Purpose Of Review: This review provides a summary of the most recent clinical trials evaluating the hemostatic agents for the treatment of coagulopathy associated with critical bleeding. In particular, antifibrinolytic agents (i.e., aprotinin, tranexamic and ε-aminocaproic acids), desmopressin, recombinant activated factor VII, fibrinogen and prothrombin complex concentrates are evaluated.
Recent Findings: Among the various therapeutic options available, tranexamic acid is emerging as the most promising. Indeed, a recent randomized trial has shown a benefit survival of the early administration of tranexamic acid in patients with trauma-induced coagulopathy.
Summary: Although preliminary data document a potential therapeutic role for prohemostatic pharmacologic approaches, further evidence arising from randomized controlled trials is needed to assess the safety and efficacy of such agents in the setting of critical bleeding.
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http://dx.doi.org/10.1097/MOH.0000000000000084 | DOI Listing |
JA Clin Rep
January 2025
Department of Anesthesiology and Critical Care Medicine, Hokkaido University Hospital, N14W5, Kita-ku, Sapporo, 060-8648, Japan.
Background: Plasma exchange (PE) removes high-molecular-weight substances and is sometimes used for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with alveolar hemorrhage. Hypotension during PE is rare, except in allergic cases. We report a case of shock likely caused by increased pulmonary vascular resistance (PVR) during PE.
View Article and Find Full Text PDFActa Obstet Gynecol Scand
January 2025
Department of Gynecology and Obstetrics, Federal University of Goiás (UFG), Goiânia, Brazil.
Introduction: Intrauterine devices (IUDs) are highly effective contraceptives. Despite their effectiveness, pregnancies can occur during IUD use, and the management of such cases, particularly when the pregnancy is desired, remains controversial.
Material And Methods: We conducted a systematic review and meta-analysis to evaluate outcomes in women who unintentionally conceived while using IUDs and chose to continue their pregnancies.
Cochrane Database Syst Rev
January 2025
Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, USA.
Background: People undergoing major orthopaedic surgery are at increased risk of postoperative thromboembolic events. Low molecular weight heparins (LMWHs) are recommended for thromboprophylaxis in this population. New oral anticoagulants, including direct factor Xa inhibitors, are recommended as alternatives.
View Article and Find Full Text PDFCochrane Database Syst Rev
January 2025
Liverpool Reviews and Implementation Group, Department of Health Data Science, University of Liverpool, Liverpool, UK.
Rationale: Postpartum haemorrhage, defined as a blood loss of 500 mL or more within 24 hours of birth, is the leading global cause of maternal morbidity and mortality. Uterine fibroids are non-cancerous growths that develop in or around the uterus, and affect an increasing number of women. Caesarean myomectomy is the surgical removal of fibroids during a caesarean section.
View Article and Find Full Text PDFObstet Med
January 2025
Intensive Care and Obstetric Research Group (GRICIO), Universidad de Cartagena, Cartagena, Colombia.
Objective: This report details the complexities of diagnosing and treating rapid-onset multisystemic hemophagocytic lymphohistiocytosis (HLH) during pregnancy, as evidenced by a fatal case in early pregnancy with severe hematological and obstetric complications.
Case Presentation: A 20-year-old pregnant woman in her second pregnancy presented at 8 weeks of gestation with abdominal pain, fever, and rectal bleeding. Laboratory tests revealed leukopenia, thrombocytopenia, and anemia, leading to immediate transfusion and intensive care unit admission.
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