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Transfusion in the Intensive Care Unit.

By: Juffermans, Nicole.
Contributor(s): Walsh, Timothy.
Material type: TextTextSeries: eBooks on Demand.Publisher: Cham : Springer, 2014Copyright date: ©2015Description: 1 online resource (185 pages).Content type: text Media type: computer Carrier type: online resourceISBN: 9783319087351.Subject(s): Critical care medicine -- Handbooks, manuals, etc | Emergency medicine -- Handbooks, manuals, etcGenre/Form: Electronic books.Additional physical formats: Print version:: Transfusion in the Intensive Care UnitDDC classification: 616.028 LOC classification: RC86-88.9RD78.3-87.3Online resources: Click here to view this ebook.
Contents:
Contents -- 1: Introduction -- References -- 2: Causes of Anemia in Critically Ill Patients -- 2.1 Introduction -- 2.2 Anemia of Chronic Disease -- 2.3 Blood Loss -- 2.3.1 Phlebotomy Losses -- 2.3.2 Hemorrhagic Losses -- 2.4 Reduced Red Cell Production -- 2.4.1 Substrate Deficiency -- 2.4.2 Inappropriately Low Circulating Erythropoietin Concentrations -- 2.5 Abnormal RBC Maturation -- 2.6 Reduced Red Cell Survival -- 2.7 Increased RBC Destruction -- 2.8 Hemodilution -- 2.9 Conclusion -- References -- 3: Red Blood Cell Transfusion Trigger in Sepsis -- 3.1 Introduction -- 3.2 Oxygen Delivery and Consumption in Sepsis -- 3.3 Anemia in Sepsis -- 3.4 Monitoring VO2/DO2 and Tissue Oxygenation During Transfusion -- 3.5 Microcirculatory Effects of Blood Transfusions -- 3.6 Putting the Theory into Practice: Clinical Trials of Transfusion Triggers in Septic Patients -- 3.7 Conclusion -- References -- 4: Red Blood Cell Transfusion Trigger in Cardiac Disease -- 4.1 Introduction -- 4.2 Cardiac Oxygen Consumption -- 4.3 Pathophysiology of Anemia in Heart Disease -- 4.4 Hemoglobin Triggers for Transfusion in Patients with Heart Disease -- 4.5 Conclusions -- References -- 5: Red Blood Cell Transfusion Trigger in Cardiac Surgery -- 5.1 Introduction -- 5.1.1 Consequences of Anaemia During Cardiac Surgery -- 5.1.2 Consequences of Red Blood Cell Transfusion in Cardiac Surgery -- 5.1.3 Practice of Red Blood Cell Transfusion in Cardiac Surgery -- 5.2 Observational Studies on Red Blood Cell Transfusion in Cardiac Surgery -- 5.3 Randomised Controlled Trials on Red Blood Cell Transfusion in Non-Cardiac Surgery Patients -- 5.4 Randomised Trials on Red Blood Cell Transfusion in Cardiac Surgery Patients -- 5.5 Summary and Conclusions -- References -- 6: Red Blood Cell Transfusion Trigger in Brain Injury.
6.1 Oxygen Transport and Anemia Physiology in the Normal Brain -- 6.2 Oxygen Transport and Anemia Physiology in the Injured Brain -- 6.3 Epidemiology and Clinical Impact of Anemia in Brain Injury -- 6.3.1 Impact of Anemia in Ischemic Stroke -- 6.3.2 Impact of Anemia in Traumatic Brain Injury -- 6.3.3 Impact of Anemia in Intracranial Hemorrhage -- 6.4 Effects of RBC Transfusion in the Injured Brain -- 6.5 Observational and Randomized Controlled Intervention Studies of the Clinical Effects of RBC Transfusion in the Injured Brain -- 6.5.1 RBC Transfusion Trigger in Ischemic Stroke -- 6.5.2 RBC Transfusion Trigger in Traumatic Brain Injury -- 6.5.3 RBC Transfusion Trigger in Intracranial Hemorrhage -- 6.6 Ongoing Studies -- 6.7 Summary -- References -- 7: Red Blood Cell Transfusion in the Elderly -- 7.1 Introduction -- 7.2 Etiology of Anemia in the Elderly -- 7.3 Physiologic Response to Anemia in the Elderly -- 7.4 Consequences of Anemia in the Elderly -- 7.5 Randomized Controlled Trials of Blood Transfusion in the Elderly -- 7.6 Clinical Guidelines on Blood Transfusion in the Elderly -- 7.7 Conclusion -- References -- 8: ScvO2 as an Alternative Transfusion Trigger -- 8.1 Introduction -- 8.2 Anaemia and Oxygen Debt -- 8.3 Central Venous Oxygen Saturation (ScvO2) as a Transfusion Trigger -- 8.4 Conclusion -- References -- 9: Alternatives to Red Blood Cell Transfusion -- 9.1 Introduction -- 9.2 Iron Supplementation -- 9.3 Erythropoiesis-Stimulating Agents -- 9.4 Hemoglobin-Based Oxygen Carriers (HBOCs) -- 9.5 Conclusion -- References -- 10: Blood-Sparing Strategies in the Intensive Care Unit -- 10.1 Introduction -- 10.2 Incidence of Anaemia and Frequency of Transfusion in Critical Care -- 10.3 Studies That Have Investigated Restrictive Transfusion Practice -- 10.4 Blood Sampling in the Critically Ill.
