The whole is greater than the sum of its parts

Kornblith, Lucy Z.; Howard, Benjamin M.; Cheung, Christopher K.; Dayter, Yelena; Pandey, Suchitra; Busch, Michael P.; Pati, Shibani; Callcut, Rachael A.; Vilardi, Ryan F.; Redick, Brittney J.; Nelson, Mary F.; Cohen, Mitchell J.

doi:10.1097/ta.0000000000000354

Cited by 60 publications

(28 citation statements)

References 33 publications

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“…Further, PLT counts decreased significantly during storage in the studies of Jobes et al [21] and Pidcoke et al [22] without any correction of the results for this confounder. Further, Kornblith et al [24] compared fresh WB to expired PLT concentrates and Rodgers et al [23] only examined up till 3 days of storage, thereby making direct comparisons with the current study difficult.…”

Section: Discussionmentioning

confidence: 85%

“…Nonetheless, the PLT aggregation capacity of WB is at least as good as it is in BCP or AP. Previous studies have shown reduced PLT aggregation capacity in BCP and AP during storage as measured by light transmission aggregometry [12][13][14][15][16][17][18] or multiple electrode aggregometry [12,13,19,20], but only few have compared PLT function in BCP or AP to that of WB [23,24]. Knowledge of PLT function in WB during storage is sparse and has shown conflicting results [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…A few studies have examined PLT activity in WB and found contradicting results depending on the agonist used [21][22][23]. Further, PLT function in WB during storage has been shown superior than that of BCP [23,24]. However, these studies assessed PLT function by methodologies that are known to be dependent on the PLT count or the medium in which the PLTs are suspended [25,26].…”

Section: Introductionmentioning

confidence: 99%

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The effects of storage on platelet function in different blood products

et al. 2018

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effects of storage on platelet function in different blood products

et al. 2018

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“…While our study reinforces WFWB as the gold-standard for hemorrhage resuscitation based on hemostatic properties, we have attempted to identify a product with comparable hemostatic properties that avoids the contemporary logistic and infectious concerns of WFWB [10,11]. Our study demonstrates that CWB holds great promise as a surrogate for WFWB, but that use of the platelet-sparing LR filter diminishes platelet function almost immediately after filtration (Table 1).…”

Section: Discussionmentioning

confidence: 97%

In vitro Analysis of the Hemostatic Properties of Whole Blood Products Prepared with a Platelet-Sparing Leukoreduction Filter

Zielinski¹,

Stubbs²,

Sf³

et al. 2018

J Thrombo Cir

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Background: Warm fresh whole blood (WFWB) is an ideal resuscitation fluid for exsanguinating patients but there are myriad logistic and infectious issues associated with its use. Cold whole blood (CWB) may be an acceptable alternative to the reconstituted whole blood (RWB), the current standard of care. A leukoreduction filter has been developed which maintains platelet count while eliminating white blood cells but its effect on platelet function is unknown. We hypothesize that CWB will retain an acceptable functional coagulation profile after filtration and over time.

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“…Haemostatic resuscitation is based on the administration of a mixture of red blood cells (RBCs), fresh frozen plasma (FFP) and platelets in approximately a 1:1:1 ratio. Such a strategy known as a 'balanced transfusion' would minimise the risk of dilution of coagulation factors leading to a reduction in the overall mortality rate in patients requiring massive transfusions [14].…”

mentioning

confidence: 99%

Advances made in resuscitation: current status

Giannoudis

2016

Eur J Trauma Emerg Surg

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To start with, coagulopathy has been shown to relate directly to the amount of fluid administered supporting the view that dilution plays a crucial role. Dysfunction of specific components and activation of protein C is connected with the exhaustion of many clotting factors [8]. Changes in pH adversely influence enzymatic function throughout the body. The degree of acidosis in the bleeding patient has been noted to correlate to the exhaustion of coagulation factors. For instance, a drop in pH from 7.4 to 7.0 decreases the activity of Factor VIIa by more than 80 % [9].It is not a surprise, therefore, that Friscknecht et al. reported that lactate >4 mmol/L odds ratio 8.70 (1.81-41.67) and pack red blood cells (PRBC) >10 units odds ratio 7.14 (1.40-40.00) were independent risk factors at ICU admission for early mortality in patients undergoing damage control management [10].For the early diagnosis of coagulopathy and the outcome of treatment, viscoelastic haemostatic assays (VHA), thromboelastography (TEG) and rotation thromboelastometry (ROTEM) representing base model assessing viscoelastic properties of coagulation in whole blood under low shear conditions have had great acceptance [11]. A graphic presentation of clot formation and subsequent lysis is obtainable following incubation of blood at 37 °C. Advantages to these diagnostic assays include assessment of combined influence of circulating plasmatic and cellular elements on clot formation and the short time that takes to make the results being available [12]. More and more trauma centers are currently using this approach of assessment and treatment of coagulation disturbances.Lately, the concept of damage control resuscitation (DCR) was introduced to optimise the resuscitation process in the multiple injured patients. The hallmark of this approach is a more focussed correction of coagulopathy and metabolic imbalances. It includes such constituents as restrictive fluidThe management of polytrauma patients has been revolutionised during the past 30 years. Major advances made in accident prevention, new car designs, rescue conditions, advanced trauma life support protocols, diagnostics, surgical approaches, intensive care support, implantology, antibiotics and pharmacotherapy in general have contributed to the overall reduction of mortality rate seen in this cohort of patients [1][2][3]. Moreover, the philosophy of damage control surgery, a process to assist resuscitation by performing surgical maneuvers of short duration in the operating theatre with a minimal invasive approach, has been successful in reducing the additional physiological burden exerted by the second hit phenomena and thus protecting the patient of developing an exaggerated immune-inflammatory response leading to early development of multiple organ dysfunction syndrome (MODS) [4][5][6].Yet, during this period of time, the three distinct peaks of mortality being at the scene of the accident (severe head injuries), first 24-48 h (uncontrolled bleeding) and days or weeks later, as a result of the m...

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The whole is greater than the sum of its parts

Cited by 60 publications

References 33 publications

The effects of storage on platelet function in different blood products

The effects of storage on platelet function in different blood products

In vitro Analysis of the Hemostatic Properties of Whole Blood Products Prepared with a Platelet-Sparing Leukoreduction Filter

Advances made in resuscitation: current status

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