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[PMID]:27774614
[Au] Autor:Dunbar NM; Olson NJ; Szczepiorkowski ZM; Martin ED; Tysarcyk RM; Triulzi DJ; Alarcon LH; Yazer MH
[Ad] Endereço:Department of Pathology and Laboratory Medicine, the Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
[Ti] Título:Blood component transfusion and wastage rates in the setting of massive transfusion in three regional trauma centers.
[So] Source:Transfusion;57(1):45-52, 2017 01.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The purpose of massive transfusion protocols (MTPs) is to provide large quantities of blood products rapidly to exsanguinating patients. The expected rates of blood product transfusion and wastage in this setting have not been defined. This study was undertaken to assess the transfusion and wastage rates for bleeding patients requiring emergency issue of blood components at three American Level I trauma centers. STUDY DESIGN AND METHODS: Three hospitals participated, all of which are Level I trauma centers that have MTPs in place where uncrossmatched red blood cells (RBCs) can be ordered with or without platelets (PLTs), plasma, and cryoprecipitate. Data on the transfusion, return to blood bank, and wastage rates were recorded on all products issued within 3 hours after MTP activation. RESULTS: The majority of products were issued to the emergency department and/or operating room at all three institutions (84%-95%). The percentage of RBCs, plasma, and PLTs transfused during MTPs were 39% to 65%, 43% to 66%, and 75% to 100%, respectively. Wastage rates were comparable for RBCs (0%-9%), plasma (0%-7%), and PLTs (0%-7%). Cryoprecipitate had the highest wastage rates at all three sites (7%-33%). CONCLUSION: A large portion of blood products issued during MTPs are not transfused. Some are wasted due to stringent storage requirements and/or limited shelf lives. The optimum ratio of transfused to returned products in these patients is likely to be determined more by clinical need than by transfusion service policy.
[Mh] Termos MeSH primário: Bancos de Sangue
Transfusão de Componentes Sanguíneos
Centros de Traumatologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13880


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[PMID]:27776795
[Au] Autor:Chang R; Folkerson LE; Sloan D; Tomasek JS; Kitagawa RS; Choi HA; Wade CE; Holcomb JB
[Ad] Endereço:Center for Translational Injury Research, University of Texas Health Science Center, Houston, TX; Department of Surgery, University of Texas Health Science Center, Houston, TX. Electronic address: ronald.chang@uth.tmc.edu.
[Ti] Título:Early plasma transfusion is associated with improved survival after isolated traumatic brain injury in patients with multifocal intracranial hemorrhage.
[So] Source:Surgery;161(2):538-545, 2017 02.
[Is] ISSN:1532-7361
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Plasma-based resuscitation improves outcomes in trauma patients with hemorrhagic shock, while large-animal and limited clinical data suggest that it also improves outcomes and is neuroprotective in the setting of combined hemorrhage and traumatic brain injury. However, the choice of initial resuscitation fluid, including the role of plasma, is unclear for patients after isolated traumatic brain injury. METHODS: We reviewed adult trauma patients admitted from January 2011 to July 2015 with isolated traumatic brain injury. "Early plasma" was defined as transfusion of plasma within 4 hours. Purposeful multiple logistic regression modeling was performed to analyze the relationship of early plasma and inhospital survival. After testing for interaction, subgroup analysis was performed based on the pattern of brain injury on initial head computed tomography: epidural hematoma, intraparenchymal contusion, subarachnoid hemorrhage, subdural hematoma, or multifocal intracranial hemorrhage. RESULTS: Of the 633 isolated traumatic brain injury patients included, 178 (28%) who received early plasma were injured more severely coagulopathic, hypoperfused, and hypotensive on admission. Survival was similar in the early plasma versus no early plasma groups (78% vs 84%, P = .08). After adjustment for covariates, early plasma was not associated with improved survival (odds ratio 1.18, 95% confidence interval 0.71-1.96). On subgroup analysis, multifocal intracranial hemorrhage was the largest subgroup with 242 patients. Of these, 61 (25%) received plasma within 4 hours. Within-group logistic regression analysis with adjustment for covariates found that early plasma was associated with improved survival (odds ratio 3.34, 95% confidence interval 1.20-9.35). CONCLUSION: Although early plasma transfusion was not associated with improved in-hospital survival for all isolated traumatic brain injury patients, early plasma was associated with increased in-hospital survival in those with multifocal intracranial hemorrhage.
[Mh] Termos MeSH primário: Transfusão de Componentes Sanguíneos/métodos
Lesões Encefálicas Traumáticas/terapia
Mortalidade Hospitalar/tendências
Hemorragias Intracranianas/terapia
Sistema de Registros
[Mh] Termos MeSH secundário: Adulto
Anticoagulantes/administração & dosagem
Lesões Encefálicas Traumáticas/complicações
Lesões Encefálicas Traumáticas/diagnóstico
Lesões Encefálicas Traumáticas/mortalidade
Estudos de Coortes
Terapia Combinada
Feminino
Escala de Coma de Glasgow
Seres Humanos
Escala de Gravidade do Ferimento
Hemorragias Intracranianas/complicações
Hemorragias Intracranianas/diagnóstico
Hemorragias Intracranianas/mortalidade
Masculino
Meia-Idade
Plasma
Estudos Retrospectivos
Medição de Risco
Análise de Sobrevida
Centros de Traumatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29220129
[Au] Autor:Selde W
[Ti] Título:Damage Control: Resuscitation.
[So] Source:JEMS;42(4):34-9, 2017 04.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Serviços Médicos de Emergência
Tratamento de Emergência
Medicina Militar
Ressuscitação/métodos
Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Transfusão de Componentes Sanguíneos
Tratamento Farmacológico
Hidratação
Hemorragia/prevenção & controle
Seres Humanos
Hipotermia/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