10.5 Strategies to Optimise Blood Use in Critical Care -- 10.6 Blood Conservation Devices -- 10.7 The Evidence for Blood Conservation Devices -- 10.8 Small Volume Blood Tubes -- 10.9 Conclusion -- References -- 11: Massive Transfusion in Trauma -- 11.1 Introduction -- 11.2 Conventional Concepts of Trauma-Induced Coagulopathy -- 11.3 Acute Traumatic Coagulopathy -- 11.4 Diagnosing TIC -- 11.5 Treating ATC -- 11.5.1 Conventional Treatment -- 11.5.2 Earlier and More FFP -- 11.5.3 The Optimal Blood Product Ratio -- 11.5.4 Massive Transfusion Protocols -- 11.5.5 Other Haemostatic Agents -- 11.5.6 Blood Pressure Target -- 11.6 Summary -- References -- 12: Transfusion in Gastrointestinal Bleeding -- 12.1 Introduction and Overview of Gastrointestinal Bleeding -- 12.2 Liver Cirrhosis and Acute Variceal Haemorrhage -- 12.3 The Coagulopathy of Liver Cirrhosis -- 12.3.1 Haemorrhagic Phenotype of Liver Cirrhosis -- 12.3.2 Propensity Towards Thrombosis in Liver Cirrhosis -- 12.4 The Practice of Transfusion of Blood Components for Variceal Bleeding -- 12.4.1 UK National Audit of the Use of Blood Components in Acute Upper GI Bleeding -- 12.4.2 UK National Audit of the Use of Blood Components in Liver Cirrhosis -- 12.5 Efficacy of Red Blood Cell Transfusion for Gastrointestinal Bleeding -- 12.5.1 Purpose of RBC Transfusion -- 12.5.2 Guidelines for RBC Transfusion in AUGIB -- 12.5.3 Observational Studies on RBC Transfusion in AUGIB -- 12.5.4 Randomised Trial Evidence -- 12.6 Mechanisms of Harm of RBCs for AUGIB -- 12.7 Platelet Transfusions in GI Bleeding -- 12.7.1 Thrombocytopenia in Cirrhosis and Variceal Bleeding -- 12.7.2 Managing Antiplatelet Therapy in Non-variceal Bleeding -- 12.8 Plasma Transfusion in GI Bleeding -- 12.9 Correcting Coagulopathy in Non-variceal Upper GI Bleeding -- 12.10 Antifibrinolytics in AUGIB.
