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Citations in Patient Blood Management James P. AuBuchon, MD, FCAP, FRCP(Edin) Bethesda, Maryland Copyright © 2014 by AABB. All rights reserved Other related publications available from the AABB: Getting Started in Patient Blood Management By James P. AuBuchon, MD, FCAP, FRCP(Edin); Kathleen Puca, MD, MT(ASCP)SBB, FCAP; Sunita Saxena, MD; Ira A. Shulman, MD; and Jonathan H. Waters, MD Standards for Perioperative Autologous Blood Collection and Administration, 4th edition Guidelines for Patient Blood Management and Blood Utilization Developed for the Clinical Transfusion Medicine Committee and the Transfusion Medicine Section Coordinating Committee by Joanne Becker, MD, and Beth Shaz, MD Blood Management: Options for Better Patient Care Edited by Jonathan H. Waters, MD The Transfusion Committee: Putting Patient Safety First, 2nd edition Edited by Sunita Saxena, MD Guidelines for Blood Recovery and Reinfusion in Surgery and Trauma Developed for the Scientific Section Coordinating Committee by Jonathan Waters, MD; Robert M. Dyga, RN, CCP; and Mark H. Yazer, MD, FRCP(C) Perioperative Blood Management: A Physician’s Handbook, 3rd edition Edited by Jonathan Waters, MD; Aryeh Shander, MD; and Karen King, MD Transfusion Medicine's Emerging Positions: Transfusion Safety Officers and Patient Blood Management Coordinators Edited by Susan T. Johnson, MSTM, MT(ASCP)SBB, and Kathleen E. Puca, MD, MT(ASCP)SBB Copyright © 2014 by AABB. All rights reserved Table of Contents Preface . vi Overview . 1 Program Management, Financial Implications, Cost-Effectiveness Analyses. 4 Anemia – Recognition and Management . 11 Use of Iron . 12 Use of Erythropoietin . 14 Utilization of Coagulation and Platelet Function Testing . 17 Indications, Utilizations, and Guidelines . 23 Red Blood Cells . 24 Frozen Plasma and Cryoprecipitate. 30 Platelets . 35 Peri-Surgical Interventions . 39 General Surgical Issues . 39 Preoperative Blood Collection and Acute Normovolemic Hemodilution. 43 Intra- and Postoperative Red Cell Recovery. 45 Issues Pertinent to Particular Disciplines . 53 Cardiology, Cardiac Surgery, Thoracic Surgery, and Vascular Surgery. 53 Critical Care . 71 Gastroenterology . 73 General Surgery . 74 Gynecology . 79 Hematology and Oncology. 80 Nephrology. 81 Obstetrics . 82 Orthopedics and Neurosurgery . 85 Oral/Facial Surgery and Otorhinolaryngology . 100 Pediatrics . 102 Transplantation . 109 Trauma and Massive Transfusion . 112 Urology . 118 Pharmacologic Interventions . 120 Measures to Reduce Blood Loss, Including Anticoagulation Reversal . 120 Effects of Antiplatelet Agents, Anticoagulation, and Hemodilution . 133 Copyright © 2014 by AABB. All rights reserved Preface Patient blood management (PBM), defined as an evidence-based, multi-disciplinary approach to optimizing the care of patients who might need transfusion, has continued to gain attention during the years since the publication of the previous list of Citations. The current compendium, including English articles listed in PubMed from January, 2010 through June, 2014, is indicative of the devel- opment of additional experience and knowledge in this important field of transfusion medicine. These are presented here to facilitate further dissemination of knowledge about the appropriate use of blood components and measures that can be implemented to avoid or delay the need for transfu- sion. The articles have been grouped according to the topics they explore. Many articles have been listed in two categories to facilitate their being found in a manual search. For example, an article on the use of tranxemic acid in arthroplasty would be listed in Pharmacologic Interventions: Measures to Reduce Blood Loss, Including Anticoagulation Reversal, as well as Issues Pertinent to Particular Disciplines: Orthopedics and Neurosurgery. However, the approach used by the compiler may not match the reader’s, and the use of electronic searching tools for keywords is encouraged to expand the number of citations identified. The compendium focuses on trials or reports of interventions to reduce the need for transfusion. Not all of the articles report decreased usage of transfusion, however, and careful reading of all papers of interest is advised. Not included are reports of the outcomes of transfusion per se, such as associating transfusion with poorer outcomes, or analyses of the effect of storage of blood compo- nents. Single case reports have also not been included. The compendium is intended to serve as a companion to the many educational publications, semi- nars and web-based sessions offered by AABB on the topic of PBM. Given the ongoing evolution of medical knowledge and scientific understanding, all readers are advised to search the most recently published literature to ensure application of the most current concepts. James P. AuBuchon, MD, FCAP, FRCP(Edin) Compiler Copyright © 2014 by AABB. All rights reserved OVERVIEW 1 Overview 1. Ansari S, Szallasi A. Blood management by transfusion triggers: When less is more. Blood Transfus 2012;10:28-33. 2. Barr PJ, Donnelly M, Cardwell CR, et al. The appropriateness of red blood cell use and the extent of overtransfusion: Right decision? Right amount? Transfusion 2011;51:1684-94. 