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A Causal Model for Prehospital Blood Transfusion and Mortality in Traumatic Hemorrhagic Shock.

OBJECTIVES: Utilization of prehospital blood transfusion (PBT) as a treatment for traumatic hemorrhagic shock (THS) has been expanding nationally, yet evidence supporting the practice in some operational environments remains limited. Development of strong scientific evidence to support this practice requires a clear causal model linking prehospital transfusion to mortality and other clinically relevant outcomes. The aim of this project is to develop such a causal model, identifying pathways among the intervention, mediators, and contextual factors through which PBT may impact mortality. METHO…

Риск передачи амилоидной патологии β через перелитые продукты крови.

Семенные белки неправильно завязываются и агрегируются для многих нейродегенеративных заболеваний. Архетипом являются прионы: только белковые инфекционные агенты, которые вызывают смертельные нейродегенеративные заболевания, включая болезнь Креуцфельда-Якоба (CJD). Недавнее признание иатрогенной амилоидной β церебральной ангиопатии (КАА) и болезни Альцгеймера, вызванной непреднамеренным посевом амилоидной патологии β в соответствии с историческими медицинскими процедурами, вызывает обеспокоенность в связи с тем, что эти заболевания могут также передаваться через компоненты и продукты крови, ка

Совпадение в аннотации оригинала
Seeded protein misfolding and aggregation are relevant to many neurodegenerative diseases. The archetype are prions: protein-only infectious … under which bloodborne prion transmission has previously occurred. We discuss the implications for blood transfusion services, particularly in light of the UK Infected Blood Inquiry, and the key questions that need to be addressed to better quantify transfusion-related risk.

Viscoelastic Hemostatic Assays are Associated With Mortality and Blood Transfusion in a Multicenter Cohort.

OBJECTIVES: Trauma-induced coagulopathy (TIC) carries significant risks, including increased mortality. Traditional TIC definitions rely on laboratories that result slowly and do not highlight therapeutic targets. We hypothesized that a TIC score, based on thromboelastography (TEG) and rotational thromboelastometry (ROTEM), collectively termed viscoelastic hemostatic assays, is associated with in-hospital mortality and packed red blood cell (pRBC) transfusion. METHODS: This retrospective cohort study used a database of adult patients undergoing institutional massive transfusion at seven level

Variation in effectiveness of blood transfusion by hospital day: A multicenter retrospective study.

BACKGROUND: Transfusion of packed red blood cells (pRBCs) below a hemoglobin concentration of 7.0 g/dL is common, but it is unclear if the timing of transfusion during hospitalization modifies transfusion effectiveness. We sought to determine if effects of pRBC transfusion are heterogenous based on time from hospital admission. METHODS: Multicenter retrospective cohort study including hospitals in the Premier Inc. AI Healthcare Database between 2016 and 2022. Hospital encounters for adults with at least one hemoglobin concentration measured between hospital Days 1-7 were included. For each da

The effect of allogeneic blood transfusion on burn mortality in a resource-limited setting.

INTRODUCTION: There are nearly 9 million new burn cases worldwide, with a disproportional burn burden in low- and middle-income countries. Patients with significant burn injury frequently require multiple blood transfusions; however, there is a paucity of data regarding the effect of allogeneic blood transfusion following burn injury in a resource-limited setting with a high anemia prevalence at baseline. This study aimed to determine the effect of blood transfusion on burn mortality. METHODS: We performed a retrospective review of patients presenting with burns between 2011 and 2019, using p…

[Blood transfusion at the stages of evacuation of the wounded in military conflicts of the XIX century].

During the 19th century, the scope of blood transfusion was significantly expanded. Along with obstetric practice, hemotransfusion has been actively used in the fight against acute blood loss in combat and traumatic injuries. New broad opportunities for the development of the method were obtained during numerous military campaigns of the XIX century, accompanied by an increase in the destructive power of firearms and the number of wounded who died from acute massive bleeding on the battlefield. The article examines how high hopes for the introduction of blood transfusion among the means of hel…

Why might cord blood be a better source of platelets for transfusion to neonates?

