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1. Acute respiratory distress syndrome, acute kidney injury, and mortality after trauma are associated with increased circulation of syndecan-1, soluble thrombomodulin, and receptor for advanced glycation end products

Author

Dixon, Alexandra, Kenny, James E., Buzzard, Lydia, Holcomb, John, Bulger, Eileen, Wade, Charles, Fabian, Timothy, Schreiber, Martin, Holcomb, John B., Wade, Charles E., del Junco, Deborah J., Fox, Erin E., Matijevic, Nena, Podbielski, Jeanette M., Beeler, Angela M., Tilley, Barbara C., Baraniuk, Sarah, DeSantis, Stacia M., Zhu, Hongjian, Nixon, Joshua, Seay, Roann, Appana, Savitri N., Yang, Hui, Gonzalez, Michael O., Baer, Lisa, Wang, Yao-Wei Willa, Hula, Brittany S., Espino, Elena, Nguyen, An, Pawelczyk, Nicholas, Arora-Nutall, Kisha D., Sharma, Rishika, Cardenas, Jessica C., Rahbar, Elaheh, Burnett, Tyrone, Jr, Clark, David, van Belle, Gerald, May, Susanne, Leroux, Brian, Hoyt, David, Powell, Judy, Sheehan, Kellie, Hubbard, Alan, Arkin, Adam P., Hess, John R., Callum, Jeannie L., Pittet, Jean-Francois, Miller, Christopher N., Cotton, Bryan A., Vincent, Laura, Welch, Timothy, Poole, Tiffany, Pivalizza, Evan G., Gumbert, Sam D., Bai, Yu, McCarthy, James J., Noland, Amy, Hobbs, Rhonda, Bulger, Eileen M., Klotz, Patricia, Cattin, Lindsay, Warner, Keir J., Wilson, Angela, Boman, David, White, Nathan, Grabinsky, Andreas, Daniel-Johnson, Jennifer A., Cohen, Mitchell Jay, Callcut, Rachael A., Nelson, Mary, Redick, Brittney, Conroy, Amanda, Steurer, Marc P., Maxim, Preston C., Fiebig, Eberhard, Moore, Joanne, Mallari, Eireen, Muskat, Peter, Johannigman, Jay A., Robinson, Bryce R. H., Branson, Richard D., Gomaa, Dina, Barczak, Christopher, Bennett, Suzanne, Carey, Patricia M., Hancock, Helen, Rodriguez, Carolina, Inaba, Kenji, Zhu, Jay G., Wong, Monica D., Menchine, Michael, Katzberg, Kelly, Henderson, Sean O., McKeever, Rodney, Shulman, Ira A., Nelson, Janice M., Tuma, Christopher W., Matsushita, Cheryl Y., Scalea, Thomas M., Stein, Deborah M., Shaffer, Cynthia K., Wade, Christine, Herrera, Anthony V., Kallam, Seeta, Wade, Sarah E., Galvagno, Samuel M., Jr, Fontaine, Magali J., Hunt, Janice M., Cooke, Rhonda K., Fabian, Timothy C., Weinberg, Jordan A., Croce, Martin A., Wilson, Suzanne, Panzer-Baggett, Stephanie, Waddle-Smith, Lynda, Flax, Sherri, Brasel, Karen J., Walsh, Pamela, Milia, David, Nelson, Allia, Kaslow, Olga, Aufderheide, Tom P., Gottschall, Jerome L., Carpenter, Erica, OʼKeeffe, Terence, Rokowski, Laurel L., Denninghoff, Kurt R., Redford, Daniel T., Novak, Deborah J., Knoll, Susan, Kerby, Jeffrey D., Bosarge, Patrick L., Pierce, Albert T., Williams, Carolyn R., Stephens, Shannon W., Wang, Henry E., Marques, Marisa B., Schreiber, Martin A., Watters, Jennifer M., Underwood, Samantha J., Groat, Tahnee, Newgard, Craig, Merkel, Matthias, Scanlan, Richard M., Miller, Beth, Rizoli, Sandro, Tien, Homer, Nascimento, Barto, Trpcic, Sandy, Sobrian-Couroux, Skeeta, Reis, Marciano, Pérez, Adic, Belo, Susan E., Merkley, Lisa, and Colavecchia, Connie

Published
2024
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3. Older Blood Is Associated With Increased Mortality and Adverse Events in Massively Transfused Trauma Patients: Secondary Analysis of the PROPPR Trial

