Article
Medicine, General & Internal
Jan A. Graw, Victoria Buenger, Lorenz A. Materne, Alexander Krannich, Felix Balzer, Roland C. E. Francis, Axel Pruss, Claudia D. Spies, Wolfgang M. Kuebler, Steffen Weber-Carstens, Mario Menk, Oliver Hunsicker
Summary: This study investigated the effects of different storage durations of PRBCs on ARDS patients. The results showed that prolonged storage of PRBCs did not increase mortality in adults with ARDS, but transfusion of long-term stored PRBCs was associated with prolonged dependence on RRT in critically ill patients with ARDS.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Surgery
Laura Baker, Lily Park, Richard Gilbert, Hilalion Ahn, Andre Martel, Tori Lenet, Alexandra Davis, Daniel I. McIsaac, Alan Tinmouth, Dean A. Fergusson, Guillaume Martel
Summary: This study systematically reviewed CPGs related to intraoperative RBC transfusions, revealing significant variability in recommendations and a lack of sufficient evidence from intraoperative settings.
Review
Hematology
Jesus Rodriguez Corte, Cristina Candal-Pedreira, Alberto Ruano-Ravina, Monica Perez-Rios, Alejandro Rivero-de-Aguilar, Marisa Lopez Garcia, Leticia Hermida Porto, Leonor Varela-Lema
Summary: Home care is a healthcare alternative to hospitalisation, including procedures such as home blood transfusions. This study aimed to assess the safety and effectiveness of home blood transfusions, as well as patient acceptance and satisfaction. The results suggest that home blood transfusion is a feasible, safe, and well-accepted procedure. However, the limited quality of existing studies is a significant limitation in drawing definitive benefit-risk conclusions.
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Review
Multidisciplinary Sciences
Ansh Desai, David Oh, Elizabeth M. Rao, Saswat Sahoo, Uma V. Mahajan, Collin M. Labak, Rohit Mauria, Varun S. Shah, Quang Nguyen, Eric Z. Herring, Theresa Elder, Amber Stout, Berje H. Shammassian
Summary: Anemia is common in AIS patients and is associated with worse outcomes. However, the optimal Hb target for AIS has not been established. This systematic review found that anemia in AIS patients is associated with longer hospital stays and increased mortality. Further research is needed to explore more aggressive transfusion parameters and determine their clinical benefits.
Article
Obstetrics & Gynecology
Nchafatso G. Obonyo, Lawrence Y. Lu, Nicole M. White, Declan P. Sela, Reema H. Rachakonda, Derek Teo, Matthew Tunbridge, Beatrice Sim, Louise E. See Hoe, Jonathon P. Fanning, John-Paul Tung, Matthew McKnoulty, Gianluigi Li Bassi, Jacky Y. Suen, John F. Fraser
Summary: This study investigated the association between transfusion of blood products close to the end of shelf-life and clinical outcomes in obstetric inpatients. The results showed that transfusing older red blood cells or platelets was not associated with increased morbidity or mortality.
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
(2023)
Article
Anesthesiology
Fraser J. D. Morris, Yoke-Lin Fung, Alison Craswell, Michelle S. Chew
Summary: Perioperative blood transfusion is associated with poorer short- and long-term postoperative outcomes in patients undergoing elective major abdominal surgery.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Review
Cardiac & Cardiovascular Systems
Yeshen Zhang, Zhengrong Xu, Yuming Huang, Qirao Ye, Nianjin Xie, Lihuan Zeng, Xingji Lian, Yining Dai, Jiyan Chen, Pengcheng He, Ning Tan, Yuanhui Liu
Summary: Both restrictive and liberal red blood cell transfusion strategies have similar effects on overall mortality and follow-up mortality in anemic AMI patients, but restrictive transfusion tends to have a higher risk of in-hospital mortality. There were no significant differences between the two groups in secondary outcomes, suggesting that further evaluation of transfusion strategy is needed in future studies.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Hematology
Jeremy W. Jacobs, Laura D. Stephens, Elizabeth S. Allen, Thomas C. Binns, Garrett S. Booth, Jeanne E. Hendrickson, Matthew S. Karafin, Christopher A. Tormey, Jennifer S. Woo, Brian D. Adkins
Summary: Hyperhaemolysis syndrome (HHS), a severe form of delayed haemolytic transfusion reaction, often occurs in patients with sickle cell disease (SCD) and involves destruction of both donor and recipient red blood cells (RBCs). This systematic review identified 51 patients with HHS, characterized their epidemiological and immunohaematological characteristics, and found that additional transfused RBCs may be associated with a longer time-to-recovery.
