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Author : Kelly Fletcher
Publisher :
Page : pages
File Size : 10,28 MB
Release : 2014
Category : Blood
ISBN :
Author : Nicole P. Juffermans
Publisher : Springer
Page : 185 pages
File Size : 32,58 MB
Release : 2014-09-30
Category : Medical
ISBN : 3319087355
Due to a high incidence of anemia, critically ill patients are frequently transfused, with up to 40% of patients receiving a transfusion during their stay in the Intensive Care Unit. It has become increasingly clear that there is an association between transfusion and adverse outcomes, underlining the need for a careful assessment of the risks and benefits of a blood transfusion. In the last decade, there have been several large clinical trials that have studied red blood cell transfusion triggers in various ICU patient populations, allowing us to take a personalized approach to transfusion. Moreover, ICU patients often suffer from coagulopathy. Recent studies have addressed the effectiveness of fresh frozen plasma and platelets to prevent or treat bleeding. Aiming at a personalized therapy approach in transfusion practice, this book is the first to offer a comprehensive summary of transfusion triggers for red blood cells in specific ICU patient populations and specific conditions. In addition, it discusses evidence for triggers for plasma and platelets and outlines the most common adverse effects of transfusion in the ICU. Transfusion in the Intensive Care Unit is a practical handbook that can be used in everyday practice to guide transfusion and thus will serve as a valuable resource for physicians, fellows and residents working in Intensive Care, Anesthesiology and Cardiac Surgery.
Author : Melissa M. Zaccheo
Publisher :
Page : 0 pages
File Size : 44,28 MB
Release : 2009
Category :
ISBN :
The purpose of this evidence-based practice change project was to implement an evidence-based education program on the topic of blood transfusion practice to ICU nurses. The goal of this project was to educate ICU nurses on blood transfusion indications, adverse events, and blood conservation interventions that can be implemented to decrease patient blood loss in an ICU setting. An outcome indicator of nursing knowledge of current evidence-based blood transfusion practice in the intensive care unit has been established. Nursing knowledge was evaluated prior to and following an education program, to assess the efficacy of the education program. Improving knowledge of professional nurses on the evidence-based topic of RBC transfusion in the ICU may improve patient outcomes through best practice actions. " -- from Introduction.
Author : Leah Flatman
Publisher :
Page : 0 pages
File Size : 39,24 MB
Release : 2021
Category :
ISBN :
"Hospital-acquired infections (HAI) are common, with an estimated 1.4 million patients worldwide being affected at any given time. It is estimated that 42% of patients admitted to adult, pediatric, or neonatal intensive care units (ICU) are diagnosed with at least one HAI during their stay. One factor that may increase the risk of HAIs is the administration of red blood cells (RBC). It is hypothesized that the increased risk is a result of immunological changes that follow the transfusion of blood products known as transfusion-related immunomodulation (TRIM). The exact mechanisms surrounding TRIM remain unclear. Thus, this MSc thesis's first study was a scoping review of published literature to provide an overview of the existing evidence on TRIM mechanisms. Our results show that TRIM mechanisms can be grouped into four categories: 1) effects related to the presence of allogeneic white blood cells (WBCs) in transfused blood, 2) apoptosis of allogeneic WBCs, 3) effects related to allogeneic RBCs, and 4) hemolysis of RBCs. The most pronounced TRIM mechanisms involve the presence of allogeneic WBCs in transfused RBC units. Consequently, pre-storage leukoreduction of RBC units, which involves filtering them to remove WBCs, was instituted in many different countries to prevent TRIM. However, pre-storage leukoreduction does not remove all WBCs from RBC units, and the minimum number of allogeneic WBCs that must be present in RBC units to potentially trigger TRIM is currently unknown. Thus, an important research question remains if the transfusion of leukoreduced RBC units could also be associated with the development of TRIM and the consequent increase in risk for HAIs. The second and third studies of this MSc thesis involves the secondary analysis of the "Transfusion Requirements in Pediatric Intensive Care Units" (TRIPICU) study, a randomized controlled trial of 637 critically ill children, to evaluate the association between transfusing leukoreduced RBCs and the incidence rate of HAIs. Study 2 primarily aimed to evaluate the use of a restrictive packed leukoreduced RBC transfusion strategy, compared