3. Berger K, Klein HG, Seitz R, et al. The Wildbad Kreuth initiative: European current practices and recommendations for optimal use of blood components. Biologicals 2011;39:189-93. 4. Bidstrup BP. Blood transfusion: The epidemic continues. Eur J Cardiothorac Surg 2012;42: 120-1. 5. Bisbe E, Moltó L. Pillar 2: Minimising bleeding and blood loss. Best Pract Res Clin Anaesthe- siol 2013;27:99-110. 6. Blood: A precious resource. Lancet 2013;381:1789. 7. Branco BC, Inaba K, Doughty R, et al. The increasing burden of phlebotomy in the develop- ment of anaemia and need for blood transfusion amongst trauma patients. Injury 2012; 43:78-83. 8. Carson JL, Kuriyan M. What should trigger a transfusion? Transfusion 2010;50:2073-5. 9. Cottrell S, Davidson V. National audit of bedside transfusion practice. Nurs Stand 2013; 27:41-8. 10. Dalrymple K, Watson D. Ten years of transfusion practitioners and better blood transfusion in Scotland. Nurs Manag (Harrow) 2014;20:27-30. 11. Dutton RP. Resuscitative strategies to maintain homeostasis during damage control surgery. Br J Surg 2012;99(Suppl 1):21-8. 12. Engelbrecht S, Wood EM, Cole-Sinclair MF. Clinical transfusion practice update: Haemovig- ilance, complications, patient blood management and national standards. Med J Aust 2013;199:397-401. 13. Faraoni D, Willems A, Van der Linden P. Erythrocyte transfusion: A fair balance. Anesthesiol- ogy 2011;115:660-1. 14. Farrugia A, Vamvakas E. Toward a patient-based paradigm for blood transfusion. J Blood Med 2014;5:5-13. 15. Farrugia A. Falsification or paradigm shift? Toward a revision of the common sense of trans- fusion. Transfusion 2011;51:216-24. 16. Frank SM, Rothschild JA, Masear CG, et al. Optimizing preoperative blood ordering with data acquired from an anesthesia information management system. Anesthesiology 2013;118:1286-97. 17. Frank SM, Savage WJ, Rothschild JA, et al. Variability in blood and blood component utiliza- tion as assessed by an anesthesia information management system. Anesthesiology 2012;117:99-106. 18. Frank SM, Wick EC, Dezern AE, et al. Risk-adjusted clinical outcomes in patients enrolled in a bloodless program. Transfusion 2014 (in press). doi: 10.1111/trf.12752. Copyright © 2014 by AABB. All rights reserved 2 CITATIONS IN PATIENT BLOOD MANAGEMENT 19. Freedman J. The ONTraC Ontario program in blood conservation. Transfus Apher Sci 2014; 50:32-6. 20. Freedman J. Transfusion—whence and why. Transfus Apher Sci 2014;50:5-9. 21. Frellick M. Better blood management could be a boon for hospitals. Hosp Health Netw 2012;86:46-8. 22. Friedman MT. Blood transfusion practices: A little consistency please. Blood Transfus 2011;9:362-5. 23. Gammon HM, Waters JH, Watt A, et al. Developing performance measures for patient blood management. Transfusion 2011;51:2500-9. 24. Gohel MS, Bulbulia RA, Poskitt KR, Whyman MR. Avoiding blood transfusion in surgical patients (including Jehovah’s Witnesses). Ann R Coll Surg Engl 2011;93:429-31. 25. Gombotz H. Patient blood management: A patient-orientated approach to blood replace- ment with the goal of reducing anemia, blood loss and the need for blood transfusion in elec- tive surgery. Transfus Med Hemother 2012;39:67-72. 26. Goodnough LT, Levy JH, Murphy MF. Concepts of blood transfusion in adults. Lancet 2013;381:1845-54. 27. Goodnough LT, Shander A. Patient blood management. Anesthesiology 2012;116:1367-76. Erratum in: Anesthesiology 2013;118:224. 28. Graham J, Grant-Casey J, Alston R, et al. Assessing transfusion competency in junior doctors: A retrospective cohort study. Transfusion 2014;54:128-36. 29. Gross I, Shander A, Sweeney J. Patient blood management and outcome, too early or not? Best Pract Res Clin Anaesthesiol 2013;27:161-72. 30. Hare GM, Freedman J, David Mazer C. Review article: Risks of anemia and related manage- ment strategies: Can perioperative blood management improve patient safety? Can J Anaesth 2013;60:168-75. 31. Hofmann A, Farmer S, Shander A. Five drivers shifting the paradigm from product-focused transfusion practice to patient blood management. Oncologist 2011;16(Suppl 3):3-11. 32. Hofmann A, Farmer S, Towler SC. Strategies to preempt and reduce the use of blood prod- ucts: An Australian perspective. Curr Opin Anaesthesiol 2012;25:66-73. 33. Howie SR. Blood sample volumes in child health research: Review of safe limits. Bull World Health Organ 2011;89:46-53. 34. Isbister JP. The three-pillar matrix of patient blood management—an overview. Best Pract Res Clin Anaesthesiol 2013;27:69-84. 35. King R, Michelman M, Curran V, et al. Patient-centered approach to ensuring appropriate- ness of care through blood management. South Med J 2013;106:362-8. 36. Koh BC, Chong LL, Goh LG, et al for the Ministry of Health Clinical Practice Guidelines Workgroup on Clinical Blood Transfusion. Ministry of health clinical practice guidelines: Clinical blood transfusion. Singapore Med J 2011;52:209-18. 37. Kumar A, Figueroa PI, Gowans KL, et al. An evolution in blood management: Past, present, and future.
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    Comparison of Fibrin Adhesives Prepared by 3 Different Methods

