Vox sanguinis
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A balanced transfusion of red blood cells, fresh frozen plasma and platelets are recommended for massively bleeding trauma patients. Fibrinogen concentrates could potentially lessen or replace the need for fresh frozen plasma and/or platelet transfusions. ⋯ Evidence for the use of fibrinogen concentrate to trauma patients with massive bleeding is lacking. Well-designed prospective, randomized, double-blinded studies evaluating the effect of fibrinogen concentrate, as the only intervention, are urgently needed.
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Multicenter Study Comparative Study
Transfusion practices in massive haemorrhage in pre-intensive and intensive care.
Primary resuscitation for massive haemorrhage often occurs in emergency departments or operating theatres, with ongoing resuscitation in the intensive care unit (ICU). The aim of the study was to retrospectively review transfusion practice in the pre-ICU phase and ICU for patients with massive haemorrhage. ⋯ Patients who died early were coagulopathic before and on ICU admission and did not correct their coagulopathy. This study also shows that coagulopathy is associated with an increased risk of mortality. Early and aggressive correction of coagulopathy for patients presenting with coagulopathy may be effective in improving mortality.
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Pathogen reduction technologies (PRT) for platelets are now compatible with both plasma and platelet additive solutions (PAS). The aim of this study was to examine the effect of PRT on the platelet storage lesion, in the presence of PAS with low plasma carryover. ⋯ Despite the observed differences in platelet metabolism and activation observed following PRT treatment in PAS and low plasma carryover, the results suggest that treatment and storage of platelets in PAS is no more detrimental to platelets than treatment and storage in plasma.