scholarly journals Massive Transfusion Protocol Activation Does Not Result in Preferential Use of Older Red Blood Cells

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Lauren M. McDaniel ◽  
Darrell J. Triulzi ◽  
James Cramer ◽  
Brian S. Zuckerbraun ◽  
Jason L. Sperry ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Clinical Outcomes ◽  
Retrospective Review ◽  
Blood Cells ◽  
Massive Transfusion ◽  
Blood Components ◽  
The Third ◽  
Massive Transfusion Protocol ◽  
To Receive ◽  
Transfusion Protocol

Widespread, anecdotal belief exists that patients receiving massive transfusion, particularly those for whom a massive transfusion protocol (MTP) is activated, are more likely to receive older red blood cells (RBCs). Retrospective review of blood bank records from calendar year 2011 identified 131 patients emergently issued ≥10 RBC units (emergency release (ER)) prior to obtaining a type and screen. This cohort was subclassified based on whether there was MTP activation. For comparison, 176 identified patients transfused with ≥10 RBC units in a routine fashion over 24 hours represented the nonemergency release (nER) cohort. Though the median age of ER RBCs was 5 days older than nER RBCs (ER 20, nER 15 days, P<0.001), both fell within the third week of storage. Regardless of MTP activation, transfused ER RBCs had the same median age (MTP 20, no-MTP 20 days, P=0.069). In the ER cohort, transition to type-specific blood components increased the median age of transfused RBC units from 17 to 36 days (P<0.001). These data refute the anecdotal belief that MTP activation results in transfusion of older RBCs. However, upon transition to type-specific blood components, the age of RBCs enters a range in which it is hypothesized that there may be a significant effect of storage age on clinical outcomes.

scholarly journals Massive Transfusion Protocol Over-Activation

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S164-S165
Author(s):  
M Abdelmonem ◽  
H Wasim ◽  
M Abdelmonem
Keyword(s):  
Blood Transfusion ◽  
Blood Cells ◽  
Blood Product ◽  
Massive Transfusion ◽  
Labor And Delivery ◽  
Massive Blood Transfusion ◽  
Packed Red Blood Cells ◽  
Massive Transfusion Protocol ◽  
The Difference ◽  
Transfusion Protocol

Abstract Introduction/Objective Massive blood transfusion protocol (MTP) is revealed in many cases, such as massive hemorrhage after surgeries, trauma settings, and labor and delivery. Patients who require blood transfusion of more than ten units of packed red blood cells in 24 hours or transfusion of more than four units of packed red blood cells (PRBCs) in one hour are the massive blood transfusion protocol candidates. Methods/Case Report A retrospective study was performed at a 225-bed level III trauma center in California. The overall massive blood transfusion protocol utilization, blood product emergency release, and blood product waste were recorded twelve months before and after launching an educational and collaboration program between blood banks and clinicians about the difference between massive transfusion protocol and blood emergency release. Results (if a Case Study enter NA) MTP utilization for the 12 months (June 2017 to June 2018) was demonstrated as 59 MTP activations: 32 MTPs from the emergency department, 4 MTPs from inpatient floors, 3 MTPs from labor and delivery, and 4 MTPs from operating rooms while the blood product emergency releases were 7 emergency releases. MTP utilization from (June 2018 to June 2019) was demonstrated as 15 MTP activations: 11 MTPs from the emergency department, 2 MTPs from inpatient floors, 1 MTPs from labor and delivery, and 1 MTPs from operating rooms, while the blood product emergency releases were 43 emergency releases. The blood product waste was reduced by 44.6% in 2018. Conclusion There was a significant reduction in MTP activation and blood product waste after implementing the educational program for the clinicians. The collaboration between the blood bank and the clinicians and coordinating educational sessions for clinicians about the difference between MTP and emergency release and the negative impact of the MTP over-activation on the blood product waste and the clinical laboratory scientists in the blood bank is vital in MTP utilization.

Blood Provision for Cardiac Ablation (CA) Procedures in the Catheterization Laboratory; a Veteran Affairs Medical Center (VAMC) Experience in a Non-Trauma Center Setting

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S167-S168
Author(s):  
J M Petersen ◽  
V Patel ◽  
D Jhala
Keyword(s):  
Quality Assurance ◽  
Massive Transfusion ◽  
Medical Center ◽  
Case Series ◽  
Blood Bank ◽  
Cardiac Ablation ◽  
Cardiac Perforation ◽  
Catheterization Laboratory ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

Abstract Introduction/Objective Cardiac perforation is a life-threatening complication (~1% risk, with reported rates between 0.2% to 5%) of CA procedures. As cardiac perforation may lead to extensive bleeding, it would be reasonable for a medical center carrying out CA to be capable of arranging for a massive transfusion protocol and for surgical repair as required. However, there is sparse literature to guide a non-trauma medical center implementing a CA program on what the number of red blood cell (RBC) units for crossmatch should be for each case. Methods In interdisciplinary collaborative meetings, the CA program logistics were agreed to between the multiple clinical services. Given the case series on the amount of drained blood in complicated cases, there was agreement that three units of RBCs would be crossmatched for each case. Education was provided on the massive transfusion protocol and on blood bank procedures. As part of quality assurance/quality improvement, records were reviewed from the beginning of the CA program (10/1/2019) to 1/31/2019 to determine number of patient cases, crossmatched units, and transfused units for quality assurance purposes. Results A total of fifteen patients underwent CA procedures, for which three units were crossmatched for each patient. As there were no cardiac perforations with the cardiac ablation procedures so far, no units were transfused. The organized approach for ensuring adequate blood bank support and education led to the reassurance, alleviation of clinical anxiety, and building of a successful CA program. Education sessions completed with thorough understanding of blood bank procedures including the massive transfusion protocol, labeling of blood bank specimens, and on ordering of blood for crossmatch. Conclusion This study provides a reference that may provide helpful guidance to other blood banks on what the number of RBCs to be crossmatched prior to each CA procedure. Multidisciplinary collaborative meetings in advance are an essential component for ensuring adequate support for CA procedures or any new service that requires blood product support. Thorough education of clinical staff on blood bank procedures particularly the massive transfusion protocol is also recommended. This procedure for massive transfusion should be available to be referred to in real time.

