Impact of Massive Transfusion Activation on Time to Delivery of the First Cooler and Patient Survival: A Study of 4,313 Consecutive Activations.

Background: In 2012, TQIP guidelines for massive transfusion protocols (MTP) recommended delivery of blood product coolers within 15 minutes. Subsequent work found that every minute delay in cooler arrival was associated with a 5% increased risk of mortality. We sought to assess the impact and sustainability of quality improvement (QI) interventions on time to MTP cooler delivery and their association with trauma patient survival.

Investigation and Treatment of Infertility in a Female Black Rhinoceros (Diceros bicornis).

A zoo-based, 11-year-old, uniparous southern black rhinoceros (Diceros bicornis minor) failed to conceive after weaning a calf. Behavioral observation and fecal progestagen monitoring confirmed irregular estrous cycles. Serial transrectal reproductive ultrasound examination revealed the cause to be recurrent anovulatory hemorrhagic follicles (AHFs).

Mathematic Modeling of Tumor Growth During [Lu]Lu-PSMA Therapy: Insights into Treatment Optimization.

The treatment regimen for [Lu]Lu-prostate-specific membrane antigen (PSMA) 617 therapy follows that of chemotherapy: 6 administrations of a fixed activity, each separated by 6 wk. Mathematic modeling can be used to test the hypothesis that the current treatment regimen for a radiopharmaceutical modality is suboptimal. A mathematic model was developed to describe tumor growth during [Lu]Lu-PSMA therapy.

Increasing the Diagnostic Utility of Heparin-Induced Thrombocytopenia (HIT) Testing: An Academic Medical Center's Utilization Analysis and Intervention.

Background: Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening adverse drug reaction with numerous diagnostic challenges. Diagnosis of HIT begins with 4T score clinical assessment, followed by laboratory testing for those not deemed low risk. Laboratory testing for HIT includes screening [enzyme-linked immunosorbent assay (ELISA)] and confirmatory [serotonin release assay (SRA)] assays, wherein SRA testing can be pursued following a positive ELISA result.

Creating a plasma coordination center to support COVID-19 outpatient trials across a national network of hospital blood banks.

Introduction: In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.

Methods: A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.