Transfusion in the mechanically ventilated patient

Juffermans, Nicole P.; Aubron, Cécile; Duranteau, Jacques; Vlaar, Alexander P.J.; Kor, Daryl J.; Muszynski, Jennifer A.; Spinella, Philip C.; Vincent, Jean‐Louis

doi:10.1007/s00134-020-06303-z

Cited by 17 publications

(15 citation statements)

References 62 publications

(82 reference statements)

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“…Nevertheless, when patients with shock and concurrent renal or cardiac failure are treated, volume overload can occur. Straightforward interventions that have been shown to decrease the risk of TACO are reduction of infusion speed and the administration of diuretics 104 …”

Section: Roadblocks In the Use Of Plasma For Shockmentioning

confidence: 99%

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Plasma as a resuscitation fluid for volume‐depleted shock: Potential benefits and risks

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Section: Roadblocks In the Use Of Plasma For Shockmentioning

confidence: 99%

“…Straightforward interventions that have been shown to decrease the risk of TACO are reduction of infusion speed and the administration of diuretics. 104 …”

Section: Roadblocks In the Use Of Plasma For Shockmentioning

confidence: 99%

Plasma as a resuscitation fluid for volume‐depleted shock: Potential benefits and risks

et al. 2021

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“…A transfusão de um produto sanguíneo é equiparada a um transplante de órgão sólido ou a um mini transplante, uma vez que exige rigor nos processos que englobam a transfusão desde a recomendação até o monitoramento do paciente (Chassé et al, 2015;Juffermans, 2020). Os eventos adversos provenientes da transfusão são tempo dependente, dose dependente e podem advir de forma simultânea, portanto, necessita de intervenção e de diagnóstico (Webert & Hededle, 2017;Jug et al, 2021).…”

Section: Introductionunclassified

Desenvolvimento do Hemomonitor com sistema de alertas para o paciente em uso de hemocomponentes

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et al. 2022

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Objetivo: Desenvolver o módulo de software Hemomonitor com sistema de alertas para monitoramento dos pacientes em uso de hemocomponentes. Metodologia: Trata-se de uma pesquisa aplicada realizada em um Hospital Universitário, cuja trajetória metodológica seguiu três etapas: 1) Caracterização do processo transfusional no local do estudo; 2) Atualização acerca dos softwares disponíveis sobre o tema por meio de uma revisão de literatura; 3) Desenvolvimento de software atualizado com base na literatura especializada. Resultados: Os fluxos de atividades desempenhadas foram deflagrados a partir da extração de dados multivariados dos sistemas, AGHUx e +Exames, utilizados pela instituição, para transformá-los em informações. Além disso, visando seu funcionamento, foi necessário parametrizar as alterações dos exames laboratoriais, certificar a prescrição do HC com a assinatura do médico responsável pelo paciente, construir um sequenciamento de solicitação de HC, permitir o compartilhamento das informações e interfaceamento entre os setores, padronizar os exames comprobatórios mediante à suspeita transfusional, identificar a amostra do paciente e da bolsa do HC de forma apropriada com a legislação, parametrizar os laudos para as provas de compatibilidade, permitir a rastreabilidade, parametrizar alterações dos sinais vitais para estabelecer vínculo temporal, definir as trilhas de auditoria, capacitar as equipes quanto à celeridade dos processos, eficiência e aproveitamento substancial dos recursos. Conclusão: A implementação do módulo Hemomonitor e a aplicação em uma unidade piloto permitiu observar que a sua utilização pode melhorar a monitorização e acompanhamento em tempo real dos pacientes em uso de HC, auxiliando na antecipação de condutas eficazes para mitigação das RT.

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“…In critically ill patients in particular, the benefit of transfusion may only be noted when normal physiologic compensation for anemia is compromised or has failed. Recent data suggests that donor RBCs are inferior to native cells in delivering oxygen, may have negative procoagulant and immunomodulatory effects (6)(7)(8)(9), and increase risk for both infectious and non-infectious serious hazards of transfusion (10)(11)(12). Transfusion has been independently associated with an increased duration of mechanical ventilatory support, increased risk of multi-organ system dysfunction and death (13,14).…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Implementation of Blood Transfusion Recommendations in Pediatric Critical Care Units

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Purpose: Risks of red blood cell transfusion may outweigh benefits for many patients in Pediatric Intensive Care Units (PICUs). The Transfusion and Anemia eXpertise Initiative (TAXI) recommendations seek to limit unnecessary and potentially harmful transfusions, but use has been variable. We sought to identify barriers and facilitators to using the TAXI recommendations to inform implementation efforts.Materials and Methods: The integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework guided semi-structured interviews conducted in 8 U.S. ICUs; 50 providers in multiple ICU roles completed interviews. Adapted Framework analysis, a form of content analysis, used the iPARIHS innovation, recipient, context and facilitation constructs and subconstructs to categorize data and identify patterns as well as unique informative statements.Results: Providers perceived that the TAXI recommendations would reduce transfusion rates and practice variability, but adoption faced challenges posed by attitudes around transfusion and care in busy and complex units. Development of widespread buy-in and inclusion in implementation, integration into workflow, designating committed champions, and monitoring outcomes data were expected to enhance implementation.Conclusions: Targeted activities to create buy-in, educate, and plan for use are necessary for TAXI implementation. Recognition of contextual challenges posed by the PICU environment and an approach that adjusts for barriers may optimize adoption.

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Transfusion in the mechanically ventilated patient

Cited by 17 publications

References 62 publications

Plasma as a resuscitation fluid for volume‐depleted shock: Potential benefits and risks

Plasma as a resuscitation fluid for volume‐depleted shock: Potential benefits and risks

Desenvolvimento do Hemomonitor com sistema de alertas para o paciente em uso de hemocomponentes

Factors Influencing Implementation of Blood Transfusion Recommendations in Pediatric Critical Care Units

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