Ian Roberts, Haleema Shakur-Still , Adefemi Afolabi, Christopher Hawkey et el (HALT-IT trial investigators) published a trial in Lancet comparing tranexamic acid to placebo in gastrointestinal hemorrhage. Background Tranexamic acid(TXA) is known to prevent the fibrinolysis. Early use of TXA reduces surgical bleeding and death related to bleeding from traumatic injury and has reduced the … Read more
J.L. Sperry, F.X. Guyette, J.B. Brown, M.H. Yazer et el published a trial of plasma vs standard fluid resuscitation in trauma patients who were at risk of hemorrhagic shock while being transported by air medical services. BACKGROUND In hospital treatment of trauma involves “damage control resuscitation” which aims to prevent coagulopathy by minimization of the use of crystalloid-based … Read more
Two recent studies caught my eye, both about blood transfusion. The first study was published in NEJM by Cooper DJ, McQuilten ZK, Nichol A et el comparing use of freshest vs oldest available blood in critically ill patients. In this international, multi center, randomized, double-blind trial, critically ill adults were assigned to receive either the freshest available, compatible, allogeneic red cells (short-term … Read more
Inform trial results were published in NEJM on Oct 24, 2016. 31,497 adult patients at six hospitals in four countries (Australia, Canada, Israel and the U.S) were randomized to receive short or long term stored blood. There was no difference in mortality among two groups. Earlier, a meta analysis of 12 randomized trials showed no … Read more
In the current issue of JAMA, published October 12, Carson et el have updated red blood cell (RBC) transfusion guidelines by AABB (American Association of Blood Banks). Based on review of 31 randomized clinical trials (RCTs) performed in a variety of different clinical settings involving more than 12 587 patients. Main recommendations Transfusion not indicated … Read more