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Visual Outcomes of Central Retinal Artery Occlusion: Exploring Treatment Strategies Beyond the Conventional Time Window.
J Stroke Cerebrovasc Dis
January 2025
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; Department of Ophthalmology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Republic of China. Electronic address:
Backgrounds/aims: Central retinal artery occlusion (CRAO) is a vision-devastating emergency. However, widely-acknowledged treatment consensus is lacking and prehospital delays commonly occur. Hence, we aimed to investigate the visual outcomes of conservative treatments (CT), local intra-arterial fibrinolysis (LIF) and hyperbaric oxygen (HBO) therapy for non-arteritic CRAO (NA-CRAO) patients beyond the conventional time window.
View Article and Find Full Text PDFFreeze-dried plasma: Hemostasis and biophysical analyses for damage control resuscitation.
Transfusion
January 2025
Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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 PDFTimeliness of reperfusion in ST-segment elevation myocardial infarction and outcomes in Kerala, India: results of the TRUST outcomes registry.
Postgrad Med J
October 2024
Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta,112 St NW, Edmonton, AB T6G 2B7, Canada.
Purpose: Transatlantic guidelines endorse quality metrics for timely reperfusion in patients with ST-elevation myocardial infarction (STEMI). Compliance in low- and middle-income countries (LMICs) is largely unknown.
Study Design: We prospectively evaluated 2928 STEMI patients in Kerala, India, across 16 PCI-capable hospitals who received reperfusion with either primary percutaneous coronary intervention (PPCI) or fibrinolysis.
Markers of Futile Resuscitation in Traumatic Hemorrhage: A Review of the Evidence and a Proposal for Futility Time-Outs during Massive Transfusion.
J Clin Med
August 2024
Futile Indicators for Stopping Transfusion in Trauma (FISTT) Collaborative Group, Indiana University School of Medicine-South Bend, South Bend, IN 46617, USA.
The reduction in the blood supply following the 2019 coronavirus pandemic has been exacerbated by the increased use of balanced resuscitation with blood components including whole blood in urban trauma centers. This reduction of the blood supply has diminished the ability of blood banks to maintain a constant supply to meet the demands associated with periodic surges of urban trauma resuscitation. This scarcity has highlighted the need for increased vigilance through blood product stewardship, particularly among severely bleeding trauma patients (SBTPs).
View Article and Find Full Text PDFImproved outcome with individualised antifibrinolytic therapy: what is the evidence?
Br J Anaesth
June 2024
Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Viscoelastic haemostatic testing (VHT) has been used to determine hyperfibrinolysis and hypofibrinolysis. When modified by addition of tissue plasminogen activator (tPA), VHT has been suggested to assess responses to antifibrinolytic therapy and to estimate the concentration of tranexamic acid in patients undergoing cardiac surgery. Despite some evidence that tPA-modified VHT might allow individualisation of antifibrinolytic therapy, further studies are warranted to prove its clinical benefit for postsurgical bleeding, transfusion of blood products, and thromboembolic events.
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