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Military Medicine Sep 2018Whole blood is the preferred product for resuscitation of severe traumatic hemorrhage. It contains all the elements of blood that are necessary for oxygen delivery and...
Whole blood is the preferred product for resuscitation of severe traumatic hemorrhage. It contains all the elements of blood that are necessary for oxygen delivery and hemostasis, in nearly physiologic ratios and concentrations. Group O whole blood that contains low titers of anti-A and anti-B antibodies (low titer group O whole blood) can be safely transfused as a universal blood product to patients of unknown blood group, facilitating rapid treatment of exsanguinating patients. Whole blood can be stored under refrigeration for up to 35 days, during which it retains acceptable hemostatic function, though supplementation with specific blood components, coagulation factors or other adjuncts may be necessary in some patients. Fresh whole blood can be collected from pre-screened donors in a walking blood bank to provide effective resuscitation when fully tested stored whole blood or blood components are unavailable and the need for transfusion is urgent. Available clinical data suggest that whole blood is at least equivalent if not superior to component therapy in the resuscitation of life-threatening hemorrhage. Low titer group O whole blood can be considered the standard of care in resuscitation of major hemorrhage.
Topics: Blood Banking; Blood Component Transfusion; Blood Transfusion; Hemorrhage; Humans; Military Personnel; Resuscitation
PubMed: 30189061
DOI: 10.1093/milmed/usy120 -
Seminars in Hematology Oct 1999Blood transfusion became a relatively safe and practicable procedure following the discovery in 1900 of blood groups and the realization early in the first World War... (Review)
Review
Blood transfusion became a relatively safe and practicable procedure following the discovery in 1900 of blood groups and the realization early in the first World War that citrate was a safe and effective anticoagulant. Transfusion may elicit the formation of antibodies in the recipient due to "foreign" antigens on the donor's red cells, white cells, or platelets. Application of the methods of molecular biology has characterized the antigens concerned and the genes that determine them. The concept of transfusing whole blood to remedy a deficiency of any constituent, for example, platelets, has been superseded by the idea of transfusing only that component of blood which is needed. Many viruses, for example, hepatitis viruses and human immunodeficiency viruses, can be transmitted by transfusion. The high degree of success in preventing their transmission is a scientific triumph.
Topics: Blood Transfusion; Erythrocytes; Granulocytes; History, 20th Century; Humans; Platelet Transfusion
PubMed: 10595754
DOI: No ID Found -
Nursing Standard (Royal College of...Blood transfusion is a potentially dangerous treatment in which adverse reactions are rare but can be fatal. This article introduces recently published national... (Review)
Review
Blood transfusion is a potentially dangerous treatment in which adverse reactions are rare but can be fatal. This article introduces recently published national guidelines for the care of recipients of a blood transfusion (BCSH 1999) and focuses in particular on the responsibilities of nurses and midwives.
Topics: Blood Grouping and Crossmatching; Blood Transfusion; Humans; Job Description; Nurse's Role; Practice Guidelines as Topic; Risk Factors; Safety Management; Transfusion Reaction
PubMed: 11974045
DOI: 10.7748/ns2000.05.14.34.47.c2837 -
Emergency Medicine Journal : EMJ Jun 2020In the era of damage control resuscitation of trauma patients with acute major haemorrhage, transfusion practice has evolved to blood component (component therapy)...
OBJECTIVE
In the era of damage control resuscitation of trauma patients with acute major haemorrhage, transfusion practice has evolved to blood component (component therapy) administered in a ratio that closely approximates whole blood (WB). However, there is a paucity of evidence supporting the optimal transfusion strategy in these patients. The primary objective was therefore to establish if there is an improvement in survival at 30 days with the use of WB transfusion compared with blood component therapy in adult trauma patients with acute major haemorrhage.
METHODOLOGY
A systematic literature search was performed on 15 December 2019 to identify studies comparing WB transfusion with component therapy in adult trauma patients and mortality at 30 days. Studies which did not report mortality were excluded. Methodological quality of included studies was interpreted using the Cochrane risk of bias tool, and rated using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Search of the databases identified 1885 records, and six studies met the inclusion criteria involving 3255 patients. Of the three studies reporting 30-day mortality (one randomised controlled trial (moderate evidence) and two retrospective (low and very low evidence, respectively)), only one study demonstrated a statistically significant difference between WB and component therapy, and two found no statistical difference. Two retrospective studies reporting in-hospital mortality found no statistical difference in unadjusted mortality, but both reported statistically significant logistic regression analyses demonstrating that those with a WB transfusion strategy were less likely to die.
CONCLUSION
Recognising the limitations of this systematic review relating to the poor-quality evidence and limited number of included trials, it does not provide evidence to support or reject use of WB transfusion compared with component therapy for adult trauma patients with acute major haemorrhage.
PROSPERO REGISTRATION NUMBER
CRD42019131406.