Author

Jones, Allison R, Patel, Rakesh P, Marques, Marisa B, Donnelly, John P, Griffin, Russell L, Pittet, Jean-Francois, Kerby, Jeffrey D, Stephens, Shannon W, DeSantis, Stacia M, Hess, John R, Wang, Henry E, Group, PROPPR Study, Holcomb, John B, Wade, Charles E, del Junco, Deborah J, Fox, Erin E, Matijevic, Nena, Podbielski, Jeanette, Beeler, Angela M, Tilley, Barbara C, Baraniuk, Sarah, Zhu, Hongjian, Nixon, Joshua, Seay, Roann, Appana, Savitri N, Yang, Hui, Gonzalez, Michael O, Baer, Lisa, Wang, Yao-Wei W, Hula, Brittany S, Espino, Elena, Nguyen, An, Pawelczyk, Nicholas, Arora-Nutall, Kisha D, Sharma, Rishika, Cardenas, Jessica C, Rahbar, Elaheh, Burnett, Tyrone, Clark, David, van Belle, Gerald, May, Susanne, Leroux, Brian, Hoyt, David, Powell, Judy, Sheehan, Kellie, Hubbard, Alan, Arkin, Adam P, Callum, Jeanne, Cotton, Bryan A, Vincent, Laura, Welch, Timothy, Poole, Tiffany, Pivalizza, Evan G, Gumbert, Sam D, Bai, Yu, McCarthy, James J, Noland, Amy, Hobbs, Rhonda, Bulger, Eileen M, Klotz, Patricia, Cattin, Lindsay, Warner, Keir J, Wilson, Angela, Boman, David, White, Nathan, Grabinsky, Andreas, Daniel-Johnson, Jennifer A, Cohen, Mitchell J, Callcut, Rachael A, Nelson, Mary, Redick, Brittney, Conroy, Amanda, Steurer, Marc P, Maxim, Preston C, Fiebig, Eberhard, Moore, Joanne, Mallari, Eireen, Muskat, Peter, Johannigman, Jay A, Robinson, Bryce RH, Branson, Richard D, Gomaa, Dina, Barczak, Christopher, Bennett, Suzanne, Carey, Patricia M, Miller, Christopher N, Hancock, Helen, Rodriguez, Carolina, Inaba, Kenji, Zhu, Jay G, Wong, Monica D, Menchine, Michael, Katzberg, Kelly, Henderson, Sean O, McKeever, Rodney, Shulman, Ira A, Nelson, Janice M, Tuma, Christopher W, and Matsushita, Cheryl Y

Subjects
Clinical Research, Clinical Trials and Supportive Activities, Hematology, Physical Injury - Accidents and Adverse Effects, Good Health and Well Being, Adult, Blood Preservation, Blood Transfusion, Critical Illness, Female, Hospital Mortality, Humans, Male, Middle Aged, Odds Ratio, Trauma Centers, PROPPR Study Group, Clinical Sciences, Emergency & Critical Care Medicine
Abstract

Study objectiveThe transfusion of older packed RBCs may be harmful in critically ill patients. We seek to determine the association between packed RBC age and mortality among trauma patients requiring massive packed RBC transfusion.MethodsWe analyzed data from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios trial. Subjects in the parent trial included critically injured adult patients admitted to 1 of 12 North American Level I trauma centers who received at least 1 unit of packed RBCs and were predicted to require massive blood transfusion. The primary exposure was volume of packed RBC units transfused during the first 24 hours of hospitalization, stratified by packed RBC age category: 0 to 7 days, 8 to 14 days, 15 to 21 days, and greater than or equal to 22 days. The primary outcome was 24-hour mortality. We evaluated the association between transfused volume of each packed RBC age category and 24-hour survival, using random-effects logistic regression, adjusting for total packed RBC volume, patient age, sex, race, mechanism of injury, Injury Severity Score, Revised Trauma Score, clinical site, and trial treatment group.ResultsThe 678 patients included in the analysis received a total of 8,830 packed RBC units. One hundred patients (14.8%) died within the first 24 hours. On multivariable analysis, the number of packed RBCs greater than or equal to 22 days old was independently associated with increased 24-hour mortality (adjusted odds ratio [OR] 1.05 per packed RBC unit; 95% confidence interval [CI] 1.01 to 1.08): OR 0.97 for 0 to 7 days old (95% CI 0.88 to 1.08), OR 1.04 for 8 to 14 days old (95% CI 0.99 to 1.09), and OR 1.02 for 15 to 21 days old (95% CI 0.98 to 1.06). Results of sensitivity analyses were similar only among patients who received greater than or equal to 10 packed RBC units.ConclusionIncreasing quantities of older packed RBCs are associated with increased likelihood of 24-hour mortality in trauma patients receiving massive packed RBC transfusion (≥10 units), but not in those who receive fewer than 10 units.

