Transfus Apher Sci
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Randomized Controlled Trial Multicenter Study
Addressing the question of the effect of RBC storage on clinical outcomes: the Red Cell Storage Duration Study (RECESS) (Section 7).
The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes which occur while RBCs are stored have led to several physiologically plausible hypotheses that these changes impair RBC function when the units are transfused. Although there is some evidence of this effect in vivo from animal model experiments, the results of several largely retrospective patient studies have not been consistent. ⋯ The primary outcome is the change in the Multiple Organ Dysfunction Score (MODS), a composite measure of multiorgan dysfunction, by day 7. Secondary outcomes include the change in the MODS by day 28, all-cause mortality, and several composite and single measures of specific organ system function. The estimated total sample size required will be 1434 evaluable subjects (717 per arm).
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Multicenter Study
Does the preoperative iron status predict transfusion requirement of orthopedic patients?
In patients scheduled for major orthopedic surgery, the presence of anemia before surgery can preclude the transfusion requirements. Iron deficiency anemia is believed to be a major cause of anemia, especially in the elderly. The importance of screening patients undergoing major orthopedic surgery in Norway for anemia and iron deficiency has not been investigated. The aim of the present study was to investigate if preoperative testing of iron status could predict transfusion requirement related to major elective orthopedic surgery. ⋯ There was no correlation between the iron status before surgery and the need for transfusion during and after surgery, although anemia before surgery was a predictor for the need for transfusion. Based in our limited study we could not recommend iron status screening before surgery. However further studies are needed to truly establish the incidence and the underlying etiology, in order to reduce the transfusion requirements.
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Multicenter Study
Evaluation of appropriate usage of fresh frozen plasma: Results of a regional audit in Iran.
Fresh frozen plasma (FFP) is a major source of coagulation factor replacement therapy for patients with clotting factor deficiency. Although FFP is readily available for use in clinical practice its administration isn't without risk. Studies on the use of FFP reveal that it is often overused or inappropriately used. We undertook an audit to assess the appropriateness of FFP transfusion in Gorgan's hospitals. ⋯ Inappropriate usage of FFP is often seen in medical facility and the right solution is needed to curb the misuse of this component. Regular utilization audit can identify correctable errors in transfusion practices. Formal education programs and existing information on FFP use should be directed to professionals ordering FFP.
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Multicenter Study
Efficacy and tolerability of a pasteurised human fibrinogen concentrate in patients with congenital fibrinogen deficiency.
The efficacy and tolerability of a pasteurised human fibrinogen concentrate were assessed in an open, multi-centre, non-controlled retrospective study in patients with congenital fibrinogen deficiency. Haemostatic efficacy was assessed by laboratory investigation and clinical observation. The study included 12 patients (afibrinogenaemia, n = 8; hypofibrinogenaemia, n = 3; dysfibrinogenaemia combined with hypofibrinogenaemia, n = 1). ⋯ In addition, one patient developed deep vein thrombosis and non-fatal pulmonary embolism with treatment for osteosynthesis after collum femoris fracture. Fibrinogen substitution could not be excluded as a contributing factor in this high-risk patient. Substitution with pasteurised human fibrinogen concentrate in patients with congenital fibrinogen deficiencies is efficient and generally well tolerated.