Purpose: To find factors that predict the requirement of packed red blood cells (pRBC) transfusion in patients with blunt trauma on arrival at the hospital.
Methods: We conducted blood tests in trauma patients whose trauma severity was suspected as being 3 and over in the Abbreviated Injury Scale. Patients were divided into the blood transfusion (BT) and control groups according to the requirement of pRBC transfusion within 24h after arrival.
Results: We analyzed 347 patients (BT group, n=14; control group, n=333). On univariate analysis, there were significant differences in Glasgow Coma Scale (GCS), rate of positive FAST (focused assessment with sonography for trauma) finding, hematocrit, international normalized ratio of prothrombin time, activated partial thromboplastin time, fibrinogen (Fib), and level of fibrin degradation products (FDP). On multivariable analysis, positive FAST finding, GCS, Fib, and FDP influenced the requirement of pRBC transfusion. In the area under the receiver operating characteristic curve analysis, Fib and FDP were markers that predicted the requirement of pRBC transfusion. The FDP/Fib ratio had a better correlation with the requirement of pRBC transfusion than FDP or Fib.
Conclusions: The FDP/Fib ratio can be easily measured and may be a predictor of the need for pRBC transfusion.
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http://dx.doi.org/10.1016/j.ajem.2017.03.009 | DOI Listing |
Am J Perinatol
December 2024
Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn.
Objective: In recent years, the management of placenta accreta spectrum (PAS) has fallen into two categories: planned hysterectomy and conservative management to preserve fertility. However, optimal management remains unclear. Therefore, we conducted a systematic review and meta-analysis comparing the two to evaluate which approach was associated with lower surgical morbidity.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Faculty of Healthcare Sciences, Eastern University of Sri Lanka, Chenkaladi, Sri Lanka.
Background: Naphthalene is an aromatic hydrocarbon that potentially produces methemoglobinaemia but rarely causes hemolysis, especially in children with underlying glucose-6-phosphate dehydrogenase deficiency. Although ingestion of a single moth ball by an older child may not be life threatening, it can be fatal if ingested by a toddler.
Case Presentation: A 2-year-old Singhalese boy developed acute severe hemolysis and methemoglobinaemia following ingestion of a mothball.
Transfus Clin Biol
December 2024
Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant Dehradun-248016 Uttarakhand, India.
In the third week of November 2024, a critical incident involving the refusal of a blood transfusion was reported at our hospital. The case involved a 65-year-old Indian patient who had been admitted for a proposed stoma closure surgery. Although the healthcare team deemed an urgent blood transfusion necessary as part of the patient's treatment plan, the transfusion was refused due to misinformation from the patient's attendants regarding the patient's original blood type.
View Article and Find Full Text PDFJ Clin Med
December 2024
Adelson School of Medicine, Ariel University, Ariel 4070000, Israel.
: The COVID-19 pandemic markedly increased the number of patients with infection-related acute respiratory distress syndrome who required extracorporeal membrane oxygenation (ECMO) and multiple blood transfusions. This study aimed to assess a potential correlation between the daily rate of transfused blood products and the intensive care unit (ICU) outcome of ECMO-supported COVID-19 patients. : Data were retrieved from the electronic databases of three Israeli tertiary care centers.
View Article and Find Full Text PDFCrit Care
December 2024
Department of Critical Care Medicine, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a supportive therapy for acute respiratory failure with increased risk of packed red blood cells (PRBC) transfusion. Blood cell salvage (BCS) aims to reduce blood transfusion, but its efficacy is unclear. This study aimed to estimate the effect of BCS at the time of removal of the ECMO circuit (ECMO decannulation) on PRBC transfused.
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