12.11 Major Haemorrhage Protocols in AUGIB -- References -- 13: Platelet Transfusion Trigger in the Intensive Care Unit -- 13.1 Introduction -- 13.1.1 What Are Platelets and Why Are They Important? -- 13.2 Factors Affecting Platelets in Critical Care Patients -- 13.3 How Common Is Thrombocytopenia and What Are the Clinical Consequences of Thrombocytopenia? -- 13.4 What Are Platelet Transfusions? -- 13.4.1 What Is a Bag of Platelets? -- 13.4.2 What Is the Effect of Platelet Transfusion on Platelet Count? -- 13.4.3 Are Platelet Transfusions Common? -- 13.5 Risks of Platelet Transfusions -- 13.6 Current Evidence for Platelet Transfusions -- 13.6.1 Platelet Transfusions in Adults Who Are Not Critically Ill: Prophylactic Transfusion -- 13.6.2 Platelet Transfusions in Adults Who Are Not Critically Ill: Perioperative and Peri-procedural Transfusion -- 13.6.3 Platelet Transfusions in Adults Who Are Not Critically Ill: Transfusion Because of Bleeding -- 13.6.4 Platelet Transfusions in Critically Ill Adults -- 13.6.5 Platelet Transfusions in Critically Ill Neonates and Children -- 13.7 Conclusion -- References -- 14: FFP Transfusion in Intensive Care Medicine -- 14.1 FFP Use in Critical Illness -- 14.1.1 What Is FFP? -- 14.1.2 Indications for FFP Use in Critical Illness -- 14.1.3 Situations in Which FFP Transfusion Is Inappropriate -- 14.1.4 FFP Use During Critical Illness -- 14.2 Tests to Assess the Risk of Bleeding -- 14.3 Utility of FFP During Coagulopathy and in Relation to Invasive Procedures -- 14.3.1 Dose Recommendations -- 14.3.2 Evidence-Based FFP Transfusion -- 14.4 Risks Associated with FFP Transfusion -- 14.5 Summary -- References -- 15: Transfusion-Related Acute Lung Injury -- 15.1 Transfusion-Related Acute Lung Injury: Definition and Pathogenesis -- 15.1.1 Definition -- 15.1.2 Pathogenesis.
15.2 Incidence of Transfusion-Related Acute Lung Injury -- 15.3 Risk Factors for Transfusion-Related Acute Lung Injury -- 15.3.1 Patient-Related Risk Factors -- 15.3.2 Mitigating Risk of TRALI by Taking an Individualized Patient Approach -- 15.3.3 Blood Product-Related Risk Factors for TRALI -- 15.3.4 Mitigating Risk of TRALI by Modifying Blood Products -- 15.4 Diagnosing Transfusion-Related Acute Lung Injury -- 15.5 Management of Suspected Transfusion-Related Acute Lung Injury -- References -- 16: Transfusion-Associated Circulatory Overload -- 16.1 Background -- 16.2 TACO: Definition and Diagnosis -- 16.3 Epidemiology and Burden of Disease -- 16.4 Pathophysiology and Risk Factors for TACO -- 16.5 Management -- 16.6 Outcomes -- 16.7 Prevention -- 16.8 Enhancing Recognition and Understanding of TACO -- 16.9 Conclusion -- References -- Index.
Summary: 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.
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RC86-88.9RD78.3-87.3 (Browse shelf) https://ebookcentral.proquest.com/lib/uttyler/detail.action?docID=1965306 Available EBC1965306

Contents -- 1: Introduction -- References -- 2: Causes of Anemia in Critically Ill Patients -- 2.1 Introduction -- 2.2 Anemia of Chronic Disease -- 2.3 Blood Loss -- 2.3.1 Phlebotomy Losses -- 2.3.2 Hemorrhagic Losses -- 2.4 Reduced Red Cell Production -- 2.4.1 Substrate Deficiency -- 2.4.2 Inappropriately Low Circulating Erythropoietin Concentrations -- 2.5 Abnormal RBC Maturation -- 2.6 Reduced Red Cell Survival -- 2.7 Increased RBC Destruction -- 2.8 Hemodilution -- 2.9 Conclusion -- References -- 3: Red Blood Cell Transfusion Trigger in Sepsis -- 3.1 Introduction -- 3.2 Oxygen Delivery and Consumption in Sepsis -- 3.3 Anemia in Sepsis -- 3.4 Monitoring VO2/DO2 and Tissue Oxygenation During Transfusion -- 3.5 Microcirculatory Effects of Blood Transfusions -- 3.6 Putting the Theory into Practice: Clinical Trials of Transfusion Triggers in Septic Patients -- 3.7 Conclusion -- References -- 4: Red Blood Cell Transfusion Trigger in Cardiac Disease -- 4.1 Introduction -- 4.2 Cardiac Oxygen Consumption -- 4.3 Pathophysiology of Anemia in Heart Disease -- 4.4 Hemoglobin Triggers for Transfusion in Patients with Heart Disease -- 4.5 Conclusions -- References -- 5: Red Blood Cell Transfusion Trigger in Cardiac Surgery -- 5.1 Introduction -- 5.1.1 Consequences of Anaemia During Cardiac Surgery -- 5.1.2 Consequences of Red Blood Cell Transfusion in Cardiac Surgery -- 5.1.3 Practice of Red Blood Cell Transfusion in Cardiac Surgery -- 5.2 Observational Studies on Red Blood Cell Transfusion in Cardiac Surgery -- 5.3 Randomised Controlled Trials on Red Blood Cell Transfusion in Non-Cardiac Surgery Patients -- 5.4 Randomised Trials on Red Blood Cell Transfusion in Cardiac Surgery Patients -- 5.5 Summary and Conclusions -- References -- 6: Red Blood Cell Transfusion Trigger in Brain Injury.

