytokines and acute phase proteins studied in patients with AP, and positively with lipase, fetuin A, and albumin measurements. These findings may indicate the role of MGP in calcium and phosphate metabolism disturbances in the course of AP.
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For intrauterine transfusion and some other rare indications, irradiation and washing or adjustment to an elevated haematocrit is necessary. No data are currently available indicating whether irradiation of red blood cell concentrates (RBCs) might impair the mechanical stability of erythrocytes during centrifugation leading to elevated haemolysis. Consequently, if irradiation and centrifugation of RBCs is necessary, there is no definitive recommendation about the preferred sequence of steps. ⋯ There is no difference in the haemolysis caused by centrifugation between irradiated and non-irradiated RBCs. However, it is well known that washing RBCs after irradiation significantly lowers the potassium content. Summarising these two findings leads to the conclusion that it is optimal first to irradiate and then to wash RBCs.
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Comparative Study
Clinical usefulness of the semiquantitative procalcitonin test in the diagnosis of bacterial infections in a third level children's hospital.
The differential diagnosis between viral and bacterial infections can be challenging in children. Procalcitonin (PCT) has been investigated as an early marker for bacterial infections. The aim of this study was to assess the usefulness of procalcitonin (PCT) compared to C-reactive protein (CRP), white cell blood count (WBC), and absolute neutrophil count (ANC) for differentiating bacterial from viral infections in a third level pediatric hospital. ⋯ The PCT semiquantitative test is not sufficiently sensitive to be used alone as a marker of bacterial infection.