Transfusion
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Meta Analysis
Exclusion criteria and adverse events in perioperative trials of tranexamic acid: a systematic review and meta-analysis.
Tranexamic acid (TXA) is an inexpensive therapy effective at minimizing perioperative blood loss and transfusion. However, it remains underutilized due to safety concerns. To date, no evidence-based guidelines exist identifying which patients should not receive TXA therapy. This study determined patient groups for whom safety information regarding TXA is lacking due to common exclusion from perioperative TXA trials. ⋯ Sufficient evidence exists to develop perioperative guidelines for TXA use in many populations. Further studies evaluating perioperative TXA use in patients with a history of thromboembolism are warranted.
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Surveys are a common tool used to gather information about practices across many medical specialties. The quality of survey reporting impacts the strength of any conclusions. Thorough and accurate reporting of survey-based research is critical for evaluation of the validity, reliability, and generalizability of the results. The objective of this study was to appraise the quality of recently reported surveys in transfusion medicine (TM). ⋯ Our findings document quality deficiencies in the reporting of research conducted using surveys in TM. Validated guidelines for the reporting of survey-based clinical research should be developed and applied to improve the quality of survey reporting in TM.
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The risks and benefits of red blood cell (RBC) transfusion in palliative care patients remain poorly understood. We reviewed the literature to summarize available information on RBC transfusion in this population. ⋯ In palliative care, RBC transfusion may provide symptom relief and improve subjective well-being, though the duration and magnitude of this effect, and transfusion-associated risks specific to this population remain unclear. Currently, no high quality evidence exists to support or guide the use of RBC transfusion in this population. Moreover, the clinical heterogeneity within the palliative population limits the interpretation of most studies.
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The risks and benefits of red blood cell (RBC) transfusion in palliative care patients remain poorly understood. We reviewed the literature to summarize available information on RBC transfusion in this population. ⋯ In palliative care, RBC transfusion may provide symptom relief and improve subjective well-being, though the duration and magnitude of this effect, and transfusion-associated risks specific to this population remain unclear. Currently, no high quality evidence exists to support or guide the use of RBC transfusion in this population. Moreover, the clinical heterogeneity within the palliative population limits the interpretation of most studies.
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Central venous catheters are frequently inserted into patients with coagulation disorders. It is unclear whether preprocedural correction of hemostasis is beneficial. We determined the incidence of bleeding complications after central venous catheter placement in patients who had severe coagulopathy and identified potential risk factors for bleeding. ⋯ The incidence of major bleeding complications after central venous catheter placement is low, even in coagulopathic patients. Based on a systematic research of the literature, strong evidence supporting the correction of hemostatic defects before central venous catheter insertion is lacking. However, well-powered randomized controlled trials will be necessary to determine the minimal platelet count, the maximal international normalized ratio, and an activated partial thromboplastin time that is safe before central venous catheter insertion.