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  • Book
    Nicole P. Juffermans, Timothy S. Walsh, editors.
    Summary: In the last decade, there have been several clinical trials that have studied red blood cell transfusion triggers in various Intensive Care Unit patient populations. Moreover, critically ill patients often suffer from coagulopathy. Recent studies have addressed the effectiveness of fresh frozen plasma and platelets to prevent or treat bleeding. This book offers a comprehensive summary of transfusion triggers for red blood cells in specific ICU patient populations and specific conditions with the aim to personalize transfusion strategy. In addition, it discusses evidence for triggers for plasma and platelets and outlines the most common adverse effects of blood transfusion in the ICU, underlining the need for a careful assessment of its risks and benefits. 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.

    Contents:
    Introduction
    Causes of Anemia in Critically Ill Patients
    Red Blood Cell Transfusion Trigger in Sepsis
    Red Blood Cell Transfusion Trigger in Cardiac Disease
    Red Blood Cell Transfusion Trigger in Cardiac Surgery.- Red Blood Cell Transfusion Trigger in Brain Injury.- Red Blood Cell Transfusion in the Elderly
    ScvO2 as an Alternative Transfusion Trigger.- Alternatives to Red Blood Cell Transfusion.- Blood Sparing Alternatives in the Intensive Care Unit.- Massive Transfusion in Trauma
    Transfusion in Gastrointestinal Bleeding.- Platelet Transfusion Trigger in the Intensive Care Unit.- FFP Transfusion in Intensive Care Medicine.- Transfusion-Related Acute Lung Injury
    Transfusion-Associated Circulatory Overload.
    Digital Access Springer 2015
  • Article
    Roe CR, Wagner GS, Young WG, Curtis SE, Cobb FR, Irvin RG.
    Clin Chem. 1979 Jan;25(1):93-8.
    We compared (a) the frequency of detection of isoenzyme MB of creatine kinase (CK; EC 2.7.3.2) in serum of patients undergoing coronary-artery bypass surgery, (b) the interval during uhich its activity was supranormal in serum, and (c) an index of the amount of CK released into blood ("CK-MB area") with postoperative electrocardiographic changes in 80 patients. The frequency of detection of CK-MB is a function of frequency of sampling during the early postoperative period. Because the duration of appearance and the calculated CK-MB area increased as the electrocardiogram became more specific for infarction (p less than 0.01), a twice-daily sampling schedule proved clinically relevant. Only 5.4% of patients had electrocardiographic evidence of infarction when CK-MB was absent by the second postoperative morning. When CK-MB was still detected at that time, 69.6% of patients had persistent new Q waves, consistent with infarction. In three patients who died postoperatively, significant myocardial necrosis was demonstrated. All three had had persistently increased values for CK-MB, related to electrocardiographic changes of infarction in one patient and ischemic changes in two. Evidently CK-MB is a more sensitive indicator of myocardial necrosis than the electrocardiogram and CK-MB area should be a useful criterion in evaluating methods of intra-operative myocardial protection.
    Digital Access Access Options