By Helen F. Galley, Helen Galley
The newest quantity within the renowned serious Care concentration sequence discusses problems with specific value at the extensive care unit. besides its better half volumes it makes a speciality of present components of dialogue and alter, and is meant as an replace for all in depth care staff and trainees.
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Extra info for Critical Care Focus 8. Blood and Blood Transfusion
Haematological advice can be confusing. New therapeutic options have not been adequately studied and the costs may be prohibitive. References 1 2 Harrison P. Progress in the assessment of platelet function. Br J Haematol 2000;111:733–44. Lee DH, Blajchman MA. Platelet substitutes and novel platelet products. Expert Opin Investig Drugs 2000;9:457–69. 35 CRITICAL CARE FOCUS: BLOOD AND BLOOD TRANSFUSION 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 36 Souter PJ, Thomas S, Hubbard AR, Poole S, Romisch J, Gray E.
J Immunol 1998;160:5130–5. Zawilska K, Zozulinska M, Turowiecka Z, Blahut M, Drobnik L, Vinazzer H. The effect of a long-acting recombinant hirudin (PEG-hirudin) on experimental disseminated intravascular coagulation (DIC) in rabbits. Thromb Res 1993;69:315–20. Dickneite G, Czech J. Combination of antibiotic treatment with the thrombin inhibitor recombinant hirudin for the therapy of experimental Klebsiella pneumoniae sepsis. Thromb Haemost 1994;71:768–72. Levi M, Cromheecke ME, de Jonge E, et al.
A certain amount of red cells improves platelet function by pushing them against the side wall of the blood vessel, reducing platelet-type intra-endothelial cell bleeding. Removal of precipitating causes such as intravenous broad-spectrum antibiotics or in the case of the obstetric patient, evacuation of the uterus, are paramount. Obviously other exacerbating factors which may make the bleeding worse, particularly hypoxia, acidosis, hypothermia, etc. should be corrected. 29 CRITICAL CARE FOCUS: BLOOD AND BLOOD TRANSFUSION Heparin therapy In my experience the benefits of heparin therapy are exceedingly limited and the risks of exacerbating the bleeding certainly outweigh any potential therapeutic benefit.