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[PMID]:29211386
[Au] Autor:Escott MEA; Bank EA; Mehkri FM; Monroe BJ
[Ti] Título:Blood Therapy: Considerations for using blood products for prehospital trauma patients.
[So] Source:JEMS;42(3):47-51, 67, 2017 Mar.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Transfusão de Componentes Sanguíneos
Serviços Médicos de Emergência
Tratamento de Emergência
Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Biomarcadores/análise
Seres Humanos
Ressuscitação/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29176851
[Au] Autor:Paternoster G; Babo Martins S; Mattivi A; Cagarelli R; Angelini P; Bellini R; Santi A; Galletti G; Pupella S; Marano G; Copello F; Rushton J; Stärk KDC; Tamba M
[Ad] Endereço:Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna (IZSLER), Brescia, Italy.
[Ti] Título:Economics of One Health: Costs and benefits of integrated West Nile virus surveillance in Emilia-Romagna.
[So] Source:PLoS One;12(11):e0188156, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Since 2013 in Emilia-Romagna, Italy, surveillance information generated in the public health and in the animal health sectors has been shared and used to guide public health interventions to mitigate the risk of West Nile virus (WNV) transmission via blood transfusion. The objective of the current study was to identify and estimate the costs and benefits associated with this One Health surveillance approach, and to compare it to an approach that does not integrate animal health information in blood donations safety policy (uni-sectoral scenario). Costs of human, animal, and entomological surveillance, sharing of information, and triggered interventions were estimated. Benefits were quantified as the averted costs of potential human cases of WNV neuroinvasive disease associated to infected blood transfusion. In the 2009-2015 period, the One Health approach was estimated to represent a cost saving of €160,921 compared to the uni-sectoral scenario. Blood donation screening was the main cost for both scenarios. The One Health approach further allowed savings of €1.21 million in terms of avoided tests on blood units. Benefits of the One Health approach due to short-term costs of hospitalization and compensation for transfusion-associated disease potentially avoided, were estimated to range from €0 to €2.98 million according to the probability of developing WNV neuroinvasive disease after receiving an infected blood transfusion.
[Mh] Termos MeSH primário: Análise Custo-Benefício
Saúde Única/economia
Vigilância da População
Febre do Nilo Ocidental/economia
Febre do Nilo Ocidental/epidemiologia
Vírus do Nilo Ocidental/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Transfusão de Componentes Sanguíneos
Feminino
Hospitalização
Seres Humanos
Itália/epidemiologia
Masculino
Meia-Idade
Febre do Nilo Ocidental/virologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188156


  6 / 3232 MEDLINE  
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[PMID]:28957937
[Au] Autor:Bidwell J
[Ad] Endereço:Josie Bidwell is assistant professor of nursing at the University of Mississippi Medical Center and a member of the Cochrane Nursing Care Field.
[Ti] Título:Plasma Transfusions Prior to Central Line Placement in People with Abnormal Coagulation.
[So] Source:Am J Nurs;117(10):67, 2017 Oct.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.
[Mh] Termos MeSH primário: Transtornos da Coagulação Sanguínea/enfermagem
Transfusão de Componentes Sanguíneos/enfermagem
Cateterismo Venoso Central/enfermagem
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000525882.97348.0a


