Hydroxyethylstarch and gelatin solutions impair blood coagulation after cardiac surgery: a prospective randomized trial.

This prospective single-blind study reports that, in comparison to Ringer acetate, both 6% HES 130/0.4 and 4% modified fluid gelatin administered postoperatively impair clot formation and strength in a dose-related fashion in cardiac surgery patients. The clinical relevance of this observation remains uncertain as postoperative blood loss and allogeneic blood transfusion were not different between […]

Endorsing single-unit transfusion combined with a restrictive haemoglobin transfusion threshold after knee arthroplasty.

The authors conducted a prospective, pre- (93 patients) and post-intervention (347 patients) study to evaluate a new transfusion strategy designed to reduce the rate of allogeneic transfusion and promote single-unit transfusion in patients undergoing primary unilateral knee arthroplasty. They conclude that restrictive hemoglobin thresholds are a safe and potent frontline strategy for decreasing the rate […]

Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.

This is a very important, landmark article describing for the first time the efficacy of an antifibrinolytic, tranexamic acid (TA), to decrease mortality in bleeding trauma patients. The study enrolled 20,211 adult trauma patients who were randomized to receive a short course of TA (2 g total) or placebo. The risk of death was decreased […]