Published
2019

5. Onset of Coagulation Function Recovery Is Delayed in Severely Injured Trauma Patients with Venous Thromboembolism

Author

McCully, Belinda H, Connelly, Christopher R, Fair, Kelly A, Holcomb, John B, Fox, Erin E, Wade, Charles E, Bulger, Eileen M, Schreiber, Martin A, Group, PROPPR Study, del Junco, Deborah J, Matijevic, Nena, Podbielski, Jeanette, Beeler, Angela M, Tilley, Barbara C, Baraniuk, Sarah, Nixon, Joshua, Seay, Roann, Appana, Savitri N, Yang, Hui, Gonzalez, Michael O, Baer, Lisa, Wang, Yao-Wei Willa, Hula, Brittany S, Espino, Elena, Nguyen, An, Pawelczyk, Nicholas, Arora-Nutall, Kisha D, Sharma, Rishika, Cardenas, Jessica C, Rahbar, Elaheh, Burnett, Tyrone, Clark, David, van Belle, Gerald, May, Susanne, Leroux, Brian, Hoyt, David, Powell, Judy, Sheehan, Kellie, Hubbard, Alan, Arkin, Adam P, Hess, John R, Callum, Jeanne, Cotton, Bryan A, Vincent, Laura, Welch, Timothy, Poole, Tiffany, Pivalizza, Evan G, Gumbert, Sam D, Bai, Yu, McCarthy, James J, Noland, Amy, Hobbs, Rhonda, Klotz, Patricia, Cattin, Lindsay, Warner, Keir J, Wilson, Angela, Boman, David, White, Nathan, Grabinsky, Andreas, Daniel-Johnson, Jennifer A, Cohen, Mitchell Jay, Callcut, Rachael A, Nelson, Mary, Redick, Brittney, Conroy, Amanda, Steurer, Marc P, Maxim, Preston C, Fiebig, Eberhard, Moore, Joanne, Mallari, Eireen, Muskat, Peter, Johannigman, Jay A, Robinson, Bryce RH, Branson, Richard D, Gomaa, Dina, Barczak, Christopher, Bennett, Suzanne, Carey, Patricia M, Miller, Christopher N, Hancock, Helen, Rodriguez, Carolina, Inaba, Kenji, Zhu, Jay G, Wong, Monica D, Menchine, Michael, Katzberg, Kelly, Henderson, Sean O, McKeever, Rodney, Shulman, Ira A, Nelson, Janice M, Tuma, Christopher W, Matsushita, Cheryl Y, Scalea, Thomas M, Stein, Deborah M, Shaffer, Cynthia K, and Wade, Christine

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Physical Injury - Accidents and Adverse Effects, Hematology, Clinical Research, Cardiovascular, Adult, Anticoagulants, Blood Coagulation Disorders, Blood Coagulation Tests, Female, Humans, Injury Severity Score, Male, Middle Aged, Recovery of Function, Thrombelastography, Trauma Centers, Venous Thromboembolism, Wounds and Injuries, PROPPR Study Group, Surgery, Clinical sciences
Abstract

