Publications by authors named "Pavenski K"
Background: Effective hemorrhage protocols prioritize immediate hemostatic resuscitation to manage hemorrhagic shock. Prehospital resuscitation using blood products, such as whole blood or alternatively dried plasma in its absence, has the potential to improve outcomes in hemorrhagic shock patients. However, integrating blood products into prehospital care poses substantial logistical challenges due to issues with storage, transport, and administration in field environments.
View Article and Find Full Text PDFBackground And Objectives: Preoperative anemia can impact postoperative outcomes, but its importance in gastrointestinal cancer patients, and significance of anemia etiology remains unclear. We aimed to characterize the frequency and impact of preoperative anemia, and iron-deficiency anemia (IDA), on perioperative outcomes.
Methods: We performed a retrospective cohort study of adult patients undergoing elective gastrointestinal cancer surgery.
Background: Hereditary hemorrhagic telangiectasia (HHT) is a genetic blood vessel disorder which may lead to chronic bleeding and red blood cell (RBC) transfusions. Data on transfusion requirements and complications in HHT patients are sparse.
Study Design And Methods: Retrospective chart review was conducted at St.
Apheresis is performed worldwide for an increasing number of indications. The development of common data elements (CDE) for apheresis related areas may facilitate conduct of new research, enhance quality initiatives including benchmarking, and improve patient care. This report describes the systematic development of the Uniform Apheresis Case Report Form (UACRF) as part of the Apheresis in the United States (ApheresUS) program.
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- The study aimed to evaluate whether higher scores on a knowledge test about blood transfusions are linked to more appropriate transfusion orders among healthcare providers.
- Participants included postgraduate trainees and faculty who had recently prescribed transfusions, and their knowledge was assessed using an online questionnaire.
- Results showed that while transfusion order appropriateness was high at 90.7%, there was a very weak correlation between knowledge test scores and order appropriateness, suggesting that other factors influence effective transfusion practices.*
Cross-reacting antiporcine factor VIII inhibitors in patients with acquired hemophilia A.
Res Pract Thromb Haemost
August 2024
Article Synopsis
- Recombinant porcine factor VIII (rpFVIII) is used to treat bleeding in patients with acquired hemophilia A.
- A significant challenge in its effectiveness is the presence of cross-reacting anti-human FVIII antibodies in patients.
- In this study, 52% of patients with acquired hemophilia A had these antibodies, which resulted in lower FVIII activity levels after receiving rpFVIII.
Article Synopsis
- Immune-mediated thrombotic thrombocytopenic purpura (iTTP) can be life-threatening even with standard treatments, so caplacizumab was studied for its effect on preventing complications by inhibiting platelet interaction with von Willebrand factor.
- The study analyzed data from the phase 3 HERCULES trial, focusing on how caplacizumab performs in different patient subgroups based on their iTTP history, severity at the start of treatment, and initial immunosuppressive drugs.
- Results showed that caplacizumab led to quicker recovery of platelet counts, reduced complications, and improved outcomes for all patient subgroups, reinforcing its safety and effectiveness when used alongside other treatments.*
Prior studies have suggested that immune thrombotic thrombocytopenic purpura (iTTP) may display seasonal variation; however, methodologic limitations and sample sizes have diminished the ability to perform a rigorous assessment. This 5-year retrospective study assessed the epidemiology of iTTP and determined whether it displays a seasonal pattern. Patients with both initial and relapsed iTTP (defined as a disintegrin and metalloprotease with thrombospondin type motifs 13 activity <10%) from 24 tertiary centers in Australia, Canada, France, Greece, Italy, Spain, and the US were included.
View Article and Find Full Text PDFBackground And Objectives: By optimizing erythropoiesis, patient blood management (PBM) programmes can reduce transfusions, lower mortality and provide cost-effective care. While definitions of anaemia have historically varied by sex, for the purposes of PBM, anaemia is defined as a haemoglobin <130 g/L. Our objective was to describe whether perioperative anaemia and transfusion rates in the PBM setting vary by sex.
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- - Neutralizing antibodies (Abs) against SARS-CoV-2 vary widely among individuals recovering from the virus, with higher levels found in those with severe COVID-19 cases.
- - Heat inactivation of convalescent serum significantly reduces its neutralization activity by inactivating complement proteins, which play a major role in the body’s immune response against the virus.