Thrombocytopenia (defined as a platelet count <150×109/L) is a common condition in preterm neonates and may occur in 18-35% of all infants admitted to the Neonatal Intensive Care Unit (NICU). Neonatal platelet functionality in terms of reactivity is often described as reduced compared to adults, even in healthy, term neonates. However, this platelet "hyporeactivity" does not correspond to a global functional impairment of the normal delicately balanced neonatal hemostatic system. The extent to which neonatal thrombocytopenia and platelet hyporeactivity contribute to the bleeding risk in preter

The effect of haemoglobin and blood transfusion on preterm infant gut perfusion and injury.

INTRODUCTION: There is significant uncertainty regarding the role that anaemia or red blood cell transfusion (RBCT) plays in the development … > 0.05). 283 RBCTs were administered; 117 (41.3%) within the first two weeks of life. Pre and post blood transfusion changes in splanchnic NIRS oxygenation, urine and stool gut injury biomarkers were measured in 165, 195 and 175 episodes of RBCT respectively. There was no significant post RBCT changes in splanchnic NIRS or gut injury biomarker levels (p > 0.05). H …

Prognostic Value of Intraoperative Blood Transfusion in Patients with Adenocarcinoma of the Esophagogastric Junction.

Background and objectives: Adenocarcinoma of the esophagogastric junction (AEG) has a complicated surgical anatomy, due to which it sometimes induces excessive intraoperative blood loss that necessitates intraoperative blood transfusion (BTF). However, few reports have focused on the impact of BTF on the survival outcomes of patients with AEG. We aimed to evaluate the impact of BTF on AEG prognosis. Materials andMethods: We included 63 patients who underwent surgical resection for AEG at our hospital between January 2010 and September 2020. Clinicopathological characteristics and survival outc…

Prevalence of iron deficiency and red blood cell transfusions in surgical patients.

BACKGROUND AND OBJECTIVES: While iron deficiency (ID) is the most common cause of anaemia, little is known about the prevalence and type of ID in preoperative surgical patients. The aims of the present study were to investigate the prevalence and types of ID in a large cohort of surgical patients, and how these are related to perioperative blood use after correction for confounders such as haemoglobin level. MATERIALS AND METHODS: Data were retrospectively extracted from electronic case records of all patients who underwent elective surgery between September 2016 and November 2017 (n = 2711).

Unrecognized Hemoglobin Variants in the Donor Blood Supply Are Detectable in the Transfused Population.

OBJECTIVES: The US Food and Drug Administration requires donated blood to be tested for various infectious diseases to ensure safety and purity. However, testing for hemoglobin variants is not required, despite reported occurrences of hemoglobin variant transfusion and concerns about the safety of such transfusions. This study aimed to investigate the frequency of hemoglobin variants within the blood supply. METHODS: We performed a 2-part study. First, we tested all RBC units in our blood bank by high-performance liquid chromatography for the presence of hemoglobin variants. Second, we perfor

Impact of allogeneic blood transfusions on clinical outcomes in severely burned patients.

BACKGROUND: Allogeneic blood transfusions are common in the treatment of severely burned patients as surgery may lead to major blood loss. However, transfusions are associated with a number of adverse events. Therefore, the purpose of our study was to investigate the impact of allogeneic blood transfusions on clinical outcomes in severely burned patients. METHODS: This retrospective study included all adult patients admitted to the burn center of the University Hospital Zurich between January 2004 and December 2014, with burn injuries greater than 10% of total body surface area and receiving …

The Effect of Blood Transfusion on Growth of Patients with Hb E/β-Thalassemia.

A retrospective evaluation of growth in 112 patients (68 males, 44 females) with Hb E (HBB: c.79G>A)/β-thalassemia (β-thal), classified as 88 transfusion-dependent thalassemia (TDT) and 24 non transfusion-dependent thalassemia (NTDT), is reported. Patients with TDT have received regular transfusions of red blood cells (RBCs) 15 mL/kg every 4 weeks to maintain pre transfusion hemoglobin (Hb) levels of at least 9.0 g/dL and were categorized according to age at initiation of regular RBC transfusion as subgroup 1, <4 years; subgroup 2, 4-10 years, and subgroup 3, >10 years. Iron chelation was init

Transfusing maternal blood to her newborn baby-irrespective of ABO mismatch.

