scholarly journals Fresh-Frozen Plasma as a Source of Exogenous Insulin-Like Growth Factor-I in the Extremely Preterm Infant

2009 ◽  
Vol 94 (2) ◽  
pp. 477-482 ◽  
Author(s):  
Ingrid Hansen-Pupp ◽  
Eva Engström ◽  
Aimon Niklasson ◽  
Ann-Cathrine Berg ◽  
Vineta Fellman ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Fresh Frozen Plasma ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Igf I ◽  
Before And After ◽  
Fresh Frozen ◽  
Igf Binding ◽  
Frozen Plasma ◽  
Igfbp 3

Abstract Context: Preterm birth is followed by a decrease in circulatory levels of IGF-I and IGF binding protein (IGFBP)-3, proteins with important neurogenic and angiogenic properties. Objective: Our objective was to evaluate the effects of iv administration of fresh-frozen plasma (FFP) from adult donors on circulatory levels of IGF-I and IGFBP-3 in extremely preterm infants. Design, Setting, and Patients: A prospective cohort study was performed in 20 extremely preterm infants [mean (sd) gestational age 25.3 (1.3) wk] with clinical requirement of FFP during the first postnatal week. Sampling was performed before initiation of transfusion, directly after, and at 6, 12, 24, and 48 h after completed FFP transfusion. Main Outcome Measures: Concentrations of IGF-I and IGFBP-3 before and after transfusion of FFP were determined. Results: FFP with a mean (sd) volume of 11 ml/kg (3.1) was administered at a median postnatal age of 2 d (range 1–7). Mean (sd) IGF-I and IGFBP-3 concentrations in administered FFP were 130 (39) and 2840 μg/liter (615), respectively. Immediately after FFP transfusion, mean (sd) concentrations of IGF-I increased by 133% from 11 (6.4) to 25 μg/liter (9.3) (P < 0.001) and IGFBP-3 by 61% from 815 (451) to 1311 μg/liter (508) (P < 0.001). Concentrations of IGF-I and IGFBP-3 remained higher at 6 (P < 0.001, P = 0.009) and 12 h (P = 0.017, P = 0.018), respectively, as compared with concentrations before FFP transfusion. Typical half-life of administrated IGF-I was 3.4 h for a 1-kg infant. Conclusion: Transfusion of FFP to extremely preterm infants during the first postnatal week elevates levels of IGF-I and IGFBP-3.

Retrospective evaluation of the indications, safety and effects of fresh frozen plasma transfusions in 36 cats (2014–2018)

2019 ◽  
Vol 22 (8) ◽  
pp. 696-704
Author(s):  
Elizabeth T Mansi ◽  
Jennifer E Waldrop ◽  
Elizabeth B Davidow
Keyword(s):  
Retrospective Study ◽  
Fresh Frozen Plasma ◽  
Packed Red Blood Cells ◽  
Tolerable Risk ◽  
Coagulation Testing ◽  
Before And After ◽  
Referral Hospitals ◽  
Fresh Frozen ◽  
Frozen Plasma ◽  
Transfusion Reactions

Objectives The goals of this study were to classify the indications, risks, effects on coagulation times and outcomes of cats receiving fresh frozen plasma (FFP) transfusions in clinical practice. Methods This was a retrospective study of FFP transfusions administered in two referral hospitals from 2014 to 2018. Transfusion administration forms and medical records were reviewed. Information was collected on indication, underlying condition, coagulation times and signs of transfusion reactions. Seven-day outcomes after FFP administration were also evaluated when available. Results Thirty-six cats received 54 FFP transfusions. Ninety-four percent of cats were administered FFP for treatment of a coagulopathy. Twenty cats had paired coagulation testing before and after FFP administration. Eighteen of these cats had improved coagulation times after receiving 1–3 units of FFP. Eight of the 36 cats had probable transfusion reactions (14.8% of 54 FFP transfusions). These reactions included respiratory signs (n = 4), fever (n = 2) and gastrointestinal signs (n = 2). Five of the eight cats with probable reactions had received packed red blood cells contemporaneously. Overall mortality rate during hospitalization was 29.7%, with 52.8% (n = 19/36) of cats confirmed to be alive 7 days after discharge. Conclusions and relevance This retrospective study shows that FFP transfusions improve coagulation times in cats. Transfusion reactions are a risk, and risk–benefit ratios must be measured prior to administration and possible reactions monitored. In the study cats, the FFP transfusions appeared to be a tolerable risk given the benefit to prolonged coagulation times.