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[PMID]:28930960
[Au] Autor:Shlaifer A; Siman-Tov M; Radomislensky I; Peleg K; Shina A; Baruch EN; Glassberg E; Yitzhak A; ITG*
[Ad] Endereço:From the The Israel Defense Forces Medical Corps (S.A., S.A., B.N.A., G.E., Y.A.), Tel-Hashomer; The Orthopedic Division (S.A.), Tel Aviv Sourasky Medical Center, Tel Aviv; Israel National Center for Trauma and Emergency Medicine (S.-T.M., R.I., P.K.), Gertner Institute for Epidemiology and Public Health Policy, Tel-Hashomer; Department of Disaster Management (P.K.), School of Public Health, Tel Aviv University, Tel Aviv; The Pinchas Bornstein Talpiot Medical Leadership Program (S.A.), The Sheba Medical Center; The Ella Lemelbaum Institute of Immuno-Oncology (B.N.A.), Institute of Oncology, The Sheba Medical Center, Ramat Gan; Sackler Faculty of Medicine (B.N.A.), Tel Aviv University, Tel Aviv, Israel; and The Department of Surgery at Uniformed Services (G.E.), University of the Health Sciences, Bethesda, MD.
[Ti] Título:Prehospital administration of freeze-dried plasma, is it the solution for trauma casualties?
[So] Source:J Trauma Acute Care Surg;83(4):675-682, 2017 Oct.
[Is] ISSN:2163-0763
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hemorrhage is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the prehospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze-dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice. In this article, we present our experience with the use of FDP at the POI and prehospital setting regarding the feasibility, safety, adverse reactions, and adherence to clinical practice guidelines. METHODS: This is a descriptive retrospective cohort study based on all casualties receiving FDP during January 2013 to June 2016. The study describes the injury, treatment, and outcome characteristics from POI until hospital discharge. RESULTS: During the study period, 109 casualties received FDP. The majority were men, aged 18 years to 35 years. Multiple severe injuries were found in almost half of the casualties, 78% had penetrating injury, and more than half were involved in a multicasualty event. Eighty-three percent were treated with one unit of FDP, 13% with two units, and 4% casualties with three units, nine patients (8.2%) were also treated in the prehospital setting with packed red blood cells. Fifty-seven percent fulfilled at least one criterion for the administration of FDP. Lifesaving interventions were required in 64%. In five (4.6%) cases, there were difficulties with FDP administration. Side effects were reported in one female patient. CONCLUSION: This study supports the usage feasibility of FDP at the POI and in the prehospital setting. Further adjustment of the clinical practice guidelines is required basing it not only on pathophysiologic parameters but also on clinical judgment. Further investigation of the available data is required to learn about the effectiveness of FDP at POI. LEVEL OF EVIDENCE: Retrospective case series study, level IV.
[Mh] Termos MeSH primário: Transfusão de Componentes Sanguíneos
Serviços Médicos de Emergência
Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Viabilidade
Feminino
Liofilização
Fidelidade a Diretrizes
Seres Humanos
Masculino
Plasma
Estudos Retrospectivos
Resultado do Tratamento
Ferimentos e Lesões/mortalidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE
[do] DOI:10.1097/TA.0000000000001569


  8 / 3232 MEDLINE  
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[PMID]:28898990
[Au] Autor:Shah N; Baker SA; Spain D; Shieh L; Shepard J; Hadhazy E; Maggio P; Goodnough LT
[Ad] Endereço:Departments ofPathology.
[Ti] Título:Real-Time Clinical Decision Support Decreases Inappropriate Plasma Transfusion.
[So] Source:Am J Clin Pathol;148(2):154-160, 2017 Aug 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less. Methods: The alert was suppressed for massive transfusion and within operative or apheresis settings. The plasma order was automatically removed upon alert acceptance while clinical exception reasons allowed for continued transfusion. Alert impact was studied comparing a 7-month control period with a 4-month intervention period. Results: Monthly plasma utilization decreased 17.4%, from a mean ± SD of 3.40 ± 0.48 to 2.82 ± 0.6 plasma units per hundred patient days (95% confidence interval [CI] of difference, -0.1 to 1.3). Plasma transfused below an INR of 1.7 or less decreased from 47.6% to 41.6% (P = .0002; odds ratio, 0.78; 95% CI, 0.69-0.89). The alert recommendation was accepted 33% of the time while clinical exceptions were chosen in the remaining cases (active bleeding, 31%; other clinical indication, 33%; and apheresis, 2%). Alert acceptance rate varied significantly among different provider specialties. Conclusions: Clinical decision support can help curtail inappropriate plasma use but needs to be part of a comprehensive strategy including audit and feedback for comprehensive, long-term changes.
[Mh] Termos MeSH primário: Transfusão de Componentes Sanguíneos/utilização
Sistemas de Apoio a Decisões Clínicas
Plasma
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx061