Managing Massive Transfusion Protocol During Cardiopulmonary Bypass in the Setting of Penetrating Traumatic Injury

2020 ◽  
pp. 000313482097977
Author(s):  
Dov Levine ◽  
Sivaveera Kandasamy ◽  
James Alford Flippin ◽  
Hirohisa Ikegami ◽  
Rachel L. Choron
Keyword(s):  
Cardiopulmonary Bypass ◽  
Massive Transfusion ◽  
Traumatic Injury ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

Effectiveness of Massive Transfusion Protocol activation in pre-hospital setting for major trauma

Injury ◽  
2021 ◽  
Author(s):  
Marco Botteri ◽  
Simone Celi ◽  
Giovanna Perone ◽  
Enrica Prati ◽  
Paola Bera ◽  
...  
Keyword(s):  
Major Trauma ◽  
Massive Transfusion ◽  
Hospital Setting ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

Anesthetic management of a patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Reza Widianto Sudjud ◽  
Djoni Kusumah Pohan ◽  
Muhammad Budi Kurniawan ◽  
Hana Nur Ramila
Keyword(s):  
Hemorrhagic Shock ◽  
Blunt Abdominal Trauma ◽  
Massive Transfusion ◽  
Damage Control ◽  
Anesthetic Management ◽  
Hollow Viscus ◽  
Permissive Hypotension ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol ◽  
Hollow Viscus Perforation

Hemorrhagic shock is a form of hypovolemic shock in which severe blood loss leads to inadequate oxygen delivery at the cellular level. Death from hemorrhage represents a substantial global problem, with more than 60,000 deaths per year in the United States and an estimated 1.9 million deaths per year worldwide, 1.5 million of which result from physical trauma. This case report aims to stress the need of handling cases of hemorrhagic shock in accordance with damage control protocol. Hemorrhagic shock management using permissive hypotension management, bleeding control, massive transfusion protocol (MTP), minimal crystalloid therapy, and adjuvant therapy is the best approach to get optimal outcome to prevent triad of death. In this case, the application of damage control resuscitation has not been fully implemented because of several constraints. Key words: Hemorrhage; Hemorrhagic shock; Permissive hypotension; Massive Transfusion Protocol; MTP; Resuscitation; Damage control Citation: Pohan DK, Sudjud RW, Kurniawan MB, Ramila HN. Anesthetic management on patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock. Anaesth. pain intensive care 2021;25(2):217-221. DOI: 10.35975/apic.v25i2.1474 Received: 11 January 2021, Reviewed: 15 January 2021, Accepted: 16 February 2021

Quality Management of massive transfusion protocol incorporating tranexamic acid adherence

2018 ◽  
Vol 57 (6) ◽  
pp. 785-789
Author(s):  
Weiwei Shi ◽  
Ram Al-Sabti ◽  
Peter A. Burke ◽  
Mauricio Gonzalez ◽  
Nelson Mantilla-Rey ◽  
...  
Keyword(s):  
Quality Management ◽  
Tranexamic Acid ◽  
Massive Transfusion ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

scholarly journals BIOLOGICAL EFFECTS OF SILICON OXIDE NANOPARTICLES ON BROILER CHICKEN

2020 ◽  
Vol 5 (2) ◽  
pp. 63-71
Author(s):  
Vladimir Nikulin ◽  
Aleksandra Mustafina
Keyword(s):  
Red Blood Cells ◽  
Total Protein ◽  
Blood Cells ◽  
Broiler Chickens ◽  
Broiler Chicken ◽  
Silicon Oxide ◽  
The Body ◽  
Control Group ◽  
The Third ◽  
Experimental Group

The aim of the study is to increase the productive qualities of broiler chickens by including ultrafine silicon oxide into main diet. During the experiment, the biological effect of ultrafine silicon oxide on broiler chickens was estab-lished. Use of ultrafine SiO2 particles for poultry feeding contributed to an increase in the number of red blood cells and content of total protein and albumins. By the end of the experiment, the number of red blood cells in birds in-creased by 17.43% (P≤0.001) – in the blood of birds of the first experimental group, 16.51% (P≤0.01) – the second one, 20.80% (P≤0.001) – the third experimental and 21.71% (P≤0.001) – the fourth experimental group, compared with the indicator of the control group. The amount of total protein in blood serum of chickens of the first and the second experimental groups increased by 1.36-1.39 %, in the third and fourth ones there was a significant (P≤0.05) increase by 5.45 and 3.05%, respectively. The blood glucose content of chickens in the experimental groups is higher by 8.04-23.65% compared to this indicator with ones in the control group. During the experiment feed con-sumption per 1 kg gain of live weight decreased: in the first experimental group by 3.00 % in the second by – 0.50 %, the third – 6.00 % the fourth– by 4.50 %, compared to this with the control group. The chicken’s vibrancy of the first the experimental group was higher by 4.77 %, the second – by 6.20 %, the third – by 19.25 % and the fourth– by 11.59% than in the control one. Consequently, when converting the feed energy into the body energy of a broiler chicken, the energy conversion coefficient of the experimental group of poultry is higher than that of the control one by 7.16-21.76 %. Thus, the most optimal dose for further research was determined.

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