6.1 Oxygen Transport and Anemia Physiology in the Normal Brain -- 6.2 Oxygen Transport and Anemia Physiology in the Injured Brain -- 6.3 Epidemiology and Clinical Impact of Anemia in Brain Injury -- 6.3.1 Impact of Anemia in Ischemic Stroke -- 6.3.2 Impact of Anemia in Traumatic Brain Injury -- 6.3.3 Impact of Anemia in Intracranial Hemorrhage -- 6.4 Effects of RBC Transfusion in the Injured Brain -- 6.5 Observational and Randomized Controlled Intervention Studies of the Clinical Effects of RBC Transfusion in the Injured Brain -- 6.5.1 RBC Transfusion Trigger in Ischemic Stroke -- 6.5.2 RBC Transfusion Trigger in Traumatic Brain Injury -- 6.5.3 RBC Transfusion Trigger in Intracranial Hemorrhage -- 6.6 Ongoing Studies -- 6.7 Summary -- References -- 7: Red Blood Cell Transfusion in the Elderly -- 7.1 Introduction -- 7.2 Etiology of Anemia in the Elderly -- 7.3 Physiologic Response to Anemia in the Elderly -- 7.4 Consequences of Anemia in the Elderly -- 7.5 Randomized Controlled Trials of Blood Transfusion in the Elderly -- 7.6 Clinical Guidelines on Blood Transfusion in the Elderly -- 7.7 Conclusion -- References -- 8: ScvO2 as an Alternative Transfusion Trigger -- 8.1 Introduction -- 8.2 Anaemia and Oxygen Debt -- 8.3 Central Venous Oxygen Saturation (ScvO2) as a Transfusion Trigger -- 8.4 Conclusion -- References -- 9: Alternatives to Red Blood Cell Transfusion -- 9.1 Introduction -- 9.2 Iron Supplementation -- 9.3 Erythropoiesis-Stimulating Agents -- 9.4 Hemoglobin-Based Oxygen Carriers (HBOCs) -- 9.5 Conclusion -- References -- 10: Blood-Sparing Strategies in the Intensive Care Unit -- 10.1 Introduction -- 10.2 Incidence of Anaemia and Frequency of Transfusion in Critical Care -- 10.3 Studies That Have Investigated Restrictive Transfusion Practice -- 10.4 Blood Sampling in the Critically Ill.

10.5 Strategies to Optimise Blood Use in Critical Care -- 10.6 Blood Conservation Devices -- 10.7 The Evidence for Blood Conservation Devices -- 10.8 Small Volume Blood Tubes -- 10.9 Conclusion -- References -- 11: Massive Transfusion in Trauma -- 11.1 Introduction -- 11.2 Conventional Concepts of Trauma-Induced Coagulopathy -- 11.3 Acute Traumatic Coagulopathy -- 11.4 Diagnosing TIC -- 11.5 Treating ATC -- 11.5.1 Conventional Treatment -- 11.5.2 Earlier and More FFP -- 11.5.3 The Optimal Blood Product Ratio -- 11.5.4 Massive Transfusion Protocols -- 11.5.5 Other Haemostatic Agents -- 11.5.6 Blood Pressure Target -- 11.6 Summary -- References -- 12: Transfusion in Gastrointestinal Bleeding -- 12.1 Introduction and Overview of Gastrointestinal Bleeding -- 12.2 Liver Cirrhosis and Acute Variceal Haemorrhage -- 12.3 The Coagulopathy of Liver Cirrhosis -- 12.3.1 Haemorrhagic Phenotype of Liver Cirrhosis -- 12.3.2 Propensity Towards Thrombosis in Liver Cirrhosis -- 12.4 The Practice of Transfusion of Blood Components for Variceal Bleeding -- 12.4.1 UK National Audit of the Use of Blood Components in Acute Upper GI Bleeding -- 12.4.2 UK National Audit of the Use of Blood Components in Liver Cirrhosis -- 12.5 Efficacy of Red Blood Cell Transfusion for Gastrointestinal Bleeding -- 12.5.1 Purpose of RBC Transfusion -- 12.5.2 Guidelines for RBC Transfusion in AUGIB -- 12.5.3 Observational Studies on RBC Transfusion in AUGIB -- 12.5.4 Randomised Trial Evidence -- 12.6 Mechanisms of Harm of RBCs for AUGIB -- 12.7 Platelet Transfusions in GI Bleeding -- 12.7.1 Thrombocytopenia in Cirrhosis and Variceal Bleeding -- 12.7.2 Managing Antiplatelet Therapy in Non-variceal Bleeding -- 12.8 Plasma Transfusion in GI Bleeding -- 12.9 Correcting Coagulopathy in Non-variceal Upper GI Bleeding -- 12.10 Antifibrinolytics in AUGIB.