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[PMID]:28892326
[Au] Autor:Wolcott K
[Ti] Título:Practice changes lower rates of transfusion, superficial SSI, and morbidity.
[So] Source:Bull Am Coll Surg;102(5):41-4, 2017 05.
[Is] ISSN:0002-8045
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Transfusão de Componentes Sanguíneos/efeitos adversos
Controle de Infecções/organização & administração
Ortopedia
Complicações Pós-Operatórias/prevenção & controle
Padrões de Prática Médica
Melhoria de Qualidade
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Transfusão de Componentes Sanguíneos/utilização
Hospitais Pediátricos
Seres Humanos
New York/epidemiologia
Estudos de Casos Organizacionais
Complicações Pós-Operatórias/epidemiologia
Infecção da Ferida Cirúrgica/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE


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[PMID]:28835441
[Au] Autor:Ciurea SO; Schafer JR; Bassett R; Denman CJ; Cao K; Willis D; Rondon G; Chen J; Soebbing D; Kaur I; Gulbis A; Ahmed S; Rezvani K; Shpall EJ; Lee DA; Champlin RE
[Ad] Endereço:Department of Stem Cell Transplantation and Cellular Therapy.
[Ti] Título:Phase 1 clinical trial using mbIL21 ex vivo-expanded donor-derived NK cells after haploidentical transplantation.
[So] Source:Blood;130(16):1857-1868, 2017 Oct 19.
[Is] ISSN:1528-0020
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Relapse has emerged as the most important cause of treatment failure after allogeneic hematopoietic stem cell transplantation (HSCT). To test the hypothesis that natural killer (NK) cells can decrease the risk of leukemia relapse, we initiated a phase 1 dose-escalation study of membrane-bound interleukin 21 (mbIL21) expanded donor NK cells infused before and after haploidentical HSCT for high-risk myeloid malignancies. The goals were to determine the safety, feasibility, and maximum tolerated dose. Patients received a melphalan-based reduced-intensity conditioning regimen and posttransplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis. NK cells were infused on days -2, +7, and +28 posttransplant. All NK expansions achieved the required cell number, and 11 of 13 patients enrolled received all 3 planned NK-cell doses (1 × 10 /kg to 1 × 10 /kg per dose). No infusional reactions or dose-limiting toxicities occurred. All patients engrafted with donor cells. Seven patients (54%) developed grade 1-2 acute GVHD (aGVHD), none developed grade 3-4 aGVHD or chronic GVHD, and a low incidence of viral complications was observed. One patient died of nonrelapse mortality; 1 patient relapsed. All others were alive and in remission at last follow-up (median, 14.7 months). NK-cell reconstitution was quantitatively, phenotypically, and functionally superior compared with a similar group of patients not receiving NK cells. In conclusion, this trial demonstrated production feasibility and safety of infusing high doses of ex vivo-expanded NK cells after haploidentical HSCT without adverse effects, increased GVHD, or higher mortality, and was associated with significantly improved NK-cell number and function, lower viral infections, and low relapse rate posttransplant.
[Mh] Termos MeSH primário: Transfusão de Componentes Sanguíneos/métodos
Neoplasias Hematológicas/terapia
Interleucinas/metabolismo
Células Matadoras Naturais/transplante
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Técnicas de Cultura de Células
Proliferação Celular
Células Cultivadas
Feminino
Haplótipos
Teste de Histocompatibilidade/métodos
Seres Humanos
Células K562
Células Matadoras Naturais/metabolismo
Células Matadoras Naturais/fisiologia
Masculino
Proteínas de Membrana/metabolismo
Meia-Idade
Doadores de Tecidos
Condicionamento Pré-Transplante/métodos
Transplante Homólogo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE I; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Interleukins); 0 (Membrane Proteins); 0 (interleukin-21)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170825
[St] Status:MEDLINE
[do] DOI:10.1182/blood-2017-05-785659



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