14 April 2017 (Friday) - Haemolysis

This image appeared this morning on a Facebook group I follow with the caption “What causes serum to look like this no matter the draw? Pt urine looks the same and the pt is apparently bleeding out of everywhere”

There is intravascular haemolysis going on here. It is *nasty*. I’ve only ever seen it this bad once before when the patient in question had swallowed the contents of a bottle of shampoo and died within hours…

13 April 20107 (Thursday) - Transfusion Evidence Alert email

The transfusion Evidence Alert email came in this morning:

Top 10 new evidence-based publications in Transfusion Medicine

Prehospital hypertonic fluid resuscitation for trauma patients: a systematic review and meta-analysis
de Crescenzo C, Gorouhi F, et al.,  The Journal of Trauma and Acute Care Surgery 2017

Effect of restrictive versus liberal red cell transfusion strategies on haemostasis: systematic review and meta-analysis
Desborough MJ, Colman KS, et al. Thrombosis and Haemostasis 2017

Effect of fibrinogen concentrate on intraoperative blood loss among patients with intraoperative bleeding during high-risk cardiac surgery: a randomized clinical trial
Bilecen S, de Groot JA, et al. JAMA 2017

Liberal versus restrictive transfusion strategy in critically ill oncologic patients: the Transfusion Requirements in Critically Ill Oncologic Patients randomized controlled trial
Bergamin FS, Almeida JP, et al. Critical Care Medicine 2017

Cell salvage used in scoliosis surgery: is it really effective?
Liu JM, Fu BQ, et al. World Neurosurgery 2017

What is the ideal route of administration of tranexamic acid in TKA? A randomized controlled trial
Lee SY, Chong S, et al. Clinical Orthopaedics and Related Research 2017

Effectiveness of prothrombin complex concentrate (PCC) in neonates and infants with bleeding or risk of bleeding: a systematic review and meta-analysis
Zeng L, Choonara I, et al. European Journal of Pediatrics. 2016.

Correction of dilutional anemia induces renal dysfunction in diabetic patients undergoing coronary artery bypass grafting: a consequence of microcirculatory alterations?
Aykut G, Kilercik M, et al. Journal of Nephrology 2017.

The effect of desmopressin on the amount of bleeding and transfusion requirements in patients undergoing heart transplant surgery
Jahangirifard A, Razavi MR, et al. Basic & Clinical Pharmacology & Toxicology 2017.

Systematic review with network meta-analysis: comparative efficacy and tolerability of different intravenous iron formulations for the treatment of iron deficiency anaemia in patients with inflammatory bowel disease
Aksan A, Isik H, et al.  Alimentary Pharmacology & Therapeutics 2017.

12 April 2017 (Wednesday) - Hb C

This image appeared this morning on a Facebook group I follow. A case of haemoglobin C disease. Target cells, HbC crystals, and nucleated red cells…

12 April 2017 (Wednesday) - Elfn Safe Tea revisited

I’ll just say read this article – it is so easy to overlook or trivialise matters of safety

https://labmedicineblog.com/2017/04/12/your-reaction-to-safety/