BRITISH JOURNAL OF HAEMATOLOGY
(2023)
Article
Multidisciplinary Sciences
Ziya Isiksacan, Angelo D'Alessandro, Susan M. Wolf, David H. McKenna, Shannon N. Tessier, Erdem Kucukal, A. Aslihan Gokaltun, Nishaka William, Rebecca D. Sandlin, John Bischof, Narla Mohandas, Michael P. Busch, Caglar Elbuken, Umut A. Gurkan, Mehmet Toner, Jason P. Acker, Martin L. Yarmush, O. Berk Usta
Summary: Transfusion of red blood cells is a valuable and widespread treatment in modern medicine. Current practices in blood transfusion overlook the variability in stored red blood cell quality. It is necessary to rethink transfusion medicine workflows and utilize novel technologies for assessing red blood cell quality.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2023)
Review
Cardiac & Cardiovascular Systems
Marco Vitolo, Davide A. Mei, Paolo Cimato, Niccolo Bonini, Jacopo F. Imberti, Paolo Cataldo, Matteo Menozzi, Tommaso Filippini, Marco Vinceti, Giuseppe Boriani
Summary: Strategies for blood conservation and careful preoperative assessment can be applied to JW patients undergoing cardiac surgery. This systematic review and meta-analysis found no substantial differences in terms of short-term mortality, myocardial infarction, and re-exploration for bleeding between JW patients receiving bloodless surgery and controls. The results support the safety and feasibility of bloodless cardiac surgery.
CURRENT PROBLEMS IN CARDIOLOGY
(2023)
Review
Surgery
Tori Lenet, Laura Baker, Lily Park, Michael Vered, Amin Zahrai, Risa Shorr, Alexandra Davis, Daniel I. McIsaac, Alan Tinmouth, Dean A. Fergusson, Guillaume Martel
Summary: This study conducted a meta-analysis of RCTs comparing intraoperative RBC transfusion strategies to evaluate their impact on postoperative morbidity, mortality, and blood product use. The results showed that intraoperative restrictive transfusion strategies reduced perioperative transfusion without increasing postoperative morbidity and mortality in 12 out of 14 trials. However, two trials reported worse outcomes, indicating the need for further research.
Review
Surgery
Amanda R. Phillips, Lillian Tran, Jill E. Foust, Nathan L. Liang
Summary: The study aimed to investigate the benefit of a greater ratio of plasma/packed red blood cells in patients with rAAAs. Some studies found that a higher ratio of plasma to packed red blood cells was associated with decreased mortality, but overall risk of bias was serious and evidence quality was very low.
JOURNAL OF VASCULAR SURGERY
(2021)
Review
Biochemistry & Molecular Biology
Thomas Hughes, David Zhang, Priya Nair, Hergen Buscher
Summary: A systematic review on blood product administration in ECMO patients revealed that evidence is mainly drawn from single-center observational trials and shows wide variability in transfusion practice, with highly variable transfusion needs. Confounding factors influencing transfusion practice should be identified in prospective multicenter studies to mitigate potential harmful effects and generate hypotheses for interventional trials.
Review
Pediatrics
Li Tang, Ting Ting Zhu, Jing Zhao
Summary: This systematic review and meta-analysis found a significant association between red blood cell transfusions (RBCT) and bronchopulmonary dysplasia (BPD) in neonates. The pooled unadjusted odds ratio (OR) and adjusted OR showed a significant association between RBCT and BPD. However, the substantial heterogeneity among the results suggests that the association between RBCT and BPD remains unclear and further well-designed studies are needed.
FRONTIERS IN PEDIATRICS
(2023)
Review
Surgery
Jacob A. Klapper, Anne C. Hicks, Leila Ledbetter, Jessica Poisson, Matthew G. Hartwig, Nazish Hashmi, Ian Welsby, Brandi A. Bottiger
Summary: Perioperative blood transfusion has been associated with acute lung injury and mortality in medical and surgical patients. The necessity of blood products during and after lung transplantation is common, but potentially modifiable. Current literature mainly consists of retrospective analyses or multicenter studies, with remaining questions regarding the effects of blood product transfusion on graft function and survival.
