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Perioperative fluids
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Manual of Neuroanesthesia, 2017
Human albumin solution is a by-product of whole-blood fractionation from donor blood and, in the United Kingdom, is available as 4.5%, 5%, and 20% solutions in 0.9% sodium chloride. It is primarily used as a resuscitative fluid following the results of several large randomized studies in critically ill patients demonstrating equal safety compared to crystalloids.11,12 However, in a subgroup analysis of the Saline versus Albumin Fluid Evaluation (SAFE) study, patients with TBI treated with albumin had significantly higher 28-day mortality than those treated with 0.9% sodium chloride.11 Until further evidence challenges this, it appears prudent to avoid albumin for resuscitation in neurosurgical patients.
Acoustophoretic purification of platelets: feasibility and impact on platelet activation and function
Published in Platelets, 2019
Pierre Bohec, Jérémie Gachelin, Véronique Ollivier, Thibaut Mutin, Xavier Télot, Benoît Ho-Tin-Noé, Sandra Sanfilippo
The relatively low platelet recovery we achieved here (approximately 58%) stresses the need and room for improvement before acoustophoretic purification of platelets can be translated into clinical practice. Nevertheless, it is worth mentioning that platelet recovery rates >85% were reported in a recent study using an acoustophoresis-based platelet isolation approach comparable to the one we used in the present study [15]. These promising results indicate that optimization of acoustophoretic platelet isolation is within range. Also, an immediate possible application of blood fractionation by acoustophoresis could perhaps be the separation of platelets from small volumes of blood for research use (for example from mouse or rat blood).
Emerging drugs for hemophilia A: insights into phase II and III clinical trials
Published in Expert Opinion on Emerging Drugs, 2021
The history of hemophilia dates back nearly 2000 years from the Talmud where skipping the religious rite of circumcision was allowed for the 3rd child born to a mother who had her previous two boys die following the procedure. Hemophilia became known as the Royal Disease upon the realization that Queen Victoria, who reigned from 1837 to 1901, was a carrier and had spread the mutation throughout many of the royal houses of Europe including to Russia and Spain. The first medical description of hemophilia, a case of a woman carrier, was first published by Dr. John Otto, a physician in the New York Hospital, in 1803 [1]. In a paper by Biggs the natural history of hemophilia without treatment was summarized, the cause of death in 113 patients were recorded (i.e. trivial injuries, fractures of leg, tooth extraction, vaccination), of whom 82 died before 15 years of age and only eight survived beyond 40 years [2]. The first treatment for hemophilia was reported in 1840 by Lane who used blood from a woman to transfuse an 11-year-old boy who bled after surgery and the child survived [3]. Following on from the transfusion of whole blood, fractionation of human plasma was developed during World War II. McMillan pioneered the use of human factor VIII (FVIII) in US in 1961 and published his experience of replacement therapy in 15 patients with hemophilia A (PWH) presenting with a variety of hemorrhagic and surgical conditions [4]. This treatment was effective in achieving hemostasis in all patients; however mild and transient hepatitis developed in one patient, which was possibly hepatitis C virus (HCV). With the recognition of need for a lot of human donors to treat PWH, bovine antihemophilic globulin was produced in UK in 1954; however early recognition of inhibitor development led the Oxford group to develop an alternative animal source of FVIII – porcine FVIII [4,5].
Soluble endoglin versus sFlt-1/PlGF ratio: detection of preeclampsia, HELLP syndrome, and FGR in a high-risk cohort
Published in Hypertension in Pregnancy, 2022
A. Iannaccone, B. Reisch, L. Mavarani, M. Darkwah Oppong, R. Kimmig, P. Mach, B. Schmidt, A. Köninger, A. Gellhaus
Blood samples (9 ml) were collected using S-Monovettes (Sarstedt AG & Co., Nümbrecht, Germany), stored at 4°C, and processed within 4 hr to avoid blood cell lysis. Blood fractionation was carried out by centrifugation for 10 min at 2500 rpm. Subsequently, 3 to 4 ml of the upper phase, constituting blood serum, was removed, stored at −80°C, and subjected to the determination of sFlt-1, PlGF, and sEng.