Rotational Throplastometry Paper

The market of human blood transfusions is broken down into different uses: Elective Surgery, Emergency Surgery and Trauma. However, Hemopure seems to be suitable only for trauma cases due to its characteristics and, again, high price. To understand the reason, it is important to notice that, actually, only 10% of the 500,000 trauma victims receives RBCs “in the field” or at the site of accident, and the remaining 95% of these people does not receive transfusions until they arrive at the hospital. This delay was often cited as a major factor to the 20,000 trauma deaths. Therefore, since the expected market share for Biopure is 25% and assuming that the total blood transfusions remain stable, the potential market size for Hemopure is approximately $350,000,000. This size is based on an average price of $700 multiplied by 2,000,000 units (around 4 blood units are needed for each Trauma case).

Sepsis is a severe complication of an inflammatory response due to various pathogens with the mortality rates ranging anywhere between twenty-five to thirty percent (Epstein, Dantes, Magill, & Fiore, 2016). Sepsis can be precipitated by various infections including some of the most common ones, like urinary tract infections, pneumonia, and cellulitis. An early sepsis recognition is crucial in improving patient outcomes and decreasing mortality rate. Thus, it is very important for a health care provider to start the necessary diagnostics and implementation of fluids, antibiotics, vasopressors and other necessary treatments based on the

Furthermore, prompt infusion of antimicrobial agents ought to be priority and this may require extra vascular access ports (Dellinger, et al., 2008). Early goal-directed resuscitation has confirmed to improved survival for emergency department patients presenting with septic shock in a randomized, controlled, single-center study. Resuscitation lessen 28-day death rate (Dellinger, et al., 2008). In a reviewed conducted by Dellinger, et al., (2012) advocated administering one litre of crystalloid or 300-500ml of colloid more than 30 minutes, to accomplish a central venous pressure (CVP) of 8 mm Hg to 12 mm Hg. Volumes ought to be increased if there are huge indications of hypoperfusion (Dellinger, 2014).

Along with potential biomarkers, research has focused on how to best treat patients with sepsis and septic shock. The current recommendations include giving IV antibiotics within 1 hour of recognition of sepsis and a minimum of 30 mL/kg of IV crystalloid fluid within the first three hours (15). This is followed by frequent reassessment and further fluid administration based off of the hemodynamic status of the patient (15). While the guidelines are widely used by practicing physicians, there are concerns about the aggressive fluid resuscitation (16-17). Some researchers are suggesting the use of ultrasound imaging techniques to help monitor the volume status of patients

Septic shock is a subset of severe sepsis and was defined as “sepsis-induced hypotension persisting despite adequate fluid resusci- tation” (see Fig. 12.1). While the quantity of fluid that qualifies as “adequate fluid resuscitation” is controversial, we believe septic shock is best defined as a “mean arterial pressure (MAP) less than 65 mmHg after a fluid challenge of 20 mL/Kg body weight (given 30–60 minutes) in patients with sepsis and in the absence of other causes for hypotension” (also see Chap. 14). According to the ACCP/SCCM defini- tions, three stages in the hierarchy of the host’s response to infection were recognized, namely, sepsis, severe sepsis and septic shock, with sepsis having the best prognosis and septic shock the worst. While the use of the SIRS criteria to define sepsis is some- what controversial [3–6], many consider sepsis to be best defined as the “systemic response to infection with the presence of some degree of organ dysfunction”

- Coagulation inhibitors and Fibrinolysis : to Localize thrombus on injury and Prevent new thrombus formation.

Introduction. GI bleeding is a major health concern in patients with severe sepsis, and has been associated with a one to four times increased risk of mortality. SUP, such as PPIs and H2RA, are recommended for patients at risk for GI bleeding. Although severe sepsis is considered a risk factor for GI bleeding, few studies have investigated the effects of SUP in patients with severe sepsis. SUP may be associated with an increased risk of HAP or CDI, therefore this study aimed to investigate the risks and benefits of SUP for patients with severe sepsis.

Sepsis is defined as the body’s inflammatory response to an infection and can quickly lead to multiple organ failure and death. Early, goal-directed therapy using the sepsis resuscitation bundle introduced in the “Surviving Sepsis Campaign” is the treatment used throughout the world for sepsis treatment (Winterbottom 2012, pp 247). There are approximately one million cases of sepsis in the United States annually and deaths total more than prostate cancer, breast cancer, and HIV/AIDS combined. Also, more than one-fourth of patients that develop sepsis will develop it on a medical-surgical unit and severe sepsis is the most common cause of

Kleinpell, Aitken, and Achorr 2013, recommend that crystalloids solutions, such as normal saline and lactated ringers, or albumin, should be the fluids of choice when initiating fluid resuscitation. Their recommendation is based on a study trial that was conducted to evaluate the effectiveness of artificial colloids. The results indicated no survival benefits when using artificial colloids comparing to crystalloids (Kleinpell, Aitken, and Achorr 2013).

alert to be for Sepsis diagnosis. (Buck, 2014) The improvement on rapid identification of patients

A recent Glycated hemoglobin (HgA1c) was obtained from the participants to determine if there was a correlation between a high TRAQ score and a low HgA1c.

Early sepsis is defined as “a suspected or proven infection and the systemic response to infection” (Porth & Matfin, 2009). During early sepsis, a hypodynamic state of vasodilation, increased release of pro-inflammatory cytokines, pooling of blood, cellular hypoxia, and vascular damage cause microthrombi. This sequence of events can lead to Systemic Inflammatory Response Syndrome (SIRS) and potential death if undetected and untreated. Detection and

“After a traumatic injury, hemorrhage is responsible for 35% of pre-hospital deaths and over 40% of deaths within the first 24 hours” (NTI, n.d.). I have worked in an intensive care unit and on a flight team. During my time as a nurse, I have cared for many patients following trauma. While working on the flight team, I became acquainted with tranexamic acid (TXA) for trauma patients who were actively, or highly suspected of, bleeding. I was familiar with TXA for post-operation coronary bypass patients, but not for trauma patients.

Thrombin is a naturally occurring protein that is present in the blood of humans and animals. The main function of thrombin is as an intermediate step during hemostasis, which slows bleeding by forming blood clots. Thrombin acts as an enzyme during an injury, converting fibrinogen to fibrin, which then causes blood clots to form. Due to its properties, thrombin’s application to the medical field includes topical surgery in the case of minor injuries as well as various other medical procedures such as neurosurgical operations. Apart from applications in the medical field, thrombin also plays significant roles by directly interacting with endothelial cells throughout the body.

Coagulation tests measure functions that are related with clotting, coagulation consists of drawing blood and observing it clot. Chelating out the calcium and beginning the clot in a controlled environment. Coagulation tests used to find out if an individual has a clotting disorders and to measure the various proteins and how they function. There are many conditions that can causes problems with coagulation for example thrombophilia and haemophilia. (TRANSFUSION MEDICINE AND HEMOSTASIS BOOK)