    Original Article Int. Arch. Otorhinolaryngol. 2013;17(1):62-65. DOI: 10.7162/S1809-97772013000100011 Comparison of fibrin adhesives prepared by 3 different methods Juliana Benthien Cavichiolo1, Maurício Buschle2, Bettina Carvalho3. 1) Medical Resident in Otolaryngology, HC-UFPR (Hospital de Clínicas da Universidade Federal do Paraná). 2) MMSc. Physician Assistant, Department of Otolaryngology, Faculty of Medicine, UFPR; Associate Professor of Otolaryngology. 3) Otolaryngologist by ABORLCCF. Institution: Hospital de Clínicas da Universidade Federal do Paraná. Curitiba / PR - Brazil. Mailing address: Juliana Benthien Cavichiolo - Rua General Carneiro, 181 - Alto da XV - Curitiba / PR - Brazil - Zip code: 80060-900 - E-mail: [email protected] Article received on May 1, 2011. Article accepted on October 25, 2012. SUMMARY Introduction: Fibrin tissue adhesive, which has applications in several areas of medicine, can be prepared by different methods. Aim: To compare fibrin tissue adhesives prepared by 3 different methods. Method: In this prospective experimental laboratory study, fibrin tissue adhesives prepared by the use of plasma fibrinogen (group 1), cryoprecipitation (group 2), and precipitation by ammonium sulfate (group 3) were tested on 15 rabbits and 10 fragments of dura mater. The quality of the clots was assessed in terms of the success of the healing process, local toxicity, graft adhesion capacity, and degree of adhesion of 2 fragments of dura mater produced. Results: All methods produced a clot with high adhesion and no toxicity, but tensile strength testing revealed that the glue produced from the ammonium sulfate-precipitated clot (group 3) was the strongest, requiring 39 g/cm ² to separate the fragments as opposed to 23 g/cm ² for group 2 and 13 g/cm ² for group 1.
  • Does Tranexamic Acid Stabilised Fibrin Support the Osteogenic Differentiation of Human Periosteum Derived Cells? J

