RESUMO
After a hiatus of several decades, the concept of cold whole blood (WB) is being reintroduced into acute clinical trauma care in the United States. Initial implementation experience and data grew from military medical applications, followed by more recent development and data acquisition in civilian institutions. Anesthesiologists, especially those who work in acute trauma facilities, are likely to be presented with patients either receiving WB from the emergency department or may have WB as a therapeutic option in massive transfusion situations. In this focused review, we briefly discuss the historical concept of WB and describe the characteristics of WB, including storage, blood group compatibility, and theoretical hemolytic risks. We summarize relevant recent retrospective military and preliminary civilian efficacy as well as safety data related to WB transfusion, and describe our experience with the initial implementation of WB transfusion at our level 1 trauma hospital. Suggestions and collective published experience from other centers as well as ours may be useful to those investigating such a program. The role of WB as a significant therapeutic option in civilian trauma awaits further prospective validation.
Assuntos
Transfusão de Sangue/métodos , Ressuscitação/métodos , Ferimentos e Lesões/terapia , Bancos de Sangue , Doadores de Sangue , Transfusão de Sangue/história , Transfusão de Sangue/mortalidade , História do Século XX , História do Século XXI , Humanos , Medicina Militar/métodos , Ressuscitação/efeitos adversos , Ressuscitação/história , Ressuscitação/mortalidade , Medição de Risco , Fatores de Risco , Reação Transfusional/etiologia , Resultado do Tratamento , Ferimentos e Lesões/história , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/fisiopatologiaRESUMO
CONCLUSIONS: Only rare cases of anti-Vel-associated mild-to-moderate hemolytic disease of the fetus and newborn have been previously reported. No case of fetal anemia requiring prenatal therapy has been noted to date. We report such a case recently encountered at our Fetal Center. Strategies are discussed for managing pregnancy complicated with alloimmunization to an antibody to a high-prevalence antigen, including sources of red blood cells for intrauterine transfusions.
Assuntos
Anemia Hemolítica Autoimune , Eritroblastose Fetal , Transfusão de Sangue Intrauterina , Feminino , Feto , Humanos , Recém-Nascido , Isoanticorpos , GravidezRESUMO
Ehrlichiosis is a tick-borne disease that ranges in severity from asymptomatic infection to fatal sepsis. Ehrlichiosis acquired from transfusion of blood products has not been documented in the literature to date. A case of Ehrlichia ewingii infection likely transmitted by transfusion of leukoreduced platelets is described, and public health implications are discussed.