Transfusion of plasma, platelets, and Red Blood Cells in a 1:1:1 versus a 1:1:2 Ration and Mortality in Patients with Severe Trauma

2018 ◽  
pp. 248-254
Author(s):  
Yuk Ming Liu ◽  
Kathryn Butler
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Clinical Case ◽  
Severe Trauma ◽  
Trauma Patients ◽  
Transfusion Ratio ◽  
Study Intervention ◽  
Traumatic Hemorrhage ◽  
Ratio Versus

This chapter provides a summary of the landmark study known as the PROPPR trial. How effective and safe is rapid transfusion of patients with severe traumatic hemorrhage using plasma, platelets, and red blood cells in a 1:1:1 ratio compared to a 1:1:2 ratio? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. A growing body of literature suggests that massive transfusion protocols confer mortality benefits for trauma patients in hemorrhagic shock; however, such protocols still require standardization. In the PROPPR trial, there was suggestion of improved hemostasis and less death from exsanguinations with a 1:1:1 transfusion ratio versus a 1:1:2 approach; however, further trials are warranted.

Transfusion Ratios in Trauma

2017 ◽  
Author(s):  
Rachel J. Kwon
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Clinical Case ◽  
Massive Transfusion ◽  
Trauma Surgery ◽  
Transfusion Strategy ◽  
Study Intervention ◽  
Related Mortality ◽  
Landmark Study

This chapter provides a summary of a landmark study in trauma surgery. Does transfusion with platelets and plasma in addition to red blood cells in patients requiring massive transfusion decrease hemorrhage-related mortality? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving a massive transfusion strategy.

Accuracy of Focused Abdominal Sonography for Trauma (FAST)

2017 ◽  
Author(s):  
Rachel J. Kwon
Keyword(s):  
Study Design ◽  
Clinical Case ◽  
Trauma Surgery ◽  
Pericardial Fluid ◽  
Trauma Patients ◽  
Design Study ◽  
Abdominal Sonography ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in trauma surgery. It deals with focused abdominal sonography for trauma (FAST). How accurate is surgeon-performed ultrasound to assess hemoperitoneum and pericardial fluid in trauma patients? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case regarding when FAST might be applicable in a trauma situation.

scholarly journals Evaluation of cellular immune response in Golden Hamsters experimentally infected with Leishmania donovani comparing with cellular immune response against chicken Red Blood Cells.

2012 ◽  
Vol 9 (1) ◽  
pp. 23-30
Author(s):  
Baghdad Science Journal
Keyword(s):  
Immune Response ◽  
Red Blood Cells ◽  
Skin Test ◽  
Blood Cells ◽  
Cellular Immune Response ◽  
Leishmania Donovani ◽  
Cellular Immune ◽  
And Control ◽  
Delayed Type Of Hypersensitivity

The Evaluation of the immune response in Golden Hamsters experimentally infected with Leishmania donovani was determined in this study, particularly, the cellular immune response. Follow up has maintained to determine the Delayed Type of Hypersensitivity using skin test both in infected and control lab animals. Chicken red blood cells were used as a parameter to evaluate the immune system; they are dull and have the ability of immunization. Two concentrations of chicken R.B.C were examined to determine which gives the higher titration in Hamsters and those were 1.5 X 109 cell/ml and 3 X 109 cell/ml , the second concentration gave the maximum titration where then used in this work. After sensitization with Chicken R.B.C for both infected and control groups, delayed type of hypersensitivity has been used against Leishmania donovani antigen and 4 days of follow up were adopted and they were (14, 30, 60, 90) day after infection. Results showed that skin test against both antigens ( L.donovani and chicken R.B.C) was significantly higher than normal at the first day of follow up ( day 14) then gradual decreasing were noticed till the last day of follow up (90). This can indicate that the infection with L.donovani activated the immune response at the beginning of infection, then leads to cellular immune suppression against both L.donovani antigen and chicken R.B.C., so that this immunosuppression is not specific.

Racial and Ethnic Disparities in Maternal Morbidity and Obstetric Care

2021 ◽  
pp. 138-143
Author(s):  
Rose L. Molina ◽  
Neel Shah
Keyword(s):  
Maternal Morbidity ◽  
Clinical Case ◽  
Ethnic Disparities ◽  
Obstetric Care ◽  
Racial And Ethnic Disparities ◽  
Care Providers ◽  
Unconscious Bias ◽  
Study Intervention

This article provides a summary of a landmark study describing racial and ethnic disparities in maternal morbidity and obstetric care practices. The article describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The article briefly reviews other relevant studies and information, and discusses implications. The article concludes with a relevant clinical case highlighting unconscious bias and how it affects the care providers deliver to their patients. Racial disparities are rampant in medicine, this article highlights the role of race in maternal outcomes.