CLINICAL TRANSPLANTATION
(2021)
Article
Medicine, Research & Experimental
Guillaume Martel, Tori Lenet, Christopher Wherrett, Francois-Martin Carrier, Leah Monette, Aklile Workneh, Karine Brousseau, Monique Ruel, Michael Chasse, Yves Collin, Franck Vandenbroucke-Menu, Elodie Hamel-Perreault, Michel-Antoine Perreault, Jeieung Park, Shirley Lim, Veronique Maltais, Philemon Leung, Richard W. D. Gilbert, Maja Segedi, Jad Abou-Khalil, Kimberly A. Bertens, Fady K. Balaa, Tim Ramsay, Dean A. Fergusson
Summary: This article discusses the concerns surrounding blood loss and red blood cell (RBC) transfusion in liver surgery, and proposes a method of reducing RBC transfusions by reducing blood volume during surgery. A multicenter randomized controlled trial will be conducted to compare the efficacy of this method with usual care.
Article
Medicine, General & Internal
Faizan Khan, Kednapa Thavorn, Doug Coyle, Sasha van Katwyk, Tobias Tritschler, Brian Hutton, Gregoire Le Gal, Marc Rodger, Dean Fergusson
Summary: This study aims to assess the differences in clinical benefits, harms, and costs of stopping versus continuing anticoagulant therapy indefinitely for a first unprovoked venous thromboembolism (VTE). A probabilistic Markov model will be developed to estimate life-years, quality-adjusted life-years, costs, and incremental cost-effectiveness ratios. The results will be disseminated through conferences and a peer-reviewed journal.
Article
Medicine, General & Internal
Lauralyn Ann McIntyre, Dean A. Fergusson, Tracy McArdle, Alison Fox-Robichaud, Shane W. English, Claudio Martin, John Marshall, Deborah J. Cook, Ian D. Graham, Steven Hawken, Colin McCartney, Kusum Menon, Raphael Saginur, Andrew Seely, Ian Stiell, Kednapa Thavorn, Charles Weijer, Akshai Iyengar, John Muscedere, Alan J. Forster, Monica Taljaard, Canadian Crit Care Trials Grp
Summary: This pilot trial aimed to evaluate the effect of normal saline and Ringer's lactate on clinically important outcomes. The study found a higher adherence rate with normal saline, but also observed more adverse events associated with it. Overall, conducting a large-scale trial in the future is feasible, but addressing logistical challenges during the planning stages will be crucial.
Review
Anesthesiology
Joel Neves Briard, Roy Nitulescu, Emile Lemoine, Polina Titova, Lauralyn McIntyre, Shane W. English, Greg Knoll, Sam D. Shemie, Claudio Martin, Alexis F. Turgeon, Francois Lauzier, Dean A. Fergusson, Michael Chasse
Summary: The purpose of this study was to synthesize the sensitivity and specificity of commonly used ancillary tests for death determination by neurologic criteria. The results showed that there is significant heterogeneity in the diagnostic accuracy of ancillary tests, and most estimates have high statistical uncertainty. High-quality studies are needed to validate the accuracy of ancillary tests for death determination by neurologic criteria.
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2023)
Letter
Clinical Neurology
Joel Neves Briard, Michael Chasse
Article
Medicine, General & Internal
Michael Chasse, Dean A. Fergusson, Alan Tinmouth, Jason P. Acker, Iris Perelman, Angie Tuttle, Shane W. English, Steven Hawken, Alan J. Forster, Nadine Shehata, Kednapa Thavorn, Kumanan Wilson, Nancy Cober, Heather Maddison, Melanie Tokessy
Summary: This multicenter, double-blind trial randomly assigned patients undergoing red-cell transfusion to receive units of red cells from either male donors or female donors. The study found no significant difference in survival between the two groups.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Deborah J. Cook, Marilyn E. Swinton, Karla D. Krewulak, Kirsten Fiest, Joanna C. Dionne, Sylvie Debigare, Gordon H. Guyatt, Shipra Taneja, Waleed Alhazzani, Karen E. A. Burns, John C. Marshall, John G. Muscedere, Audrey Gouskos, Simon Finfer, Adam M. Deane, John A. Myburgh, Bram Rochwerg, Ian Ball, Tina Mele, Daniel J. Niven, Shane W. English, Madeleine Verhovsek, Meredith Vanstone, Canadian Critical Care Trials Grp
Summary: This study aims to understand the importance of features, tests, and treatments for upper gastrointestinal bleeding to patients and families. Through qualitative research and quantitative data analysis, the values and perspectives of patients and families will be synthesized to create a new trial outcome for stress ulcer prophylaxis.