Effect of an Educational Presentation about Extremely Preterm Infants on Knowledge and Attitudes of Health Care Providers

2017 ◽  
Vol 34 (10) ◽  
pp. 0982-0989 ◽  
Author(s):  
Stefani Doucette ◽  
Brigitte Lemyre ◽  
Thierry Daboval ◽  
Sandra Dunn ◽  
Salwa Akiki ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Survival Rates ◽  
Care Providers ◽  
Perinatal Medicine ◽  
Knowledge And Attitudes ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Before And After

Objective To determine healthcare providers' knowledge (HCP) about survival rates of extremely preterm infants (EPI) and attitudes toward resuscitation before and after an educational presentation and, to examine the relationship between knowledge and attitudes toward resuscitation. Study Design Participants completed a survey before and after attending a presentation detailing evidence-based estimates of survival rates and surrounding ethical issues. Respondents included neonatologists, obstetricians, pediatricians, maternal-fetal medicine specialists, trainees in pediatrics, obstetrics, neonatal-perinatal medicine and neonatal and obstetrical nurses. Results In total, 166 participants attended an educational presentation and 130 participants completed both pre- and postsurveys (response rate 78%). Prepresentation, for all gestations, ≤ 50% of respondents correctly identified survival/intact survival rates. Postpresentation, correct responses regarding survival/intact survival rates ranged from 49 to 86% (p < 0.001) and attitudes shifted toward being more likely to resuscitate at all gestations regardless of parental wishes. There was a weak-to-modest relationship (Spearman's coefficient 0.24–0.40, p < 0.001–0.004) between knowledge responses and attitudes. Conclusion Attendance at an educational presentation did improve HCP knowledge about survival and long term outcomes for EPI, but HCP still underestimated survival and were not always willing to resuscitate in accordance with parental wishes. These findings may represent barriers to some experts' recommendation to use shared decision-making with parents when considering the resuscitation options for their EPI.

Ontogenic and nutritional changes in circulating insulin-like growth factor (IGF)-I, IGF-II and IGF-binding proteins in growing ewe and ram lambs

1997 ◽  
Vol 155 (1) ◽  
pp. 47-54 ◽  
Author(s):  
KL Gatford ◽  
KJ Quinn ◽  
PE Walton ◽  
PA Grant ◽  
BJ Hosking ◽  
...  
Keyword(s):  
Sex Differences ◽  
Feed Intake ◽  
Plasma Concentrations ◽  
Endocrine System ◽  
Igf Binding Proteins ◽  
Igf I ◽  
Before And After ◽  
Igf Binding ◽  
Igf Binding Protein ◽  
Igfbp 3

The ontogeny of the IGF endocrine system was investigated in 15 young lambs before and after weaning at 62 days of age. Before weaning, plasma IGF-I concentrations were higher in rams than ewes, and plasma concentrations of IGF-II and IGF-binding protein-3 (IGFBP-3) also tended to be higher in rams than in ewes. Feed intake of ewes and rams was restricted after weaning to remove sex differences in feed intake. Plasma concentrations of IGF-I and IGFBP-3 did not differ between rams and ewes at 100 days of age, but plasma IGF-II was higher in rams than in ewes at this time. Since circulating concentrations of GH were higher in rams than in ewes at 100 days of age, this implies that the restricted feed intake blocked the IGF-I and IGFBP-3 responses to GH. We conclude that sex differences in circulating IGF-I and IGFBP-3 concentrations in the growing lamb alter with age, and are not present when nutrition is restricted.

scholarly journals Effect of Plasma Exchange in Thyroid Storm With Consideration of Its Distribution Into the Extravascular Space

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Mai Shinohara ◽  
Toyoyoshi Uchida ◽  
Takashi Funayama ◽  
Mika Watanabe ◽  
Makio Kusaoi ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Plasma Exchange ◽  
Fresh Frozen Plasma ◽  
Thyroid Storm ◽  
Extravascular Space ◽  
Before And After ◽  
Fresh Frozen ◽  
Thyroid Hormone Levels ◽  
Frozen Plasma

Abstract Plasma exchange (PE), which directly removes some plasma thyroid hormones, is a treatment option for thyroid storm. However, the effect of PE has not been accurately assessed yet. Here we assessed the effect of PE in a patient with thyroid storm while taking into consideration the distribution of thyroid hormones in the extravascular space. A 51-year-old woman with thyroid storm underwent 2 PE procedures at our hospital. By measuring changes in thyroid hormone levels in plasma, fresh frozen plasma (FFP) used, and waste fluid during each 2.5-hour PE procedure, we calculated the efficiency of thyroid hormone removal based on the hypothesis that total thyroid hormone content before and after PE is the same. During the patient’s first PE procedure, the estimated thyroxine (T4) balance in the extravascular space (ΔX) was −70 μg, which corresponds to approximately 19% of T4 in the waste fluid. During the second PE procedure, ΔX was −131 μg, which corresponds to approximately 52% of T4 in the waste fluid. These data indicated that the source of removed T4 during PE varies. The amount of T4 removed from the extravascular space should be taken into account during assessment of the effect of PE in thyroid storm.

Efficacy of Lower Dose Rituximab by Adding Fresh Frozen Plasma for the Treatment of Idiopathic Thrombocytopenic Purpura

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4682-4682
Author(s):  
Mei Sun ◽  
JIan Gu ◽  
Bin He ◽  
Xiao-Yan Xie ◽  
Bao-An Chen ◽  
...  
Keyword(s):  
B Cells ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Fresh Frozen Plasma ◽  
Thrombocytopenic Purpura ◽  
Median Response ◽  
Before And After ◽  
Fresh Frozen ◽  
Frozen Plasma

Abstract Abstract 4682 OBJECTIVE: To evaluate the effectiveness and safety of lower dose rituximab by adding fresh frozen plasma in the treatment of patients with idiopathic thrombocytopenic purpura (ITP). METHODS: A prospective study was performed at Subei People,Hospital Affiliated to Yang Zhou University involving the use of lower dose rituximab combining fresh frozen plasma in 15 patients who had previously been treated with steroids, intravenous immunoglobulin (IVIG) or splenectomy. Fifteen patients with refractory ITP which were unresponsive to or relapse after the above said treatment were treated with two hundreds millilitre of fresh frozen plasma (FFP) followed with rituximab (100 mg/m2 per week for four weeks) and oral Medrol (24mg per day). Whole blood cell count in all cases and B cells of CD19 (+)/CD20 (+) were detected in eight cases before and after rituximab therapy. RESULTS: Complete response (CR) was achieved in 7 patients (46.67%), response (R) in 13(86.67%), and non-response (NR) in 2 (13.33%). The median follow-up time was 4 weeks. The median response and CR time were 7 and 14 days, respectively. CD19 (+) CD20 (+) B cells significantly decreased (P < 0.01). There were no severe adverse effects during rituximab therapy. CONCLUSION: Lower dose rituximab by adding fresh frozen plasma is effective and safe for ITP. Our therapeutic regimen is superior to other relative studies; however, a randomized control trial is needed to confirm the results of our study. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Management of Anticoagulants before and after Endoscopy

2003 ◽  
Vol 17 (5) ◽  
pp. 329-332 ◽  
Author(s):  
Axel Hittelet ◽  
Jacques Devière
Keyword(s):  
High Risk ◽  
Warfarin Therapy ◽  
Fresh Frozen Plasma ◽  
Stent Insertion ◽  
Normal Range ◽  
Endoscopic Retrograde ◽  
Before And After ◽  
Fresh Frozen ◽  
Inflammatory Drugs ◽  
Frozen Plasma

The risk of procedure-related bleeding while taking anticoagulants needs to be weighed against the risk of thromboembolism from discontinuing these drugs. It is not necessary to adjust anticoagulation for low-risk procedures, such as upper endoscopy with biopsy, colonoscopy with biopsy or endoscopic retrograde cholangiopancreatography with stent insertion (but without sphincterotomy). Procedures that incur a high risk of bleeding include polypectomy, endoscopic sphincterotomy, laser therapy, mucosal ablation and treatment of varices. For these procedures, warfarin should be discontinued four to five days beforehand. Depending on the risk of thromboembolism, that is based on the nature of the underlying condition, the patient may require vitamin K and/or fresh frozen plasma (to ensure that coagulation parameters are within the normal range) or heparin infusions (to ensure that some degree of anticoagulation is maintained). Low molecular weight heparin is an alternative to unfractionated heparin for select cases with a high risk of thromboembolism. Warfarin therapy may generally be resumed on the night of the procedure and may be supplemented by heparin in patients with a high risk of thromboembolism. It is not necessary to discontinue acetylsalicylic acid or nonsteroidal anti-inflammatory drugs, when used in standard doses, for endoscopic procedures. There are insufficient data to make recommendations regarding newer antiplatelet drugs, such as ticlopidine or clopidogrel, but it is prudent to discontinue these medications seven to 10 days before a high-risk procedure.

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