    Does Tranexamic Acid Stabilised Fibrin Support the Osteogenic Differentiation of Human Periosteum Derived Cells? J

    JEuropean Demol et Cells al. and Materials Vol. 21 2011 (pages 272-285) DOI: 10.22203/eCM.v021a21 Fibrin for osteogenic differentiation ISSN of1473-2262 hPDCs? DOES TRANEXAMIC ACID STABILISED FIBRIN SUPPORT THE OSTEOGENIC DIFFERENTIATION OF HUMAN PERIOSTEUM DERIVED CELLS? J. Demol1,3, J. Eyckmans2,3, S.J. Roberts2,3, F.P. Luyten2,3 and H. Van Oosterwyck1,3,* 1 Division of Biomechanics and Engineering Design, 2 Laboratory for Skeletal Development and Joint Disorders, 3 Prometheus, Division of Skeletal Tissue Engineering Leuven, K.U. Leuven, Leuven, Belgium Abstract Introduction Fibrin sealants have long been used as carrier for osteogenic Fibrin is a natural polymer that is formed during blood cells in bone regeneration. However, it has not been clotting from its precursor protein fibrinogen. The demonstrated whether fibrin’s role is limited to delivering conversion of fibrinogen to fibrin is triggered by thrombin cells to the bone defect or whether fibrin enhances (Blomback, 1996). In fibrin sealants, this coagulation osteogenesis. This study investigated fibrin’s influence on process has been engineered into an adhesive system that the behaviour of human periosteum-derived cells (hPDCs) is widely used in many surgical fields to promote when cultured in vitro under osteogenic conditions in two- haemostasis, sealing and tissue bonding. Commercial dimensional (fibrin substrate) and three-dimensional (fibrin fibrin sealant kits contain highly purified and virally carrier) environments. Tranexamic acid (TEA) was used inactivated human fibrinogen and human thrombin to reduce fibrin degradation after investigating its effect (Jackson, 2001). Fibrin is a non-cytotoxic, fully on hPDCs in monolayer culture on plastic. TEA did not resorbable, bioactive matrix with multiple interaction sites affect proliferation nor calcium deposition of hPDCs under for cells and other proteins (Mosesson et al., 2001).
  • A Study on Ulinastatin in Preventing Post ERCP Pancreatitis

    A Study on Ulinastatin in Preventing Post ERCP Pancreatitis

    International Journal of Advances in Medicine Vedamanickam R et al. Int J Adv Med. 2017 Dec;4(6):1528-1531 http://www.ijmedicine.com pISSN 2349-3925 | eISSN 2349-3933 DOI: http://dx.doi.org/10.18203/2349-3933.ijam20175083 Original Research Article A study on ulinastatin in preventing post ERCP pancreatitis R. Vedamanickam1, Vinoth Kumar2*, Hariprasad2 1Department of Medicine, 2Department of Gasto and Hepatology , SREE Balaji Medical College and Hospital, Chrompet, Chennai, Tamil Nadu, India Received: 19 September 2017 Accepted: 25 October 2017 *Correspondence: Dr. Vinothkumar, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Pancreatitis remains the major complication of endoscopic retrograde cholangiopancreatography (ERCP), and hyperenzymemia after ERCP is common. Ulinastatin, a protease inhibitor, has proved effective in the treatment of acute pancreatitis. The aim of this study was to assess the efficacy of ulinastatin, compare to placebo study to assess the incidence of complication due to ERCPP procedure. Methods: In this study a randomized placebo controlled trial, patients undergoing the first ERCP was randomizing to receive ulinastatin one lakh units (or) placebo by intravenous infusion one hour before ERCP for ten minutes duration. Clinical evaluation, serum amylase, ware analysed before the procedure 4 hours and 24 hours after the procedure. Results: Total of 46 patients were enrolled (23 in ulinastatin and 23 in placebo group).
  • SAP American Society of Hematology Self-Assessment Program