Topics: Adult; Blood Component Transfusion; Blood Transfusion; Hemorrhage; Humans; Resuscitation; Wounds and Injuries
PubMed: 32376677
DOI: 10.1136/emermed-2019-209040 -
Hematology/oncology Clinics of North... Apr 2016A safe supply of blood and the knowledge, skill, and resources for the appropriate use of blood are essential for medical services. Many problems are faced in the... (Review)
Review
A safe supply of blood and the knowledge, skill, and resources for the appropriate use of blood are essential for medical services. Many problems are faced in the development of transfusion services in low- or medium-income countries (LMICs). Unfortunately, in many countries, providing safe blood is made more difficult by a lack of blood donors and the high frequency of transfusion-transmissible infections. The problems are compounded by the frequent need for urgent life-saving transfusions. This article examines the problems in supply, safety, and use of blood and how they are being addressed in LMICs, predominantly focusing on sub-Saharan Africa.
Topics: Blood Donors; Blood Safety; Blood Transfusion; Developing Countries; Humans; Quality Improvement; Transfusion Reaction
PubMed: 27040966
DOI: 10.1016/j.hoc.2015.11.011 -
Knee Surgery, Sports Traumatology,... Sep 2017To study whether autologus blood transfusion systems reduce the requirement of allogneic blood transfusion in patients undergoing total knee arthroplasty. (Review)
Review
PURPOSE
To study whether autologus blood transfusion systems reduce the requirement of allogneic blood transfusion in patients undergoing total knee arthroplasty.
METHODS
A comprehensive search of the published literature with PubMed, Scopus and Science direct database was performed. The following search terms were used: (total knee replacement) OR (total knee arthroplasty) OR (TKA) AND (blood transfusion) OR (autologous transfusion) OR (autologous transfusion system). Using search syntax, a total of 748 search results were obtained (79 from PubMed, 586 from Science direct and 83 from Scopus). Twenty-one randomized control trials were included for this meta-analysis.
RESULTS
The allogenic transfusion rate in autologus blood transfusion (study) group was significantly lower than the control group (28.4 and 53.5 %, respectively) (p value 0.0001, Relative risk: 0.5). The median units of allogenic blood transfused in study control group and control group were 0.1 (0.1-3.0) and 1.3 (0.3-2.6), respectively. The median hospital stay in study group was 9 (6.7-15.6) days and control group was 8.7 (6.6-16.7) days. The median cost incurred for blood transfusion per patient in study and control groups was 175 (85.7-260) and 254.7 (235-300) euros, respectively.
CONCLUSION
This meta-analysis demonstrates that the use of auto-transfusion systems is a cost-effective method to reduce the need for and quantity of allogenic transfusion in elective total knee arthroplasty.
LEVEL OF EVIDENCE
Level I.
Topics: Arthroplasty, Replacement, Knee; Blood Transfusion; Blood Transfusion, Autologous; Humans; Length of Stay
PubMed: 27085359
DOI: 10.1007/s00167-016-4116-z -
Current Opinion in Anaesthesiology Feb 2015Anemia has been demonstrated to be detrimental in several populations such as high-surgical-risk patients, critically ill elderly, and cardiac patients. Red blood cell... (Review)
Review
PURPOSE OF REVIEW
Anemia has been demonstrated to be detrimental in several populations such as high-surgical-risk patients, critically ill elderly, and cardiac patients. Red blood cell transfusion is the most commonly prescribed therapy for anemia. Despite being life-saving, it carries a risk that ranges from mild complications to death. The aim of this review is to discuss the risks of anemia and blood transfusion, and to describe recent developments in the strategies to reduce allogeneic blood transfusion.
RECENT FINDINGS
In the past decades, clinical studies comparing transfusion strategies in different populations were conducted. Despite the challenges imposed by the development of such studies, evidence-based medicine on transfusion medicine in critically ill patients is being created. Different results arising from these studies reflect population heterogeneity, specific circumstances, and difficulties in measuring the impact of anemia and transfusion in a clinical trial.
SUMMARY
An adequate judgment of a clinical condition associated with proper application of the available literature is the cornerstone in the management of transfusion in critical care. Apart from this individualized strategy, the institution of a patient blood management program allows goal-directed approach through preoperative recognition of anemia, surgical efforts to minimize blood loss, and continuous assessment of the coagulation status.
Topics: Anemia; Blood Transfusion; Erythrocyte Transfusion; Humans; Latin America; Randomized Controlled Trials as Topic; Transfusion Reaction
PubMed: 25486489
DOI: 10.1097/ACO.0000000000000144 -
British Medical Journal (Clinical... Jul 1985
Topics: Blood Transfusion; Blood Transfusion, Autologous; Hemodilution; Hospitals; Humans; Surgical Procedures, Operative; United Kingdom
PubMed: 3926134
DOI: 10.1136/bmj.291.6490.234 -
Emergency Nurse : the Journal of the... Mar 2006
Review
Topics: Blood Transfusion; Emergency Nursing; Health Care Surveys; Humans; Nursing Audit; Practice Guidelines as Topic; Surveys and Questionnaires; United Kingdom
PubMed: 16566313
DOI: 10.7748/en.13.10.18.s19 -
Transfusion Dec 2017
Topics: Blood Transfusion; Blood Transfusion, Autologous; Humans; Platelet Transfusion
PubMed: 29226371
DOI: 10.1111/trf.14385