Transfusion
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Randomized Controlled Trial Multicenter Study Controlled Clinical Trial
The treatment of bleeding is to stop the bleeding! Treatment of trauma-related hemorrhage.
The secret with any alternative to transfusion is to minimize the need for transfusion in the first place. This can be done by reducing the volume of blood loss. The volume of blood being lost can be reduced by direct methods where possible (i.e., hemostasis at the point of bleeding), or by improving the coagulation profile of the patient, thereby improving the extrinsic coagulation. Recombinant activated factor VII (rFVIIa) offers theoretical possibilities of improving the coagulation profile. ⋯ Treatment with adjunctive rFVIIa significantly reduces transfusion requirements in the 48 hours after severe injury and these procoagulant effects may improve clinical outcome at 30 days.
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Multicenter Study
Cryoprecipitate use in 25 Canadian hospitals: commonly used outside of the published guidelines.
Canadian Blood Services' disposition reports suggested considerable variation in cryoprecipitate use and prompted this national audit. ⋯ A 2-month audit of cryoprecipitate use in Canada revealed that the majority of cryoprecipitate use in Canada is not in accordance with published guidelines.
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Multicenter Study
Staff attitudes about event reporting and patient safety culture in hospital transfusion services.
Little is known about how transfusion service staff view issues pertaining to event reporting and patient safety. The goal of this study was to assess transfusion service staff attitudes about these issues. ⋯ Overall, the transfusion services had very positive attitudes about event reporting and safety culture. Transfusion services do well recording events that result in patient harm or have the potential for harm, but there is a need to increase reporting of deviations from procedures and mistakes that staff catch and correct on their own. In addition, there are a few areas of safety culture that warrant improvement, particularly the transfusion service's work relationship with nursing staff. The study provides useful descriptive information about how staff view event reporting and safety-related issues and identifies strengths and areas for improvement.
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Randomized Controlled Trial Multicenter Study
A multicenter pilot-randomized controlled trial of the feasibility of an augmented red blood cell transfusion strategy for patients treated with induction chemotherapy for acute leukemia or stem cell transplantation.
Anemia may be an important factor contributing to an increased risk of bleeding, particularly in patients with thrombocytopenia. ⋯ This pilot study thus indicated that it would be feasible to enroll the required number of patients to enable the performance of a large RCT to investigate the effect of Hb on bleeding risk in thrombocytopenic patients.
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Multicenter Study
Blood transfusions in children: a multi-institutional analysis of practices and complications.
Blood product transfusions are a valuable health-care resource. Guidelines for transfusion exist, but variability in their application, particularly in children, remains. The risk factors that threaten transfusion safety are well established, but because their occurrence in children is rare, single-institution studies have limited utility in determining the rates of occurrence. An epidemiologic approach that investigates blood transfusions in hospitalized children may help improve our understanding of transfused blood products in this vulnerable population. ⋯ The administration of blood products to children is a common practice in academic children's hospitals. Complications associated with these transfused products are rare.