Tranexamic Acid fails to work in Gastrointestinal hemorrhage

Ian Roberts, Haleema Shakur-Still , Adefemi Afolabi, Christopher Hawkey et el (HALT-IT trial investigators) published a trial in Lancet  comparing tranexamic acid to placebo in gastrointestinal hemorrhage. Background Tranexamic acid(TXA) is known to prevent the  fibrinolysis.  Early use of TXA reduces surgical bleeding and death related to bleeding from traumatic injury and has reduced the … Read more

Plasma as pre hospital resuscitation in trauma patients

J.L. Sperry, F.X. Guyette, J.B. Brown, M.H. Yazer et el published a trial of plasma vs standard fluid resuscitation in trauma patients who were at risk of hemorrhagic shock while being transported by air medical services. BACKGROUND In hospital treatment of trauma involves “damage control resuscitation” which aims to prevent coagulopathy by minimization of the use of crystalloid-based … Read more

Old blood and female blood

Two recent studies caught my eye, both about blood transfusion. The first study was published in NEJM by Cooper DJ, McQuilten ZK, Nichol A et el comparing use of freshest vs oldest available blood in critically ill patients.  In this international, multi center, randomized, double-blind trial, critically ill adults were assigned to receive either the freshest available, compatible, allogeneic red cells (short-term … Read more

Inform Trial : No effect of blood storage time on mortality after transfusion

Inform trial results were published in NEJM on Oct 24, 2016. 31,497 adult patients  at six hospitals in four countries (Australia, Canada, Israel and the U.S) were randomized to receive short or long term stored blood. There was no difference in mortality among two groups. Earlier, a meta analysis of 12 randomized trials showed no … Read more

Blood transfusion: Less is more

In the current issue of JAMA, published October 12, Carson et el have updated red blood cell (RBC) transfusion guidelines by AABB (American Association of Blood Banks). Based on review of 31 randomized clinical trials (RCTs) performed in a variety of different clinical settings involving more than 12 587 patients.   Main recommendations Transfusion  not indicated … Read more

Steroids Have No Effect on ICU Outcomes in Intubated Patients With Angioedema.Read more
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