12.11 Major Haemorrhage Protocols in AUGIB -- References -- 13: Platelet Transfusion Trigger in the Intensive Care Unit -- 13.1 Introduction -- 13.1.1 What Are Platelets and Why Are They Important? -- 13.2 Factors Affecting Platelets in Critical Care Patients -- 13.3 How Common Is Thrombocytopenia and What Are the Clinical Consequences of Thrombocytopenia? -- 13.4 What Are Platelet Transfusions? -- 13.4.1 What Is a Bag of Platelets? -- 13.4.2 What Is the Effect of Platelet Transfusion on Platelet Count? -- 13.4.3 Are Platelet Transfusions Common? -- 13.5 Risks of Platelet Transfusions -- 13.6 Current Evidence for Platelet Transfusions -- 13.6.1 Platelet Transfusions in Adults Who Are Not Critically Ill: Prophylactic Transfusion -- 13.6.2 Platelet Transfusions in Adults Who Are Not Critically Ill: Perioperative and Peri-procedural Transfusion -- 13.6.3 Platelet Transfusions in Adults Who Are Not Critically Ill: Transfusion Because of Bleeding -- 13.6.4 Platelet Transfusions in Critically Ill Adults -- 13.6.5 Platelet Transfusions in Critically Ill Neonates and Children -- 13.7 Conclusion -- References -- 14: FFP Transfusion in Intensive Care Medicine -- 14.1 FFP Use in Critical Illness -- 14.1.1 What Is FFP? -- 14.1.2 Indications for FFP Use in Critical Illness -- 14.1.3 Situations in Which FFP Transfusion Is Inappropriate -- 14.1.4 FFP Use During Critical Illness -- 14.2 Tests to Assess the Risk of Bleeding -- 14.3 Utility of FFP During Coagulopathy and in Relation to Invasive Procedures -- 14.3.1 Dose Recommendations -- 14.3.2 Evidence-Based FFP Transfusion -- 14.4 Risks Associated with FFP Transfusion -- 14.5 Summary -- References -- 15: Transfusion-Related Acute Lung Injury -- 15.1 Transfusion-Related Acute Lung Injury: Definition and Pathogenesis -- 15.1.1 Definition -- 15.1.2 Pathogenesis.

15.2 Incidence of Transfusion-Related Acute Lung Injury -- 15.3 Risk Factors for Transfusion-Related Acute Lung Injury -- 15.3.1 Patient-Related Risk Factors -- 15.3.2 Mitigating Risk of TRALI by Taking an Individualized Patient Approach -- 15.3.3 Blood Product-Related Risk Factors for TRALI -- 15.3.4 Mitigating Risk of TRALI by Modifying Blood Products -- 15.4 Diagnosing Transfusion-Related Acute Lung Injury -- 15.5 Management of Suspected Transfusion-Related Acute Lung Injury -- References -- 16: Transfusion-Associated Circulatory Overload -- 16.1 Background -- 16.2 TACO: Definition and Diagnosis -- 16.3 Epidemiology and Burden of Disease -- 16.4 Pathophysiology and Risk Factors for TACO -- 16.5 Management -- 16.6 Outcomes -- 16.7 Prevention -- 16.8 Enhancing Recognition and Understanding of TACO -- 16.9 Conclusion -- References -- Index.

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.

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