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Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery
CONCLUSIONS: In some types of elective surgery, cell salvage may reduce the need for and volume of allogeneic transfusion, alongside evidence of no difference in adverse events, when compared to no cell salvage. Further research is required to establish why other surgeries show no benefit from CS, through further analysis of the current evidence. More large RCTs in under-reported specialities are needed to expand the evidence base for exploring the impact of CS.PMID:37681564 | PMC:PMC10486190 | DOI:10.1002/14651858.CD001888.pub5
Source: Cochrane Database of Systematic Reviews - September 8, 2023 Category: General Medicine Authors: Thomas D Lloyd Louise J Geneen Keeley Bernhardt William McClune Scott J Fernquest Tamara Brown Carolyn Dor ée Susan J Brunskill Michael F Murphy Antony Jr Palmer Source Type: research

Pharmacological interventions for the prevention of bleeding in people undergoing definitive fixation or joint replacement for  hip, pelvic and long bone fractures
CONCLUSIONS: We cannot draw conclusions from the current evidence due to lack of data. Most published studies included in our analyses assessed the use of tranexamic acid (compared to placebo, or using different routes of administration). We identified 27 prospectively registered ongoing RCTs (total target recruitment of 4177 participants by end of 2023). The ongoing trials create six new comparisons: tranexamic acid (tablet + injection) versus placebo; intravenous tranexamic acid versus oral tranexamic acid; topical tranexamic acid versus oral tranexamic acid; different intravenous tranexamic acid dosing regimes; topical ...
Source: Cochrane Database of Systematic Reviews - June 5, 2023 Category: General Medicine Authors: Victoria N Gibbs Rita Champaneria Louise J Geneen Parag Raval Carolyn Dor ée Susan J Brunskill Alex Novak Antony Jr Palmer Lise J Estcourt Source Type: research

Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis
CONCLUSIONS: The comparative effects of different ESAs on blood transfusions, death (any cause and cardiovascular), major cardiovascular events, myocardial infarction, stroke, vascular access thrombosis, kidney failure, fatigue and breathlessness were uncertain.PMID:36791280 | PMC:PMC9924302 | DOI:10.1002/14651858.CD010590.pub3
Source: Cochrane Database of Systematic Reviews - February 15, 2023 Category: General Medicine Authors: Edmund Ym Chung Suetonia C Palmer Valeria M Saglimbene Jonathan C Craig Marcello Tonelli Giovanni Fm Strippoli Source Type: research

Postoperative thrombotic effects of tranexamic acid in open heart surgery
ConclusionsIn patients receiving tranexamic acid infusion at 50  mg/kg dose, reexploration rates remained at 4.1% even after major cardiac surgeries. No thrombosis, stroke, or seizure were reported. Our findings support that tranexamic acid is a safe drug which has positive effect on reducing perioperative bleeding.
Source: Irish Journal of Medical Science - February 28, 2019 Category: General Medicine Source Type: research

Antithrombotic stewardship: a multidisciplinary team approach towards improving antithrombotic therapy outcomes during and after hospitalisation: a study protocol
In this study, the effect of the implementation of a multidisciplinary antithrombotic team is compared with usual care using a pre-post study design. The study is performed at the Erasmus University Medical Center Rotterdam and the Reinier de Graaf Hospital Delft. Patients who are or will be treated with antithrombotics are included in the study. We aim to include 1900 patients, 950 in each hospital. Primary outcome is the proportion of patients with a composite end point consisting of ≥1 bleeding or ≥1 thrombotic event from the beginning of antithrombotic therapy (or hospitalisation) until 3 months after hospit...
Source: BMJ Open - December 19, 2016 Category: Journals (General) Authors: Dreijer, A. R., Kruip, M. J. H. A., Diepstraten, J., Polinder, S., Brouwer, R., Leebeek, F. W. G., Vulto, A. G., van den Bemt, P. M. L. A. Tags: Open access, Epidemiology, Haematology (incl blood transfusion), Health economics Protocol Source Type: research

Early versus delayed erythropoietin for the anaemia of end-stage kidney disease.
CONCLUSIONS: We found no evidence to assess the benefits and harms of early versus delayed EPO for the anaemia of ESKD. PMID: 26671531 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 16, 2015 Category: Journals (General) Authors: Coronado Daza J, Martí-Carvajal AJ, Ariza García A, Rodelo Ceballos J, Yomayusa González N, Páez-Canro C, Loza Munárriz C, Urrútia G Tags: Cochrane Database Syst Rev Source Type: research

Antifibrinolytic drugs for acute traumatic injury.
CONCLUSIONS: TXA safely reduces mortality in trauma patients with bleeding without increasing the risk of adverse events.  TXA should be given as early as possible and within three hours of injury, as further analysis of the CRASH-2 trial showed that treatment later than this is unlikely to be effective and may be harmful. Although there is some promising evidence for the effect of TXA in patients with TBI, substantial uncertainty remains.Two ongoing trials being conducted in patients with isolated TBI should resolve these remaining uncertainties. PMID: 25956410 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 9, 2015 Category: Journals (General) Authors: Ker K, Roberts I, Shakur H, Coats TJ Tags: Cochrane Database Syst Rev Source Type: research

Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis.
CONCLUSIONS: In the CKD setting, there is currently insufficient evidence to suggest the superiority of any ESA formulation based on available safety and efficacy data. Directly comparative data for the effectiveness of different ESA formulations based on patient-centred outcomes (such as quality of life, fatigue, and functional status) are sparse and poorly reported and current research studies are unable to inform care. All proprietary ESAs (epoetin alfa, epoetin beta, darbepoetin alfa, and methoxy polyethylene glycol-epoetin beta) prevent blood transfusions but information for biosimilar ESAs is less conclusive. Compara...
Source: Cochrane Database of Systematic Reviews - December 8, 2014 Category: Journals (General) Authors: Palmer SC, Saglimbene V, Mavridis D, Salanti G, Craig JC, Tonelli M, Wiebe N, Strippoli GF Tags: Cochrane Database Syst Rev Source Type: research

Erythropoiesis-stimulating agents in chronic kidney disease: What have we learned in 25 years?
Abstract Since the pioneering studies by Eschbach et al in 1987, erythropoiesis-stimulating agents (ESAs) have become the mainstay of anemia therapy in chronic kidney disease (CKD) patients. The introduction of ESAs 25 years ago markedly improved the lives of many patients with CKD, who until then had severe, often transfusion-dependent anemia. However, randomized controlled trials demonstrate an increased risk for cardiovascular events such as stroke, thrombosis, and death at nearly normal hemoglobin concentrations and higher ESA doses in CKD. By contrast, kidney transplant recipients may represent a unique popu...
Source: J Formos Med Assoc - September 30, 2013 Category: Journals (General) Authors: Hung SC, Lin YP, Tarng DC Tags: J Formos Med Assoc Source Type: research

Tranexamic acid for reducing mortality in emergency and urgent surgery.
CONCLUSIONS: There is evidence that tranexamic acid reduces blood transfusion in patients undergoing emergency or urgent surgery. There is a need for a large pragmatic clinical trial to assess the effects of routine use of tranexamic acid on mortality in a heterogeneous group of urgent and emergency surgical patients. PMID: 23440847 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - March 2, 2013 Category: Journals (General) Authors: Perel P, Ker K, Morales Uribe CH, Roberts I Tags: Cochrane Database Syst Rev Source Type: research