Immediate Effects of Individualized Heparin and Protamine Management on Hemostatic Activation and Platelet Function in Adult Patients Undergoing Cardiac Surgery with Tranexamic Acid Antifibrinolytic Therapy
This randomized prospective study was initiated to clarify whether individualized heparin and protamine dosing has immediate effects on hemostatic activation and platelet function in adult cardiac surgery.
Assessment and Management of Massive Bleeding: Coagulation Assessment, Pharmacologic Strategies, and Transfusion Management
This review details the current knowledge in massive hemorrhage with regard to the pathophysiology and laboratory assessment of the coagulation disturbance, the role of plasma and platelet transfusion, the role of pharmaceutical strategies, and the clinical value of having a massive transfusion protocol.
Low Hemorrhage-Related Mortality in Trauma Patients in a Level I Trauma Center Employing Transfusion Packages and Early Thromboelastography-Directed Hemostatic Resuscitation with Plasma and Platelets
This was a prospective study of adult trauma patients admitted to a Level I trauma center. Demography, Injury Severity Score (ISS), transfusion therapy, and mortality were registered. Hemostatic resuscitation was based on a massive transfusion protocolencompassing transfusion packages and thromboelastography (TEG)-guided therapy.
Platelet Concentrates, from Whole Blood or Collected by Apheresis
The quality and characteristics of platelets during storage are affected by a number of factors, such as anticoagulant, centrifugation and processing after collection, and pre- or post storage pooling, but when comparing literature on the various methods, most differences balance out.
Influence of Different Tranexamic Acid Administration Methods during and after Cardiac Surgery on Coagulation Function and Postoperative Blood Loss
This study evaluates the influence of different tranexamic acid administration methods during and after cardiac surgery with cardiopulmonary bypass(CPB) on coagulation function and postoperative bleeding.
Antifibrinolytic Agents in Current Anaesthetic Practice
Antifibrinolytic drugs have become almost ubiquitous in their use during major surgery when bleeding is expected or commonplace. Inhibition of the fibrinolytic pathway after tissue injury has been consistently shown to reduce postoperative or traumatic bleeding. We have reviewed the current literature for this increasingly popular class of drugs to support clinical judgement in daily anaesthetic practice.
Evolution of US Military Transfusion Support for Resuscitation of Trauma and Hemorrhagic Shock
Here we review the lessons learned by coalition medical personnel regarding resuscitation of severe trauma, integrating knowledge gained from massive transfusion, autopsies, and extensive review of medical records contained in the Joint Theater Trauma Registry. Changes in clinical care included the shift to resuscitation with 1:1:1 component therapy, use of fresh whole blood, and the application of both medical devices and pharmaceutical adjuncts to reduce bleeding.
Tranexamic Acid in Remote Damage Control Resuscitation
In this paper, the authors review the current state of the art for tranexamic acid (TXA) and its potential benefits to those patients who are in need of a massive transfusion. Specifically addressed are its biologic and pharmacologic properties, as well the results of a number of recent studies.
An Observational Study of the Fresh Frozen Plasma: Red Blood Cell Ratio in Postpartum Hemorrhage
In this retrospective study, a higher FFP:RBC ratio was associated with a lower requirement for advanced interventional procedures in the setting of postpartum hemorrhage.
Massive Bleeding and Massive Transfusion
This review surveys current literature on fluid resuscitation, blood transfusion, and hemostatic agents currently used during massive hemorrhage in order to optimize patients'blood and coagulation management in emergency medical aid.
Impact of Retransfusion of Blood Processed in Cell-Saver on Coagulation Versus Cardiopulmonary Bypass: A Prospective Observational Study Using Thromboelastography
In this study we compared an impact of retransfusion of blood processed in cell-saver (CS) with that of cardiopulmonary bypass (CPB) on blood coagulation in patients undergoing cardiac surgery.
Monitoring Incomplete Heparin Reversal and Heparin Rebound After Cardiac Surgery
In this study we assessed the incidence of incomplete heparin reversal and heparin rebound after cardiac surgery with cardiopulmonary bypass (CPB) and the ability of the activated coagulation time (ACT) and thromboelastography (TEG) to detect these phenomena. DESIGN: