Transfusion of Red Blood Cells, Tranexamic Acid and Fibrinogen Concentrate for Severe Trauma Hemorrhage

2019 ◽  
Author(s):  
Keyword(s):  
Tranexamic Acid ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Severe Trauma ◽  
Fibrinogen Concentrate

scholarly journals Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma

JAMA ◽  
2015 ◽  
Vol 313 (5) ◽  
pp. 471 ◽  
Author(s):  
John B. Holcomb ◽  
Barbara C. Tilley ◽  
Sarah Baraniuk ◽  
Erin E. Fox ◽  
Charles E. Wade ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Severe Trauma

scholarly journals Evaluation of the Safety of Fibrinogen Concentrate Administration for Bleeding Control in Neurosurgery

2018 ◽  
Vol 25 (4) ◽  
pp. 343-348
Author(s):  
Cristiane Tavares ◽  
Seigi Sazaki ◽  
Kazuco Nakai Murata ◽  
Andrei F. Joaquim ◽  
Helder Tedeschi
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Allergic Reactions ◽  
Bleeding Control ◽  
Fibrinogen Concentrate ◽  
Neurosurgical Procedure ◽  
Prophylactic Use ◽  
Neurological Surgery ◽  
Platelet Transfusions

Background and Objective: Bleeding control is extremely important in any surgical procedure, especially in neurological surgery. Hemodilution with colloid and crystalloid may predispose to functional impairment of fibrinogen, which replacement may be beneficial. We evaluated the safety of fibrinogen concentrate administration in patients who underwent a neurosurgical procedure. Method: We reviewed the medical charts of a series of consecutive patients who received prophylactic fibrinogen concentrate and underwent a neurosurgical procedure for different pathologies in our institution from July 2009 to July 2010. Adverse effects, red blood cells and platelet transfusions were carefully recorded in all cases. Results: Twelve patients were included in our study. There were seven (58%) men and five (42%) women, with a median age of 37 years. All patients had a normal baseline laboratory tests. There was no case of allergic reactions or any adverse events related to fibrinogen administration. None of them required red blood cells or platelet transfusions after surgery, and there were no thrombotic events during 30 days of follow-up. Conclusion: The prophylactic use of fibrinogen concentrate appears to be safe in neurosurgery and may reduce the need of blood derivatives transfusion. Additional prospective studies should be performed to assess the efficacy of this strategy.

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.

scholarly journals RELATIONSHIP BETWEEN TRANSFUSION OF PACKED RED BLOOD CELLS, PLASMA FREE HEMOGLOBIN AND STORAGE TIME IN PATIENTS WITH SEVERE TRAUMA

2015 ◽  
Vol 3 (Suppl 1) ◽  
pp. A916
Author(s):  
S Chacón Alves ◽  
M Chico Fernández ◽  
C García Fuentes ◽  
A Del Pino Ramírez ◽  
N Zurera Plaza ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Storage Time ◽  
Severe Trauma ◽  
Free Hemoglobin ◽  
Packed Red Blood Cells ◽  
And Storage

scholarly journals Tranexamic Acid Alters The Immunophenotype of Phagocytes After Lower Limb Surgery

2021 ◽  
Author(s):  
Dominik F. Draxler ◽  
Gryselda Hanafi ◽  
Saffanah Zahra ◽  
Fiona McCutcheon ◽  
Heidi Ho ◽  
...  
Keyword(s):  
Immune Response ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Red Blood Cells ◽  
Nk Cells ◽  
Lower Limb ◽  
Blood Cells ◽  
Immune Cell ◽  
Lower Limb Surgery ◽  
Time Point

Abstract Introduction: Tranexamic acid (TXA) is an antifibrinolytic agent frequently used in elective surgery to reduce blood loss. We recently found it also acts as a potent immune-modulator in patients undergoing cardiac surgery.Methods: Patients undergoing lower limb surgery were enrolled into the “Tranexamic Acid in Lower Limb Arthroplasty” (TALLAS) pilot study. The cellular immune response was characterised longitudinally pre- and post-operatively using full blood examination (FBE) and comprehensive immune cell phenotyping by flowcytometry. Red blood cells and platelets were determined in the FBE and levels of T cell cytokines and the plasmin-antiplasmin complex determined using ELISA.Results: TXA administration increased the proportion of circulating CD141+ conventional dendritic cells (cDC) on post-operative day (POD) 3. It also reduced the expression of CD83 and TNFR2 on classical monocytes and levels of circulating IL-10 at the end of surgery (EOS) time point, whilst increasing the expression of CCR4 on natural killer (NK) cells at EOS, and reducing TNFR2 on POD-3 on NK cells. Red blood cells and platelets were decreased to a lower extent at POD-1 in the TXA group, representing reduced blood loss. Discussion: In this investigation we have extended our examination on the immunomodulatory effects of TXA in surgery by also characterising the end of surgery time point and including B cells and neutrophils in our immune analysis, elucidating new immunophenotypic changes in phagocytes as well as NK cells. This study enhances our understanding of TXA-mediated effects on the haemostatic and immune response in surgery, validating changes in important functional immune cell subsets in orthopaedic patients.

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