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Background: Early identification of massive transfusion (MT) requirement in geriatric patients with severe trauma is challenging. Existing systems for predicting MT need in trauma patients have not been systematically evaluated for their relevance to the geriatric population. This study aimed to evaluate the predictive accuracy of initial vital signs and the Glasgow coma scale (GCS) in geriatric trauma patients for predicting MT.
View Article and Find Full Text PDFImpact of Massive Transfusion Activation on Time to Delivery of the First Cooler and Patient Survival: A Study of 4,313 Consecutive Activations.
J Am Coll Surg
January 2025
Department of Surgery, McGovern Medical School, Houston, Texas.
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.
View Article and Find Full Text PDF[Clinical practice guidelines for perioperative fluid therapy in Chinese adult patients (2025 edition)].
Zhonghua Yi Xue Za Zhi
January 2025
Perioperative fluid therapy is a pivotal component of surgical patient management, as appropriate fluid administration can significantly enhance postoperative recovery. To standardize perioperative fluid therapy for adult patients in China, the Geriatric Anesthesia and Perioperative Management Group of the Chinese Society of Anesthesiology has developed the "Clinical Practice Guidelines for Perioperative Fluid Therapy in Chinese Adult Patients". Based on current clinical status in China, this guideline addressed 11 key areas based on clinical evidence, more than 30% of which is from China researchers, including principles for the selection of common fluid types, preoperative fasting and hydration following enhanced recovery after surgery (ERAS) protocols, intraoperative fluid requirements for adult patients, perioperative volume assessment, perioperative evaluation of volume overload/insufficiency, goal-directed fluid therapy, restrictive fluid therapy, perioperative fluid therapy strategies for high-risk patients, fluid resuscitation for massive blood loss, the relationship between perioperative fluid therapy and postoperative complications, and the relationship between perioperative fluid therapy and ERAS.
View Article and Find Full Text PDFCasein Kinases 2-dependent phosphorylation of the placental ligand VAR2CSA regulates Plasmodium falciparum-infected erythrocytes cytoadhesion.
PLoS Pathog
January 2025
Sorbonne Université, CNRS, Inserm, Centre d'Immunologie et des Maladies Infectieuses, CIMI, Paris, France.
Placental malaria is characterized by the massive accumulation and sequestration of infected erythrocytes in the placental intervillous blood spaces, causing severe birth outcomes. The variant surface antigen VAR2CSA is associated with Plasmodium falciparum sequestration in the placenta via its capacity to adhere to chondroitin sulfate A. We have previously shown that the extracellular region of VAR2CSA is phosphorylated on several residues and that the phosphorylation enhances the adhesive properties of CSA-binding infected erythrocytes.
View Article and Find Full Text PDFIs pre-hospital haemoglobin an efficient marker of the need for transfusion and haemorrhagic shock in severe trauma patients? A retrospective observational study.
Eur J Trauma Emerg Surg
January 2025
Intensive Care Department, Sainte Anne Military Teaching Hospital, Toulon, France.
Background: Haemorrhagic shock is the leading cause of preventable death among trauma patients. Early detection of severe haemorrhage is essential for initiating timely resuscitation and mobilizing resources for massive transfusion (MT) protocols and damage control procedures. This study aimed to assess the predictive value of prehospital haemoglobin (Hb) levels for the need for transfusion at admission, the presence of haemorrhagic shock (HS), and the necessity for MT or haemostatic surgery.
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