BackgroundAltered coagulation function after trauma can contribute to development of venous thromboembolism (VTE). Severe trauma impairs coagulation function, but the trajectory for recovery is not known. We hypothesized that enhanced, early recovery of coagulation function increases VTE risk in severely injured trauma patients.Study designSecondary analysis was performed on data from the Pragmatic Randomized Optimal Platelet and Plasma Ratio (PROPPR) trial, excluding patients who died within 24 hours or were on pre-injury anticoagulants. Patient characteristics, adverse outcomes, and parameters of platelet function and coagulation (thromboelastography) were compared from admission to 72 hours between VTE (n = 83) and non-VTE (n = 475) patients. A p value < 0.05 indicates significance.ResultsDespite similar patient demographics, VTE patients exhibited hypercoagulable thromboelastography parameters and enhanced platelet function at admission (p < 0.05). Both groups exhibited hypocoagulable thromboelastography parameters, platelet dysfunction, and suppressed clot lysis (low clot lysis at 30 minutes) 2 hours after admission (p < 0.05). The VTE patients exhibited delayed coagulation recovery (a significant change compared with 2 hours) of K-value (48 vs 24 hours), α-angle (no recovery), maximum amplitude (24 vs 12 hours), and clot lysis at 30 minutes (48 vs 12 hours). Platelet function recovery mediated by arachidonic acid (72 vs 4 hours), ADP (72 vs 12 hours), and collagen (48 vs 12 hours) was delayed in VTE patients. The VTE patients had lower mortality (4% vs 13%; p < 0.05), but fewer hospital-free days (0 days [interquartile range 0 to 8 days] vs 10 days [interquartile range 0 to 20 days]; p < 0.05) and higher complication rates (p < 0.05).ConclusionsRecovery from platelet dysfunction and coagulopathy after severe trauma were delayed in VTE patients. Suppressed clot lysis and compensatory mechanisms associated with altered coagulation that can potentiate VTE formation require additional investigation.

Published
2017

7. Elevated Syndecan-1 after Trauma and Risk of Sepsis: A Secondary Analysis of Patients from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial

Author

Holcomb, John B., Wade, Charles E, del Junco, Deborah J., Fox, Erin E., Matijevic, Nena, Podbielski, Jeanette, Beeler, Angela M., Tilley, Barbara C., Baraniuk, Sarah, Zhu, Hongjian, Nixon, Joshua, Seay, Roann, Appana, Savitri N., Yang, Hui, Gonzalez, Michael O., Baer, Lisa, Willa Wang, Yao-Wei, Hula, Brittany S., Espino, Elena, Nguyen, An, Pawelczyk, Nicholas, Arora-Nutall, Kisha D., Sharma, Rishika, Cardenas, Jessica C., Rahbar, Elaheh, Burnett, Tyrone, Jr., Clark, David, van Belle, Gerald, May, Susanne, Leroux, Brian, Hoyt, David, Powell, Judy, Sheehan, Kellie, Hubbard, Alan, Arkin, Adam P., Hess, John R., Callum, Jeanne, Cotton, Bryan A., Vincent, Laura, Welch, Timothy, Poole, Tiffany, Pivalizza, Evan G., Gumbert, Sam D., Bai, Yu, McCarthy, James J., Noland, Amy, Hobbs, Rhonda, Bulger, Eileen M., Klotz, Patricia, Cattin, Lindsay, Warner, Keir J., Wilson, Angela, Boman, David, White, Nathan, Grabinsky, Andreas, Daniel-Johnson, Jennifer A., Cohen, Mitchell Jay, Callcut, Rachael A., Nelson, Mary, Redick, Brittney, Conroy, Amanda, Steurer, Marc P., Maxim, Preston C, Fiebig, Eberhard, Moore, Joanne, Mallari, Eireen, Muskat, Peter, Johannigman, Jay A., Robinson, Bryce RH., Branson, Richard D., Gomaa, Dina, Barczak, Christopher, Bennett, Suzanne, Carey, Patricia M., Miller, Christopher N., Hancock, Helen, Rodriguez, Carolina, Inaba, Kenji, Zhu, Jay G., Wong, Monica D., Menchine, Michael, Katzberg, Kelly, Henderson, Sean O., McKeever, Rodney, Shulman, Ira A., Nelson, Janice M., Tuma, Christopher W., Matsushita, Cheryl Y, Scalea, Thomas M., Stein, Deborah M., Shaffer, Cynthia K., Wade, Christine, Herrera, Anthony V., Kallam, Seeta, Wade, Sarah E., Galvagno, Samuel M., Jr., Fontaine, Magali J., Hunt, Janice M., Cooke, Rhonda K., Fabian, Timothy C., Weinberg, Jordan A., Croce, Martin A., Wilson, Suzanne, Panzer-Baggett, Stephanie, Waddle-Smith, Lynda, Flax, Sherri, Brasel, Karen J., Walsh, Pamela, Milia, David, Nelson, Allia, Kaslow, Olga, Aufderheide, Tom P., Gottschall, Jerome L., Carpenter, Erica, O'Keeffe, Terence, Rokowski, Laurel L., Denninghoff, Kurt R., Redford, Daniel T., Novak, Deborah J., Knoll, Susan, Kerby, Jeffrey D., Pittet, Jean-Francois, Bosarge, Patrick L., Pierce, Albert T., Williams, Carolyn R., Stephens, Shannon W., Wang, Henry E., Marques, Marisa B., Schreiber, Martin A., Watters, Jennifer M., Underwood, Samantha J., Groat, Tahnee, Newgard, Craig, Merkel, Matthias, Scanlan, Richard M., Miller, Beth, Rizoli, Sandro, Tien, Homer, Nascimento, Barto, Trpcic, Sandy, Sobrian-Couroux, Skeeta, Reis, Marciano, Pérez, Adic, Belo, Susan E., Merkley, Lisa, Colavecchia, Connie, Wei, Shuyan, Gonzalez Rodriguez, Erika, Chang, Ronald, Kao, Lillian S., and Wade, Charles E.