Background: Though blood transfusions are the common procedures in pediatric patients, transfusion reactions are rare in children. Though in adults, uncross-matched ABO group-specific blood is used in emergencies, there are no such reports in neonates and children. There are stray case reports about transfusing maternal blood for her baby and maternal blood is de facto compatible regardless of an ABO mismatchObjective: Confirming our previous hypothesis that maternal blood is compatible with her baby's blood; and maternal blood can be used for transfusion in her newborn baby irrespective of AB…

Risk perception of blood transfusions - a comparison of patients and allied healthcare professionals.

BACKGROUND: Due to an increasing demand in health care services plans to substitute selective physician-conducted medical activities have become attractive. Because administration of a blood transfusion is a highly standardized procedure, it might be evaluated if obtaining a patient's consent for a blood transfusion can be delegated to allied healthcare professionals. Physicians and patients perceive risks of transfusions differently. However, it is unknown how allied healthcare professionals perceive risks of transfusion-associated adverse events. METHODS: Patients (n = 506) and allied healt…

Prehospital Blood Transfusions in Pediatric Patients by a Helicopter Emergency Medical Service.

OBJECTIVE: In the prehospital setting, the Nijmegen and Rotterdam helicopter emergency medical services administer packed red blood cells to critically ill or injured pediatric patients. Blood is given on scene or during transport and is derived from nearby hospitals. We summarize our experience with prehospital blood use in pediatric patients. METHODS: The databases from both the Nijmegen and Rotterdam helicopter emergency medical services were reviewed for all pediatric (< 18 years) patients who received packed red blood cells on scene or during transport to the hospital. RESULTS: Between

[Initial hemoglobin value as a predictor of allogeneic blood transfusion in hip fracture].

INTRODUCTION: Hip fracture is a cause of major morbidity and mortality and is often associated with high blood transfusion rate, non-complication-free therapy. The objective of the study is to evaluate the factors dependent and independent of the transfusional act, as well as to elaborate an algorithm that allows us to make a decision making based on a statistical model rationalizing the use of blood. MATERIAL AND METHODS: Prospective study on 100 patients older than 65 years intervened for hip fracture consecutively. We analyzed demographic data, drug taking, comorbidity, pre- and postoperat…

Lead and Mercury Levels in Preterm Infants Before and After Blood Transfusions.

Very low birth weight (VLBW) infants usually receive packed red blood cell unit (pRBC) transfusions. Heavy metal transfer via pRBCs is not widely discussed before. This study aimed to determine pre-/post-transfusion erythrocyte lead and mercury levels in infants and to correlate these levels to heavy metal concentrations in pRBCs. VLBW infants (n = 80), needing pRBC transfusion for the first time, were enrolled. Erythrocyte heavy metal levels were determined in pre-/post-transfusion blood samples and also in pRBC units. Mean lead and mercury levels in the pRBCs were found to be 16.3 ± 10.8 and

Blood transfusion for anaemia of prematurity: Current practice in Australia and New Zealand.

AIM: To characterise the current transfusion practice among clinicians in Australasian neonatal units and factors that influence their decision-making. METHODS: Members of the Australia and New Zealand Neonatal Network (ANZNN) and practitioners at their local institutions were invited to participate in a 15-question web-based survey between 1 June and 31 July 2016. The survey was designed to assess (i) haemoglobin-based transfusion thresholds; (ii) presence of local guidelines; (iii) preference for a restrictive or liberal transfusion policy; (iv) perceived benefits and risks of transfusion;

Obstetric hemorrhage and safe blood for transfusion in Ethiopia: the challenges of bridging the gap.

BACKGROUND: Obstetric hemorrhage is a leading cause of maternal death in sub-Saharan Africa, and the shortage of blood for transfusion is a contributory factor. In Ethiopia, the National Blood Bank Service continues to be confronted with challenges in its efforts to ensure the availability of blood for health care facilities. This paper reviews the available data on the contribution of obstetric hemorrhage to maternal mortality and examines the current status of the blood supply in Ethiopia. STUDY DESIGN AND METHODS: We reviewed the published literature and data from the Ethiopian Federal Min