Transfus Apher Sci
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More than 50% of all red cells are used to treat patients who are hemorrhaging either due to spontaneous bleeding, trauma or surgery and all platelet products and most plasma is given to prevent or treat bleeding patients. Therefore, knowledge of hemostasis is important to transfusion medicine specialists. There are three requirements to function in this capacity. One, understand the test used to assess hemostasis; two: understand the composition of blood components thoroughly and three, have a knowledge of the clinical studies in which hemostasis risk was assessed using tests of hemostasis and the clinical utility of blood components in bleeding risk attenuation.
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Apheresis is used as therapeutic approach to improve outcome of patients with severe sepsis, septic shock and multi organ dysfunction syndrome. The concept is to reduce the extent of toxins and cytokines as well as other activators of the various cascade systems. In addition the replacement of plasma, in some of the protocols, helps to substitute with substances that are consumed/complex bound by the inflammatory reactions during the severe clinical condition. This article reviews literature in the field of adsorption technologies as well as plasma exchange techniques.
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Massive transfusion is a consequence of uncontrolled bleeding. It taxes the resources of both hospital and physicians. It occurs most commonly in trauma, cardiac and vascular surgery and less frequently in obstetrics. ⋯ The protocol was developed with the input from transfusion medicine, trauma surgery, emergency and ICU and anaesthesia. The protocol is distributed with the 7th unit of blood issued and is a reminder of the principles. Results are tracked and may lead to modifications in the protocol.
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Children and adolescents comprise a significant proportion of the hemophilia population, including those patients who have developed inhibitors to factor VIII or FIX. We examine the use of rFVIIa for the treatment of bleeding episodes and the prevention of bleeding in children and adolescents with hemophilia A and B with inhibitors, focusing on registry data and recent clinical trial results. Based on this review of the literature, we conclude that recombinant FVIIa is safe and effective for use in controlling bleeding in these patient populations.