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Alternative Approaches to Human Blood Resources in Clinical by W. G. van Aken (auth.), C. Th. Smit Sibinga, P. C. Das, J.

By W. G. van Aken (auth.), C. Th. Smit Sibinga, P. C. Das, J. C. Fratantoni (eds.)

Currently blood is a risky factor. the protection of blood and the quantification of transfusion hazards were dominant issues that experience inspired the advance of different methods during this speedily constructing zone. In scientific drugs traditional blood and its elements are utilized in supportive treatments depending on the alternative of obvious uncritical set off elements. A compounding issue is intensity of potential medical trials for proof. Such trials in severe care parts will be of large worth, not just in recording adversarial results and under-transfusion, but in addition indicating the price of determination research and cost-effectiveness in transfusion perform. replacement ways comprise using cytokines, development elements, humanised monoclonal antibodies, recombinant plasma components, and buffy coat derived average human interferons. those are being more and more carried out within the hospital. suggestions for oxygen shipping are being built and fibrinogen covered microcapsules are being investigated for thrombocytopenia. In surgical sufferers, a variety of crystalloid and colloid mixtures are explored as quantity replacements. to prevent allogeneic transfusions, worthwhile blood saving equipment comprise a variety of suggestions, similar to autologous deposits, normovolemic haemodilution and numerous brokers together with aprotinin, tranecamic acid, desmopressin and erythropoietin, yet their use in sanatorium exhibits significant diversifications. That umbilical twine blood can be a major resource of allogeneic stem cells in similar and unrelated transplantation is illustrated via the expanding variety of wire blood banks in Europe and in different places. destiny blood assets tend to face numerous demanding situations: instant demanding situations relate to elevated regulatory and political oversights; intermediate suggestions would supply a few advancements in public health and wellbeing and alleviate public worry yet not really tackle the commercial demanding situations thrust upon the therapy method.
As we method the yr 2000, the foremost matters approximately transfusion drugs stay its logistics, security and effectiveness. This subject is gifted within the lawsuits of the twenty second overseas Symposium on Blood Transfusion, built in 21 updated themes, accumulated and mentioned in 4 sections.
This publication should be of well timed worth to scholars, execs and all others or considering the sector of transfusion drugs, no matter if medical or related.

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Additional info for Alternative Approaches to Human Blood Resources in Clinical Practice: Proceedings of the Twenty-Second International Symposium on Blood Transfusion, Groningen 1997, organized by the Red Cross Blood Bank Noord Nederland

Sample text

52. Wendel HP, Heller W, Michel J, et al. Lower cardiac troponin T levels in patients undergoing cardiopulmonary bypass and receiving high-dose aprotinin therapy indicate reduction of perioperative myocardial damage. J Thorac Cardiovasc Surg 1995; 109: 1164-72. 53. Bidstrup BP, Royston D, McGuinness C, Sapsford RN. Aprotinin in aspirinpretreated patients. Perfusion 1990;5(suppl):77-81. 54. Menichetti A, Tritapepe L, Ruvolo G, et al. Changes in coagulation patterns, blood loss and blood use after cardiopulmonary bypass: aprotinin vs tranexamic acid vs epsilon aminocaproic acid.

Linden JV, Paul B, Dressler KP. A report of 104 transfusion errors in New York State. Transfusion 1992;32:601-6. 116. LeLorier J, Gregoire G, Benhaddad A, Lapierre J, Derderian F. Discrepancies between meta-analyses and subsequent large randomized, controlled trials. N Engl J Med 1997;337:536-42. 117. Lemmer JH Jr. Reporting the results of blood conservation studies: The need for uniform and comprehensive methods. Ann Thorac Surg 1994;58: 1305-6. * The International Study of Peri-operative Transfusion ([SPOT) Investigators are the following: Coordinating Centre and Canadian Investigators Phil Wells, MD; George Wells, PhD; Fraser Rubens, MD; Annette O'Connor, PhD; Laura McAuley BSc; Andreas Laupacis, MD (Chair); Jack Kitts, MD; Paul Hebert, MD; Ian Graham, PhD; Dean Fergusson, MHA (Coordinator); Greg Bryson, MD.

The results of these meta-analyses suggest that further large randomized trials using clear transfusion guidelines need to be done. Questions of particular interest include comparison of high and low doses of aprotinin, determining whether ANH is efficacious, establishing whether desmopressin truly is efficacious in cardiac patients on aspirin, and direct comparison of these technologies with each other and with "optimal clinical management". Economic evaluations should be incorporated into the design of these studies to determine the costeffectiveness of the various options, and side-effects should be carefully evaluated.

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