to a liberal leukoreduced RBC transfusion strategy, on the incidence rate of HAI in critically ill children. Furthermore, we aimed to evaluate the association between 1) leukoreduced RBC transfusion and HAI incidence rate, 2) the number of leukoreduced RBC transfusions and HAI incidence rate, and 3) the volume of leukoreduced RBC transfusions and HAI incidence rate (secondary aims). The incidence rate ratio (IRR) for the association of a restrictive transfusion strategy was found to be 0.91 (95% confidence interval [CI] 0.70, 1.19). The results of our quasi-Poisson multivariable regression models showed that the association of transfusion of leukoreduced RBCs (IRR 1.15; 95% CI 0.69, 1.91) and volume of leukoreduced RBC transfusions (IRR 1.73; 95% CI 0.94, 3.18) on HAI incidence rate were inconclusive. However, we observed a statistically significant association between the number of leukoreduced RBC transfusions and HAI incidence rate when critically ill children receive e" blood transfusions (IRR 2.32; 95% CI 1.14, 4.71). In study 3, we aimed to evaluate the association between the length of storage of transfused leukoreduced RBC units and the HAI incidence rate. The results of our quasi-Poisson multivariable model showed a statistically significant association between the transfusion of RBC units stored for e"5 days and an increase in HAI incidence rate (IRR 3.66; 95% CI 1.22, 10.98). The results of this MSc thesis help to inform transfusion practices and future research in the pediatric critical care setting as it demonstrates that reducing the number of transfusions of leukoreduced RBCs performed in patients and limiting the transfusion of very old leukoreduced blood are associated with a reduction in the incidence of HAI in this patient population"--
Author :
Publisher :
Page : 1938 pages
File Size : 42,79 MB
Release : 2004
Category : Medicine
ISBN :
Vols. for 1963- include as pt. 2 of the Jan. issue: Medical subject headings.
Author :
Publisher :
Page : 1836 pages
File Size : 46,9 MB
Release : 2000
Category : Medicine
ISBN :
Author : World Health Organization
Publisher : World Health Organization
Page : 442 pages
File Size : 37,95 MB
Release : 2013
Category : Business & Economics
ISBN : 9241548371
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.
Author : World Health Organization
Publisher :
Page : 0 pages
File Size : 33,94 MB
Release : 2013
Category : Medical
ISBN : 9789241548519
The WHO guidelines on assessing donor suitability for blood donation have been developed to assist blood transfusion services in countries that are establishing or strengthening national systems for the selection of blood donors. They are designed for use by policy makers in national blood programmes in ministries of health, national advisory bodies such as national blood commissions or councils, and blood transfusion services.
Author : H. A. Harfi
Publisher : Springer Science & Business Media
Page : 4213 pages
File Size : 20,60 MB
Release : 2012-01-10
Category : Medical
ISBN : 3642022022
The new edition of this classic reference offers a problem-based approach to pediatric diseases. It encompasses almost all pediatric subspecialties and covers every pediatric disease and organ system. It includes case studies and over 750 lavish illustrations.
Author : Chaim Hershko
Publisher : Springer Science & Business Media
Page : 275 pages
File Size : 31,62 MB
Release : 2012-12-06
Category : Science
ISBN : 1461505933
Within the last few years, iron research has yielded exciting new insights into the under standing of normal iron homeostasis. However, normal iron physiology offers little protec tion from the toxic effects of pathological iron accumulation, because nature did not equip us with effective mechanisms of iron excretion. Excess iron may be effectively removed by phlebotomy in hereditary hemochromatosis, but this method cannot be applied to chronic anemias associated with iron overload. In these diseases, iron chelating therapy is the only method available for preventing early death caused mainly by myocardial and hepatic iron toxicity. Iron chelating therapy has changed the quality of life and life expectancy of thalassemic patients. However, the high cost and rigorous requirements of deferoxamine therapy, and the significant toxicity of deferiprone underline the need for the continued development of new and improved orally effective iron chelators. Such development, and the evolution of improved strategies of iron chelating therapy require better understanding of the pathophysiology of iron toxicity and the mechanism of action of iron chelating drugs. The timeliness of the present volume is underlined by several significant develop ments in recent years. New insights have been gained into the molecular basis of aberrant iron handling in hereditary disorders and the pathophysiology of iron overload (Chapters 1-5).