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Magic in a bottle? A Focused review of factor concentrates for the intraoperative treatment of acquired coagulopathy - Fibrinogen concentrate, prothrombin complex concentrate, and recombinant activated factor VII.
Best Pract Res Clin Anaesthesiol
December 2023
Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Goal-directed administration of blood components including red cells, platelets, plasma, and factor concentrates plays a critical role in the management of intraoperative coagulopathy. Increasingly commonly used, purified and recombinant factor concentrates are being recognized for their logistical advantages and potentially superior efficacy. Three- and four-factor prothrombin concentrates, fibrinogen concentrates and activated factor VII have an evolving evidence base relative to frozen plasma and cryoprecipitate.
View Article and Find Full Text PDFPreoperative iron therapy: Where are we?
Best Pract Res Clin Anaesthesiol
December 2023
School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
Preoperative anemia affects one-third of patients undergoing major surgery and is associated with worse perioperative and postoperative outcomes; including length of hospital stay, allogeneic blood transfusion, morbidity, and mortality. Iron deficiency is the most common cause of anemia, and associative data suggests that preoperative correction of iron deficiency anemia could improve postoperative patient outcomes. However, data from randomized controlled trials (RCTs) do not appear to support the routine use of iron therapy to treat preoperative anemia.
View Article and Find Full Text PDFHow low can you go: Restrictive transfusion strategies in major surgery and physiological triggers.
Best Pract Res Clin Anaesthesiol
December 2023
Department of Anesthesia, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Anemia and red blood cell transfusion are associated with adverse outcomes. Large randomized trials have demonstrated that restrictive transfusion strategies can safely reduce patient exposure to transfusion, forming a foundational pillar of patient blood management. The restrictive transfusion thresholds in these trials ranged from 7 to 8 g/dL for different populations and this variability is reflected in recent guideline recommendations for transfusion triggers.
View Article and Find Full Text PDFThe effect of web-based breastfeeding education given to primiparous pregnant women: a randomised controlled study.
Afr J Reprod Health
December 2024
Department of Nursing Obstetrics and Gynaecology Nursing Department, Istanbul-Turkey.
This was a randomised controlled study to investigate the effect of web-based breastfeeding education given to primiparous pregnant women on postpartum breastfeeding. The study included a total of 120 primiparous pregnant women, including control group (n:60) and experimental group (n:60). The study was conducted in a district in northern Turkey.
View Article and Find Full Text PDFEffectiveness of nursing care for cervical cancer patients undergoing chemotherapy: Systematic review and meta-analysis.
Afr J Reprod Health
December 2024
Department of Integrated Oncology(I), HangZhou Cancer Hospital, HangZhou, China.
Nursing interventions play a critical role in enhancing the quality of life (QoL) and therapeutic outcomes for cervical cancer patients undergoing chemotherapy. However, variations in nursing interventions and patient results require a meta-analysis to consolidate evidence on the most effective nursing approaches. This meta-analysis assessed how nursing care interventions influence QoL, adherence to chemotherapy, and the management of symptoms in cervical cancer patients.
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