Published
2018
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8. S30 Prior Statin Use on Outcomes in Acute Pancreatitis: A Propensity Score Analysis

Author

Huang, Linda, primary, Koh, Jennifer, additional, Kim, Jin Sun, additional, Sumethasorn, Matt, additional, Wang, Sarah, additional, Klinhom, Chanidapa, additional, Amini, Maziar, additional, Vazquez, Alejandro, additional, Chang, Patrick, additional, Jeon, Christie, additional, Pandol, Stephen, additional, Shulman, Ira, additional, and Buxbaum, James, additional

Published
2023
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11. Onset of Coagulation Function Recovery Is Delayed in Severely Injured Trauma Patients with Venous Thromboembolism

Author

Holcomb, John B., Wade, Charles E., del Junco, Deborah J., Fox, Erin E., Matijevic, Nena, Podbielski, Jeanette, Beeler, Angela M., Tilley, Barbara C., Baraniuk, Sarah, Nixon, Joshua, Seay, Roann, Appana, Savitri N., Yang, Hui, Gonzalez, Michael O., Baer, Lisa, Willa Wang, Yao-Wei, Hula, Brittany S., Espino, Elena, Nguyen, An, Pawelczyk, Nicholas, Arora-Nutall, Kisha D., Sharma, Rishika, Cardenas, Jessica C., Rahbar, Elaheh, Burnett, Tyrone, Jr., Clark, David, van Belle, Gerald, May, Susanne, Leroux, Brian, Hoyt, David, Powell, Judy, Sheehan, Kellie, Hubbard, Alan, Arkin, Adam P., Hess, John R., Callum, Jeanne, Cotton, Bryan A., Vincent, Laura, Welch, Timothy, Poole, Tiffany, Pivalizza, Evan G., Gumbert, Sam D., Bai, Yu, McCarthy, James J., Noland, Amy, Hobbs, Rhonda, Bulger, Eileen M., Klotz, Patricia, Cattin, Lindsay, Warner, Keir J., Wilson, Angela, Boman, David, White, Nathan, Grabinsky, Andreas, Daniel-Johnson, Jennifer A., Cohen, Mitchell Jay, Callcut, Rachael A., Nelson, Mary, Redick, Brittney, Conroy, Amanda, Steurer, Marc P., Maxim, Preston C., Fiebig, Eberhard, Moore, Joanne, Mallari, Eireen, Muskat, Peter, Johannigman, Jay A., Robinson, Bryce RH., Branson, Richard D., Gomaa, Dina, Barczak, Christopher, Bennett, Suzanne, Carey, Patricia M., Miller, Christopher N., Hancock, Helen, Rodriguez, Carolina, Inaba, Kenji, Zhu, Jay G., Wong, Monica D., Menchine, Michael, Katzberg, Kelly, Henderson, Sean O., McKeever, Rodney, Shulman, Ira A., Nelson, Janice M., Tuma, Christopher W., Matsushita, Cheryl Y., Scalea, Thomas M., Stein, Deborah M., Shaffer, Cynthia K., Wade, Christine, Herrera, Anthony V., Kallam, Seeta, Wade, Sarah E., Galvagno, Samuel M., Jr., Fontaine, Magali J., Hunt, Janice M., Cooke, Rhonda K., Fabian, Timothy C., Weinberg, Jordan A., Croce, Martin A., Wilson, Suzanne, Panzer-Baggett, Stephanie, Waddle-Smith, Lynda, Flax, Sherri, Brasel, Karen J., Walsh, Pamela, Milia, David, Nelson, Allia, Kaslow, Olga, Aufderheide, Tom P., Gottschall, Jerome L., Carpenter, Erica, O'Keeffe, Terence, Rokowski, Laurel L., Denninghoff, Kurt R., Redford, Daniel T., Novak, Deborah J., Knoll, Susan, Kerby, Jeffrey D., Pittet, Jean-Francois, Bosarge, Patrick L., Pierce, Albert T., Williams, Carolyn R., Stephens, Shannon W., Wang, Henry E., Marques, Marisa B., Schreiber, Martin A., Watters, Jennifer M., Underwood, Samantha J., Groat, Tahnee, Newgard, Craig, Merkel, Matthias, Scanlan, Richard M., Miller, Beth, Rizoli, Sandro, Tien, Homer, Nascimento, Barto, Trpcic, Sandy, Sobrian-Couroux, Skeeta, Reis, Marciano, Pérez, Adic, Belo, Susan E., Merkley, Lisa, Colavecchia, Connie, McCully, Belinda H., Connelly, Christopher R., and Fair, Kelly A.

