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The Medical Management of Military Injuries
Published in Melanie Franklyn, Peter Vee Sin Lee, Military Injury Biomechanics, 2017
Damian Keene, Peter Mahoney, Johno Breeze, Arul Ramasamy
During uncontrolled haemorrhage, volume loss needs to be restored quickly in order to prevent death. Since the 1980s, donated blood has been separated into four basic components: packed red blood cells (PRBC), fresh frozen plasma (FFP), platelets and cryoprecipitate. This was done to allow the administration of specific components without the risk of exposing patients to all aspects of donated blood. Prior to this, whole blood was used during trauma resuscitation. Evidence from military and civilian practice has demonstrated that resuscitating with blood products in a 1:1:1 ratio, platelets, FFP and PRBC (effectively reconstituting the donated blood), improves mortality (Borgman et al. 2007; Holcomb et al. 2015). During this initial phase, blood products are given following permissive hypotension principles in a fixed ratio to maintain adequate tissue perfusion.
Pulmonary complications of blood transfusion
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Patricia M Kopko, Mark A Popovsky
TRALI has been associated with the transfusion of all plasma-containing blood components including whole blood, packed red blood cells, granulocytes collected by apheresis, platelet concentrates, apheresis platelets, fresh frozen plasma and cryoprecipitate.1,17–21 There are a few case reports of TRALI following the administration of intravenous immune globulin.22 The risk of TRALI from a type of blood component appears to be related to the volume of plasma in the component.23 Components that contain large amounts of plasma such as whole blood, plasma and apheresis platelets have been disproportionately implicated in TRALI cases.24
Good management practices of venomous snakes in captivity to produce biological venom-based medicines: achieving replicability and contributing to pharmaceutical industry
Published in Journal of Toxicology and Environmental Health, Part B, 2021
Lucilene Santos, Cristiano Oliveira, Barbara Marques Vasconcelos, Daniela Vilela, Leonardo Melo, Lívia Ambrósio, Amanda da Silva, Leticia Murback, Jacqueline Kurissio, Joeliton Cavalcante, Claudia Vilalva Cassaro, Luciana Barros, Benedito Barraviera, Rui Seabra Ferreira
The heterologous fibrin sealant, investigated for more than two decades by CEVAP, consists of a serine protease extracted from the venom of Crotalus durissus terrificus (South American rattlesnake) and a fibrinogen-rich cryoprecipitate extracted from blood of buffaloes (Bubalus bubalis) (Barros et al. 2009; Buchaim et al. 2019; Ferreira et al. 2017). Previous pre-clinical studies conducted with the sealant allowed the Brazilian Health Regulatory Agency (ANVISA) to authorize a phase I/II clinical trial treating 30 patients with chronic venous ulcers. The result showed a safe and promising product. Upon approval of this Phase I/II report, it might be possible to request the clinical efficacy trial (Phase III), which will be multicentric and comprised of hundreds of participants. In 2018, the Ministry of Health approved the construction of a Factory at the CEVAP to produce Samples of Biological Medicines for Clinical Research that will have the main mission to produce samples in accordance with the Good Manufacturing Practice required by ANVISA (Abbade et al. 2015, 2020; Ferreira et al. 2017; Pontes et al. 2017).