Hydrocortisone Therapy for Patients with Septic Shock

2018 ◽  
pp. 301-306
Author(s):  
Ryan J. Horvath ◽  
Edward Bittner
Keyword(s):  
Septic Shock ◽  
Study Design ◽  
Steroid Therapy ◽  
Clinical Case ◽  
Low Dose ◽  
Vasopressor Therapy ◽  
Surviving Sepsis Campaign ◽  
Number Of Patients ◽  
Study Intervention

This chapter provides a summary of the landmark study known as the CORTICUS trial. Among patients suffering from septic shock, does low dose hydrocortisone improve mortality? Starting with that question, it describes the basics of the study, including funding, study location, the population studies, number of patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The CORTICUS trial failed to demonstrate a benefit on mortality with steroid therapy among patients with septic shock. Based on CORTICUS and other studies, the Surviving Sepsis Campaign guidelines no longer recommend steroids for all patients with septic shock. Corticosteroids should be considered, however, for patients with septic shock who do not respond to fluids and vasopressor therapy.

Use of Procalcitonin to Reduce Patients’ Exposure to Antibiotics in Intensive Care Units (PRORATA Trial)

2018 ◽  
pp. 276-281
Author(s):  
Alice Gallo De Moraes ◽  
Dante Schiavo
Keyword(s):  
Antibiotic Resistance ◽  
Intensive Care ◽  
Bacterial Infections ◽  
Clinical Case ◽  
Adverse Outcomes ◽  
Control Group ◽  
Antibiotic Exposure ◽  
Icu Patients ◽  
Study Intervention

This chapter provides a summary of the landmark study known as the PRORATA trial. Does a procalcitonin (PCT)-based strategy to treat suspected bacterial infections in ICU patients reduce antibiotic exposure without adverse outcomes? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The study suggests that critically ill patients managed with a PCT-guided antibiotic strategy to treat suspected bacterial infections results in more antibiotic-free days than those managing patients with clinical guidelines alone. The mortality of patients in the PCT arm was non-inferior to those in the control group at day 28 and at day 60. The strategy could be beneficial for reducing antibiotic resistance in the ICU.

Comparison of 8 versus 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults

2018 ◽  
pp. 257-262
Author(s):  
Laurie O. Mark ◽  
Jean Kwo
Keyword(s):  
Antibiotic Therapy ◽  
Randomized Trial ◽  
Study Design ◽  
Clinical Case ◽  
Pulmonary Infection ◽  
Ventilator Associated Pneumonia ◽  
Icu Patients ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of the landmark study “Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” In adult patients with ventilator-associated pneumonia (VAP), is treatment with an 8-day course of antimicrobials as effective as a 15-day course? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. In ICU patients who develop microbiologically proven VAP, an 8-day antimicrobial course is not inferior to a 15-day course with respect to all-cause mortality or recurrence of pulmonary infection. However, these findings may not apply to patients who are immunocompromised, and shorter or longer duration of antibiotics may sometimes be indicated.

Efficacy and Safety of Recombinant Human Activated Protein C for Severe Sepsis

2018 ◽  
pp. 61-67
Author(s):  
Anna M. Ward ◽  
Richard M. Pino
Keyword(s):  
Severe Sepsis ◽  
Study Design ◽  
Protein C ◽  
Clinical Case ◽  
Activated Protein C ◽  
Efficacy And Safety ◽  
Prowess Trial ◽  
Study Intervention ◽  
Prowess Study

This chapter provides a summary of the landmark study known as the PROWESS Study. Does treatment with DAA reduce the rate of death from any cause among patients with severe sepsis? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The PROWESS trial demonstrated a mortality benefit for DAA among patients with severe sepsis. However, the subsequent ADDRESS, RESOLVE, and PROWESS-SHOCK trials did not demonstrate a benefit of the medication, thus calling the results of PROWESS into question.

The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) Trial

2018 ◽  
Author(s):  
Nikhil Gupta ◽  
Catherine Chiles
Keyword(s):  
Coronary Artery Disease ◽  
Clinical Case ◽  
Short Term ◽  
Interpersonal Therapy ◽  
Randomized Evaluation ◽  
Artery Disease ◽  
Study Intervention ◽  
Overall Health Status ◽  
Landmark Study

This chapter provides a summary of a landmark study in psychiatry in primary care to mediate the effect of depression on overall health status . In the treatment of patients with major depression and coronary artery disease, what is the short-term efficacy of a selective serotonin reuptake inhibitor (citalopram) and/or interpersonal therapy? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

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