Article
Medicine, General & Internal
Michelle E. Kho, Julie Reid, Alexander J. Molloy, Margaret S. Herridge, Andrew J. Seely, Jill C. Rudkowski, Lisa Buckingham, Diane Heels-Ansdell, Tim Karachi, Alison Fox-Robichaud, Ian M. Ball, Karen E. A. Burns, Joseph R. Pellizzari, Christopher Farley, Sue Berney, Amy M. Pastva, Bram Rochwerg, Frederick D'Aragon, Francois Lamontagne, Erick H. Duan, Jennifer L. Y. Tsang, Patrick Archambault, Shane W. English, John Muscedere, Karim Serri, Jean-Eric Tarride, Sangeeta Mehta, Avelino C. Verceles, Brenda Reeve, Heather O'Grady, Laurel Kelly, Geoff Strong, Abby H. Hurd, Lehana Thabane, Deborah J. Cook
Summary: This article describes the protocol for an international, multicentre randomised controlled trial (RCT) to determine the effectiveness of early in-bed cycling versus routine physiotherapy (PT) in critically ill, mechanically ventilated adults. The primary outcome is the Physical Function ICU Test-scored (PFIT-s) at 3 days post-ICU discharge.
Review
Critical Care Medicine
Hashim Kareemi, Michael Pratte, Shane English, Ariel Hendin
Summary: Elevated intracranial pressure (ICP) can have serious consequences on patient mortality and neurologic outcomes. However, its early detection is challenging due to the various manifestations it can present. In this review, we provide an evidence-based approach to recognizing and managing suspected or confirmed elevated ICP in the first minutes to hours of resuscitation. We discuss the utility of invasive and noninvasive diagnostic methods and identify core management principles including noninvasive maneuvers, neuroprotective intubation and ventilation strategies, and pharmacologic therapies.
JOURNAL OF INTENSIVE CARE MEDICINE
(2023)
Review
Medicine, General & Internal
MengQi Zhang, Dean Fergusson, Rahul Sharma, Ciel L. Khoo, Asher C. Mendelson, Braedon McDonald, Kimberly M. Macala, Neha T. Sharma, Sean T. Gill, Kirsten Fiest, Christian Lehmann, Risa Shorr, Forough Jahandideh, Stephane Bourque, Patricia Liaw, Alison Fox-Robichaud, Manoj Lalu
Summary: This study aims to systematically review the impact of biological sex on baseline and treatment responses in animal models of sepsis. It will include screening and data extraction of relevant studies from MEDLINE and Embase databases from 2011 to present. The results will be pooled and subjected to meta-analysis, and the risk of bias in the studies will be assessed. The purpose of this study is to provide a framework for sex-based analysis in future preclinical systematic reviews.
SYSTEMATIC REVIEWS
(2023)
Article
Critical Care Medicine
Luke A. Terrett, Lauralyn Mcintyre, Alexis F. Turgeon, Shane W. English
Summary: Anemia is common in patients with aSAH and is associated with unfavorable outcomes. aSAH has unique characteristics, such as early and delayed phases, which may affect the effects of anemia and transfusion. The available data on transfusion in aSAH are limited and conflicting, and current transfusion targets for other critically ill populations may not be applicable. Upcoming clinical trials will provide more specific guidance for transfusion in aSAH.
NEUROCRITICAL CARE
(2023)
Article
Medicine, General & Internal
Dugald Seely, Mark Legacy, Ellen Conte, Caitlyn Keates, Athanasios Psihogios, Tim Ramsay, Dean A. Fergusson, Salmaan Kanji, John-Graydon Simmons, Kumanan Wilson
Summary: In this double-blind, placebo-controlled, randomized trial, a combination of vitamin C, vitamin D3, vitamin K2, and zinc showed no clinically or statistically significant effects on overall health in outpatients diagnosed with COVID-19. The study was stopped prematurely due to insufficient recruitment capacity. Further research is needed to determine the clinical utility of these supplements for COVID-19.
Article
Health Care Sciences & Services
Julia F. Shaw, Yongdong Ouyang, Dean A. Fergusson, Tracy McArdle, Claudio Martin, Deborah Cook, Ian D. Graham, Steven Hawken, Colin J. L. McCartney, Kusum Menon, Raphael Saginur, Andrew Seely, Ian Stiell, Alison Fox-Robichaud, Shane English, John Marshall, Kednapa Thavorn, Monica Taljaard, Lauralyn A. McIntyre
Summary: This article presents the background, objectives, methods, and results of the FLUID trial. The trial aims to evaluate the effectiveness of a hospital-wide policy that stocks either NS or RL as the main crystalloid fluid in 16 hospitals in Ontario, Canada. The primary outcome is a composite of death and hospital readmission within 90 days of hospitalization. The results will provide important information on the effects of these fluids on clinically relevant outcomes.
JMIR RESEARCH PROTOCOLS
(2023)