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The risk associated with aprotinin in cardiac surgery.

To read the commentary by Dean A. Fergusson, MHA, PhD, from the University of Ottawa Centre for Transfusion Research, please click here. See also the comment by Robert J. Porte, MD, PhD, Department of Surgery, Section Hepatobiliary Surgery and Liver Transplantation, and Herman G.D. Hendriks, MD, PhD, Department of Anesthesiology, University Medical Center Groningen, The […]

Recombinant factor VIIa: how safe is the stuff?

This editorial highlights the safety of rFVIIa in view of the relatively small number of thrombotic complications reported with the use of over 700,000 doses of rFVIIa. In many of the reported cases other predisposing factors for thrombosis were present. Nevertheless, the author agrees with the recommendation that until results of more clinical trials are […]

Transfusion medicine service policies for recombinant factor VIIa administration.

The increasing success reported in the use of rFVIIa to control severe bleeding in surgery and trauma in hemophilia and non-hemophilia patients has made it necessary to formulate protocols and guidelines which may be followed in managing such patients. This is an excellent paper by transfusion medicine service at Washington University School of Medicine which […]

Preoperative acute normovolemic hemodilution: a meta-analysis.

This meta-analysis reviewed 42 trials evaluating the efficacy and safety of preoperative acute normovolemic hemodilution (ANH). The authors reported that the risk of allogeneic transfusion was similar among patients receiving ANH and those receiving another blood conservation technique or usual care. Patients receiving ANH, however, had less total bleeding than patients receiving usual care and […]

Patient safety and blood transfusion: new solutions.

Interesting paper on new solutions for making transfusions safer. The only aspect which is missing is a better education of the staff involved in hemotherapy, which is even more important than monitoring, etc. – Volker Kretschmer

Tolerance to acute isovolemic hemodilution: effect of anesthetic depth.

This is a very important contribution to the field of acute normovolemic hemodilution (ANH), because it clearly indicates the need of adjusting the depth of anesthesia in dependence upon the initial and the target hematocrit of the patient undergoing intentional hemodilution. The article is a must for each clinician using ANH in practice. – Konrad […]

Experience with use of recombinant activated factor VII.

This is a case report of successfully treating hemorrhage with rFVIIa in four patients with factor VIII and one with factor V inhibitor. One patient was initially treated with APCC (Autoplex) and blood products unsuccessfully. The authors confirm the efficacy and safety of rFVIIa and suggest carrying out cost effectiveness analysis. Further information is required […]

The use of bovine hemoglobin glutamer-250 (Hemopure (R)) in surgical patients: Results of a multicenter, randomized, single-blinded trial.

The authors conducted a study on the safety of hemoglobin glutamer-250 in surgical patients. The protocol consisted of exposing (different) patients to increasing doses of hemoglobin glutamer-250 while safety was monitored. Control patients received Ringer’ lactate solution. The results are not unexpected. Basically, in these patients who bled on average 1.7 L during surgery, hemoglobin […]