    SAP American Society of Hematology Self-Assessment Program

    ASH®-SAP American Society of Hematology Self-Assessment Program SIXTH EDITION BK-ASH-SAP_6E-150511-FM.indd 1 4/29/2016 3:59:06 PM Disclosures As a provider accredited by the Accreditation Council for Hemostasis Research Society of North America (HTRS); Continuing Medical Education (ACCME), the American member of an advisory board for GlaxoSmithKline. Society of Hematology must ensure balance, independence, objectivity, and scientific rigor in all of the educational ac- Chapter 4, Hematopoietic growth factors tivities it sponsors. All authors are expected to disclose any financial relationships with any proprietary entity producing Aaron T. Gerds declares no competing financial interest. health care goods or services that have occurred within 24 Alan E. Lichtin declares no competing financial interest. months from the start of or during the production of the work and that are relevant to the author’s content. If an au- Chapter 5, Iron metabolism, iron overload, thor has such a financial interest, then she or he must dis- and the porphyrias close the name of the commercial interest and nature of the relationship (eg, consultant, grantee, etc.). An author who Heather A. Leitch has received honoraria, research funding, has no such financial relationship must declare that she or and/or served on advisory boards for Alexion, Apo-Pharma, he has nothing to disclose. The intent of this disclosure is Celgene, and Novartis. She is a member of the Exjade speak- not to prevent an author with a significant financial or other ers’ bureau. Jecko Thachil declares no competing financial relationship from making a presentation, but rather to pro- interest.
  • Pok News Digest a Monthly News Digest on Pakistan Occupied Kashmir

    Pok News Digest a Monthly News Digest on Pakistan Occupied Kashmir

    POK NEWS DIGEST A MONTHLY NEWS DIGEST ON PAKISTAN OCCUPIED KASHMIR Volume 1 Number 5 October 2008 • Political Developments Conspiracy to Divide Gilgit Baltistan People Will Fail, Says GBUM Afghans to be Kicked Out of Gilgit Baltistan Kashmir Issue to be Finalized During Govt’s Tenure, Says Kaira MJC Condemns Zardari’s Statement on Kashmir • Economic Developments Line of Control Becomes Line of Commerce PoK Team Crosses Over, Hopes to Trade Peace Kohala Power Project Attracts Chinese Firm • International Developments EU Team Welcomes Reopening of Kashmir Trade Route Kashmir Solidarity Day Observed in Washington Compiled by Dr Priyanka Singh • Other Developments Kashmiris Observe 61st Founding Day Layout KIU Regional Campus in Baltistan Demanded Sanjay Kumar INSTITUTE FOR DEFENCE STUDIES AND ANALYSES No. 1, Development Enclave, Rao Tula Ram Marg October 2008 New Delhi-110 010 1 Jammu & Kashmir (Source: Based on the Survey of India Map, Govt of India 2000 ) October 2008 2 About this Issue One of the reports in this issue indicates that the PPP-led government in Pakistan intends to withdraw the Legal Framework Order of 2004 from Gilgit Baltistan and replace it with a new constitutional package which embodies an “AJK” like political set up for the Northern Areas- a set up which comprises a president, a cabinet headed by a prime minister and a High Court. The local PPP leadership in consultation with the establishment in Pakistan is reportedly working on finalities of political transition in the Northern Areas. On a positive note, at least the government of Pakistan has finally admitted that people in this region were subjected to deprivation from basic political rights and economic gains.