Publications by authors named "Declan Sela"
Background: Packed red blood cell (pRBC) transfusion is a relatively safe and mainstay treatment commonly used in cardiac surgical patients. However, there is limited evidence on clinical effects of transfusing blood nearing end-of shelf life that has undergone biochemical changes during storage.
Objective: To investigate evidence of associations between morbidity/mortality and transfusion of blood near end of shelf-life (> 35 days) in cardiac surgical patients.
Introduction: In December 2019, the COVID-19 pandemic highlighted the urgent need for rapid collaboration, research, and interventions. International research collaborations foster more significant responses to rapid global changes by enabling international, multicentre research, decreasing biases, and increasing study validity while reducing overall research time and costs. However, there has been low uptake of collaborative research by African institutions and individuals.
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- Shock-induced endotheliopathy (SHINE) is a condition characterized by severe endothelial dysfunction due to extreme sympathetic activation during shock states, which can worsen organ perfusion despite aggressive resuscitation efforts.
- This study systematically reviewed literature from Jan 2011 to July 2023, focusing on how resuscitation can affect endothelial health in critically ill patients, while excluding animal studies and reviews.
- Out of 32 relevant studies analyzed, many identified biomarkers related to endothelial damage, but only a few comparable studies were suitable for a quantitative meta-analysis on specific markers like syndecan-1 and thrombomodulin, indicating significant variability in the results.
Article Synopsis
- This study examined the impact of transfusing blood products that are close to their shelf-life on clinical outcomes in obstetric patients in Queensland, Australia, from 2007 to 2013.
- Comparing fresh (less than 21 days old for RBC, less than 3 days for PLT) to old blood products (35 days or older for RBC, 4 days or older for PLT), researchers found no significant difference in patient outcomes such as hospital stay length or morbidity.
- The results indicated that using older RBC or PLT did not lead to higher rates of complications or mortality among the patients studied.
The right ventricle (RV) has a critical role in hemodynamics and right ventricular failure (RVF) often leads to poor clinical outcome. Despite the clinical importance of RVF, its definition and recognition currently rely on patients' symptoms and signs, rather than on objective parameters from quantifying RV dimensions and function. A key challenge is the geometrical complexity of the RV, which often makes it difficult to assess RV function accurately.
View Article and Find Full Text PDFObjectives: To determine the prevalence and outcomes associated with hemorrhage, disseminated intravascular coagulopathy, and thrombosis (HECTOR) complications in ICU patients with COVID-19.
Design: Prospective, observational study.
Setting: Two hundred twenty-nine ICUs across 32 countries.