Vox sanguinis
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EU law requires a haemoglobin of > or = 12.5 g/dl for women or > or = 13.5 g/dl for men at the time of donation. As capillary and venous haemoglobin values may differ in the same subject, we examined whether a capillary haemoglobin level of 12.0 g/dl for women or 13.0 g/dl for men, is equivalent to a venous haemoglobin level of > or = 12.5 g/dl and > or = 13.5 g/dl, respectively, to avoid unnecessary loss of blood donations. ⋯ Capillary haemoglobin levels of 12.0-12.5 g/dl in healthy females or 13.0-13.5 g/dl in healthy males are substantively equivalent to venous haemoglobin levels of > or = 12.5 and > or = 13.5 g/dl for women and men respectively. This finding has permitted an additional 32 990 blood units to be collected over the period of the study, a gain of 9.4%.
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Recombinant activated factor VIIa (rFVIIa) is increasingly being used in non-haemophiliac patients for the treatment of severe bleeding refractory to standard interventions. Optimal dosing regimens remain debated in cardiac surgery. Therefore, this study investigated the use of different rFVIIa dosing practices on response to bleeding and patient outcomes in cardiac surgery patients using data from the Haemostasis Registry. ⋯ These findings raise the important question of whether lower doses of rFVIIa may be as effective as higher doses in the treatment of severe bleeding in cardiac surgery patients.
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Based on relatively recent clinical work, considerable enthusiasm has been generated for the increased use of plasma and platelet in the earlier resuscitation of massively transfused patients. The aim of this review was to examine the currently available evidence for the increase in plasma/platelet to red cell transfusion ratio during massive transfusion. ⋯ Although there is some evidence to support the increase use of plasma and platelets in massive transfusion, the true efficacy of such practice has not yet been proven by prospective randomized controlled trials. The available retrospective studies raise many important questions that need to be addressed in future clinical trials.
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After large volume bone marrow (BM) harvest, donors and patients can develop severe anaemia, because collected BM can contain up to 20% of their red cell mass. In a prospective analysis, we investigated the feasibility to recover red blood cells (RBCs) from the harvested BM and investigated whether these RBC units meet the quality requirements of the European Council. ⋯ RBCs, collected from bone marrow harvests, can be used for autologous blood support to minimize allogeneic blood transfusions in donors and patients after large volume BM donation.