Predicting Transfusion Risks to Power Safer Blood Management

This systematic review analyzed the use of Artificial Intelligence (AI) models over the past decade in identifying and predicting Adverse Transfusion Reactions (ATRs) and their implications for clinical management. The... read more

A Shift in Strategy: Rethinking Blood Transfusions for Brain Injury

Recent clinical trials have challenged the standard practice of using a restrictive Red Blood Cell (RBC) transfusion strategy for critically ill brain-injured patients (ABI). Restrictive Approach is Questioned: The prevailing... read more

Sepsis, Hemoglobin, and Harm: Transfusions Hurt When Hemoglobin Hits 10g/dL

Red Blood Cell (RBC) transfusions are common in septic patients, but this study highlights the potential for harm at higher hemoglobin (Hgb) levels. Although they may be physiologically guided up to an Hgb of 9-10g/dL, the... read more

Hemodynamic and Neurological Presentations of Invasive Meningococcal Disease in Adults

Neurological and hemodynamic presentation of invasive meningococcal disease (IMD) are clinically and prognostically distinct. Recognition of these phenotypes is critical for appropriate management and prediction of outcome. Of... read more

Restrictive vs. Liberal Transfusion Strategy in Patients with Spontaneous ICH

Red blood cell transfusions are commonly administered to anemic patients with spontaneous intracerebral hemorrhage (ICH); however, the optimal hemoglobin threshold to initiate transfusion is uncertain in this population.... read more

Association Between Initial Blood Product Transfusion with a Higher Plasma-to-red Blood Cell Ratio and Mortality in Adults with Severe Bleeding Following Trauma

This study demonstrates that a high fresh-frozen plasma (FFP) to packed red blood cells (PRBC) ratio (>1:1.5) is associated with reduced 24-hour and 30-day mortality rates among trauma patients with massive hemorrhage. However,... read more

The ICU Survival Book

The ICU Survival Book is a guide for residents, students, advanced practice providers, and critical care nurses who want to learn the basics of critical care medicine. This reference is designed to follow the systems-based... read more

The ICU Survival Book

Platelet Transfusions: Ten Things ICU Specialists Need to Know

Thrombocytopenia is common in critically ill patients and is associated with higher bleeding risk and worse outcomes. Platelet transfusions are frequently used to prevent or treat bleeding, though often with uncertain... read more

Factors Affecting the Duration of Hospitalization in Urology and Nephrology Patients in the ICU

Factors affecting ICU stay length in Urology and Nephrology patients who required close monitoring and specialized medical staff were investigated. The study found a positive association between prolonged ICU stays and elevated... read more

Thrombocytopenia and Platelet Transfusions in ICU Patients

In this international prospective cohort study of acutely admitted adult ICU patients, we found that 43% had thrombocytopenia; 23% at ICU admission and 20% developed it during ICU stay. Patients with thrombocytopenia... read more

Acute Undifferentiated Fever with Thrombocytopenia: Clinical and Etiological Profile

Prompt recognition and management of thrombocytopenia in acute undifferentiated fever are vital. Thrombocytopenia, along with organ dysfunction and shock, significantly influence patient outcomes. Tailored interventions based... read more

Neonatology Questions and Controversies: Neonatal Hemodynamics

Dr. Richard Polin's Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering trustworthy guidance on up-to-date diagnostic and treatment... read more

Neonatology Questions and Controversies: Neonatal Hemodynamics

No Benefits For Using 4-Factor Prothrombin Complex Concentrate (4F-PCC) in Trauma Patients

Early administration of 4-factor prothrombin complex concentrate (4F-PCC) was of no benefit to patients with trauma at risk of massive transfusion, the randomized PROCOAG trial from France showed. Among over 300 patients... read more

PPIs Should Not Be Prescribed for Upper GI Bleeds

The topic of PPIs for upper GI bleeds was one of the first posts on First10EM. There is no new evidence, and the bottom line is the same (just don’t use them), so if you are a long time reader, you can probably skip this... read more

Resuscitation with Blood Products in Patients with Trauma-related Hemorrhagic Shock Receiving Prehospital Care

The trial did not show that prehospital PRBC–LyoPlas resuscitation was superior to 0·9% sodium chloride for adult patients with trauma related hemorrhagic shock. Further research is required to identify the characteristics... read more

Cluster ICU Treatment Strategies for TBI by Hospital Treatment Preferences?

Although correlations between treatment policies within domains were found, the failure to cluster hospitals indicates that a specific treatment choice within a domain is not a proxy for other treatment choices within or... read more

Prolonged Blood Storage and Risk of Posttransfusion AKI

In a population of patients without severely impaired baseline renal function receiving fewer than 10 erythrocyte units, duration of blood storage had no effect on the incidence of posttransfusion acute kidney injury (AKI). The... read more

Predicting Outcomes in Pediatric Trauma Patients Using rSI Multiplied by GCS

Reverse shock index multiplied by Glasgow Coma Scale outperformed SI and shock index pediatric age-adjusted (SIPA) in the early identification of traumatically injured children at risk for early interventions, such as blood... read more

Economical provision of blood components for critical patient transport across a large geographic area

With appropriate attention to detail, it is possible to provide life-saving blood components to aeromedical transport services across a large geographic area with efficient blood component usage, minimal blood wastage, and... read more

Precision Medicine in ARDS

Acute respiratory distress syndrome (ARDS) is a devastating critical illness that can be triggered by a wide range of insults and remains associated with a high mortality of around 40%. The search for targeted treatment for... read more

Combined Platelet and Erythrocyte Salvage: Evaluation of a New Filtration-based Autotransfusion Device

This study demonstrated the performance of the SAME device. Platelets and red blood cells were salvaged without significant impact on cell integrity and function. In the meantime, leukocytes were not activated, and the washing... read more

Transfusion Strategies for Acute Upper Gastrointestinal Bleeding

As compared with a liberal transfusion strategy, a restrictive strategy significantly improved outcomes in patients with acute upper gastrointestinal bleeding. We enrolled 921 patients with severe acute upper gastrointestinal... read more