Transfusion therapy in emergency medicine

Kruskall, Margot S.; Mintz, Paul D.; Bergin, James J.; Johnston, Marilyn F. M.; Klein, Harvey G.; Miller, Jacqueline D.; Rutman, Roanne; Silberstein, Leslie E.

doi:10.1016/s0196-0644(88)80774-1

Cited by 33 publications

(7 citation statements)

References 83 publications

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“…Physiological changes such as the development of metabolic acidosis, hypothermia, hypocalcaemia and hypokalaemia exert adverse effects on coagulation which-improve when they are corrected. In summary, it is primarily the disease itself (hypoperfusion) and not the treatment (transfusion) that causes the coagulopathy in these patients [7,27,37].…”

Section: Aetiologymentioning

confidence: 99%

Massive Blood Transfusion

Donaldson¹,

Seaman²,

Park³

1992

British Journal of Anaesthesia

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Section: Aetiologymentioning

confidence: 99%

Massive Blood Transfusion

Donaldson¹,

Seaman²,

Park³

1992

British Journal of Anaesthesia

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“…Our search identified by chance 12 Consensus Guidelines that mentioned HES: six were unfavorable to HES use by either favoring crystalloids [53, 59, 62] or cautioning specifically against the use of HES [56–58] and four were neutral, recommending the use of either crystalloids or artificial/synthetic colloids [55, 60, 63, 64]. Only two of the 12 guidelines were favorable to HES by either directly recommending HES [61] or indirectly recommending HES by cautioning against higher molecular weight formulations but not newer lower molecular weight formulations [54].…”

Section: Resultsmentioning

confidence: 99%

Systematic analysis of hydroxyethyl starch (HES) reviews: proliferation of low-quality reviews overwhelms the results of well-performed meta-analyses

et al. 2012

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Purpose Hydroxyethyl starch (HES) is a synthetic colloid used widely for resuscitation despite the availability of safer, less costly fluids. Numerous HES reviews have been published that may have influenced clinicians’ practice. We have therefore examined the relationship between the methodological quality of published HES reviews, authors’ potential conflicts of interest (pCOI) and the recommendations made. Methods Systematic analysis of reviews on HES use. Results Between 1975 and 2010, 165 reviews were published containing recommendations for or against HES use. From the 1990s onwards, favorable reviews increased from two to eight per year and HES’s share of the artificial colloid market tripled from 20 to 60 %. Only 7 % (12/165) of these reviews of HES use contained meta-analyses; these 7 % had higher Overview Quality Assessment Questionnaire (OQAQ) scores [median (range) 6.5 (3–7)] than reviews without meta-analysis [2 (1–4); p < 0.001]. The rates of recommending against HES use are 83 % (10/12) in meta-analyses and 20 % (31/153) in reviews without meta-analysis (p < 0.0001). Fourteen authors published the majority (70/124) of positive reviews, and ten of these 14 had or have since developed a pCOI with various manufacturers of HES. Conclusions Low-quality HES reviews reached different conclusions than high-quality meta-analyses from independent entities, such as Cochrane Reviews. The majority of these low-quality positive HES reviews were written by a small group of authors, most of whom had or have since established ties to industry. The proliferation of positive HES reviews has been associated with increased utilization of an expensive therapy despite the lack of evidence for meaningful clinical benefit and increased risks. Clinicians need to be more informed that marketing efforts are potentially influencing scientific literature.

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“…Knowledge of the central venous pressure is helpful to gauge the adequacy of volume administration without overresuscitating the patient because this can provoke more bleeding from previously decompressed varices or lead to other complications such as acute pulmonary edema. 121,122 Prophylactic endotracheal intubation should be considered in the setting of significant upper gastrointestinal hemorrhage prior to endoscopic intervention for airway protection. Figure 4 proposes an algorithm for the management of AVH.…”

Section: Variceal Hemorrhage-general Considerationsmentioning

confidence: 99%

Intensive Management of Hepatic Failure

Rinella¹,

Sanyal²

2006

Semin Respir Crit Care Med

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A substantial number of patients with liver failure are admitted to the intensive care unit; thus a thorough understanding of the prevention and treatment of complications in such patients is imperative. The management of liver failure is demanding and often involves the combined efforts of many specialists. Critically ill patients with hepatic failure encompass a broad spectrum of disease, ranging from acute liver failure in a patient with no prior history of liver disease, to acute or chronic liver failure. The initial assessment and management of acute liver failure are reviewed with an emphasis on the prevention and treatment of brain edema in the pretransplant setting. The current treatment of complications resulting from decompensated chronic liver disease such as portal hypertensive bleeding; infection, renal failure, and hepatic encephalopathy are then discussed.

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Transfusion therapy in emergency medicine

Cited by 33 publications

References 83 publications

Massive Blood Transfusion

Massive Blood Transfusion

Systematic analysis of hydroxyethyl starch (HES) reviews: proliferation of low-quality reviews overwhelms the results of well-performed meta-analyses

Intensive Management of Hepatic Failure

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