- - The study highlights that the complement pathway is crucial for effective viral neutralization and that its contribution can be more than 50% of the neutralizing effect in untreated serum.
Article Synopsis
- Albumin is commonly used in various clinical settings for improving blood flow, fluid removal, and managing cirrhosis complications, leading to guidelines created by the International Collaboration for Transfusion Medicine.
- A dedicated panel, including researchers and a patient representative, developed these guidelines based on a systematic review of existing studies, resulting in 14 recommendations for adult and pediatric critical care, cardiovascular surgery, kidney therapy, and cirrhosis management.
- Most recommendations (12 out of 14) advised against widespread albumin usage in many scenarios, highlighting a lack of strong evidence, with only two recommendations suggesting conditional use in specific cirrhosis cases.
Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare condition caused by severe ADAMTS13 deficiency, leading to platelet aggregation and thrombosis. Despite treatment, patients are prone to cognitive impairment and depression. We investigated brain changes in iTTP patients during remission using advanced magnetic resonance imaging (MRI) techniques, correlating these changes with mood and neurocognitive tests.
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- Red blood cell transfusions can be beneficial but come with potential risks, necessitating guidelines for their use in both adults and children.
- Studies involved numerous randomized controlled trials which found that restrictive transfusion strategies (transfusing at lower hemoglobin thresholds) generally do not harm patient outcomes for most populations.
- Recommendations include using restrictive strategies for stable adult patients, advising transfusions at hemoglobin levels below 7 g/dL, with some exceptions based on specific patient conditions like cardiac or orthopedic surgeries.
Article Synopsis
- Cold stored platelets (CSP) are better for clot initiation and managing active bleeding, while room temperature platelets (RTP) are preferred for increasing platelet counts in patients needing preventive transfusions.
- A simulation study compared two hospital scenarios: one using only RTP (No-CSP) and the other using both RTP and CSP (CSP), with findings suggesting that an outside supply of CSP is necessary due to on-site conversion limits.
- While CSP can improve treatment outcomes for trauma patients, the study concludes that introducing CSP won't significantly reduce RTP wastage, primarily because only a few RTP units can be converted on-site.
Article Synopsis
- Resource-limited settings often struggle to provide essential education for safe surgical practices, highlighting the need for improved access to curricula, particularly in transfusion medicine.
- The Transfusion Camp curriculum was developed through a partnership between Rwanda and Canada, involving experts who created a course that combined online content with in-person seminars, tailored to local needs.
- Evaluation of the pilot course showed positive reception among trainees, although a preference for in-person learning was noted, suggesting future courses should focus on ongoing education for practicing physicians.
Background: Early resuscitation with blood components or products is emerging as best practice in selected patients with trauma and medical patients; as a result, out-of-hospital transfusion (OHT) programs are being developed based on limited and often conflicting evidence. This study aimed to provide guidance to Canadian critical care transport organizations on the development of OHT protocols.
Methods: The study period was July 2021 to June 2022.
Article Synopsis
- * Researchers created an animation to educate preoperative surgical patients about anemia and its management, aiming to empower them to take an active role in their health.
- * Feedback from 51 participants showed that the majority found the animation easy to understand, gaining a better understanding of anemia, with nearly all expressing increased confidence in following their PBM plans.
An overview of Patient Blood Management (PBM), with its main scope to preserve the patient's own blood to improve the patient's outcome, is presented here, including the research gaps that needs to be addressed, particularly in the pediatric age group. Next, novel techniques to analyse PBM data and the challenges and strategies of PBM implementation will also be discussed.
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- Transfusion Camp is a 5-day educational program aimed at improving transfusion medicine knowledge among trainees from Canada and beyond, with a focus on its impact on clinical practice.
- A retrospective analysis of surveys from 2018-2021 showed that 68% of participants felt the Camp positively influenced their practice, climbing to 83% by the end of the program, with key areas of impact including transfusion indications and risk management.
- The results suggest that Transfusion Camp is an effective teaching method, with greater reported benefits in more advanced trainees (especially PGY-4+) and highlights areas for future curriculum improvement.
Background: Congenital thrombotic thrombocytopenic purpura is caused by defects in the ADAMTS13 gene. ADAMTS13 is normally preactivated by conformational changes of the Metalloprotease (M) domain. Studying a novel congenital thrombotic thrombocytopenic purpura p.
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