Transfusion
-
The use of international normalized ratio (INR) to diagnose vitamin K-dependent coagulation factor (VitK-CF) deficiency in trauma has limitations (inability to predict bleeding and long turnaround times). Thromboelastography (TEG) assesses the entire coagulation process. With TEG, reaction time (TEG-R) is used to assess global coagulation factor activity and takes less than 10 minutes. We assessed the ability of TEG-R to detect VitK-CF deficiency in trauma, compared to the INR. ⋯ Our study suggests that TEG-R is not superior at identifying VitK-CF deficiency compared to INR in trauma.
-
Providing transfusion support for patients with placenta accreta is a challenging task. There is no consensus on predelivery transfusion planning for these patients and the prevalence of massive transfusion is unknown. With little published experience, it is difficult to predict blood component usage accurately. Therefore, this retrospective study spanning 14 years quantified blood usage and clinical outcome in a group of patients with placenta accreta. ⋯ The delivery of patients with placenta accreta is a high-risk procedure that requires multidisciplinary planning and adequate resources to optimize outcome. Transfusion services should have a protocol for managing these cases that addresses preoperative blood component preparation and intraoperative management, should massive hemorrhage occur.
-
Multicenter Study Comparative Study
Reliability of capillary hemoglobin screening under routine conditions.
Capillary hemoglobin (Hb) measurement before admission for whole blood donation is performed in many blood donation services, in spite of several studies reporting many donors with low Hb values being missed by capillary Hb screening. ⋯ The currently available methods for capillary Hb screening allow reliable determination of predonation Hb values under routine conditions. Additional venous Hb measurements in donors with too low capillary Hb values might reduce the rate of deferred donors by approximately one-third.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Postoperative complications associated with transfusion of platelets and plasma in cardiac surgery.
Studies in cardiac surgery have reported increased postoperative morbidity and mortality after allogeneic red blood cell (RBC) transfusions. Whether platelet (PLT) and/or plasma transfusions are a marker for more concomitant RBC transfusions or are independently associated with complications after cardiac surgery is unknown. ⋯ Although it is difficult to separate the effects of blood components, we found that in cardiac surgery, perioperative plasma transfusions are independently associated with all-cause mortality. WBC-containing RBC transfusions and PLT transfusions are independently associated with mortality in the presence of infections in the postoperative period. Future transfusion studies in cardiac surgery should concomitantly consider the possible adverse effects of all the various transfused blood components.