Published
2017
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25. Making thawed universal donor plasma available rapidly for massively bleeding trauma patients: experience from the Pragmatic, Randomized Optimal Platelets and Plasma Ratios (PROPPR) trial

Author

Novak, Deborah J., Bai, Yu, Cooke, Rhonda K., Marques, Marisa B., Fontaine, Magali J., Gottschall, Jerome L., Carey, Patricia M., Scanlan, Richard M., Fiebig, Eberhard W., Shulman, Ira A., Nelson, Janice M., Flax, Sherri, Duncan, Veda, Daniel-Johnson, Jennifer A., Callum, Jeannie L., Holcomb, John B., Fox, Erin E., Baraniuk, Sarah, Tilley, Barbara C., Schreiber, Martin A., Inaba, Kenji, Rizoli, Sandro, Podbielski, Jeanette M., Cotton, Bryan A., and Hess, John R.

Published
2015
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28. Lactated Ringers vs Normal Saline Resuscitation for Mild Acute Pancreatitis: A Randomized Trial

Author

Lee, Alice, primary, Ko, Christopher, additional, Buitrago, Carlos, additional, Hiramoto, Brent, additional, Hilson, Liam, additional, Buxbaum, James, additional, Lee, Alice, additional, Furey, Cameron, additional, Tonthat, Alexander, additional, Evans, Nicole, additional, Yeh, Jeffrey, additional, Nguyen, Stefan, additional, Serna, Jessica, additional, Shulman, Ira, additional, Matsushima, Kazuhide, additional, and Banks, Peter, additional

Published
2021
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33. Management of patients refractory to platelet transfusion

Author

Sacher, Ronald A., Kickler, Thomas S., Schiffer, Charles A., Sherman, Laurence A., Bracey, Arthur W., and Shulman, Ira A.

Subjects
Thrombocytopenia -- Diagnosis, Thrombocytopenia -- Care and treatment
Published
2003

37. Contributors

Author

Adams, Sharon, primary, Alving, Barbara, additional, Anderson, Kenneth C., additional, AuBuchon, James P., additional, Bandarenko, Nicholas, additional, Barrett, Jon, additional, Benjamin, Richard J., additional, Benn, Howard, additional, Beyer, Ginine M., additional, Blajchman, Morris A., additional, Blumberg, Neil, additional, Brecher, Mark E., additional, Broxmeyer, Hal E., additional, Busch, Michael P., additional, Callum, Jeannie L., additional, Campbell-Lee, Sally A., additional, Carson, Jeffrey L., additional, Clark, Kenneth A., additional, Corash, Laurence, additional, Crookes, Robert L., additional, Culler, Elizabeth E., additional, Cunningham, Melody J., additional, Davey, Richard J., additional, Devine, Dana V., additional, Dodd, Roger Y., additional, Duncan, Alexander, additional, Dzik, Walter H., additional, Eckman, James R., additional, Eisenbrey, A. Bradley, additional, Fiebig, Eberhard W., additional, Fisk, John M., additional, Geiger, Terrence L., additional, Goldman, Mindy, additional, Harris, Shealynn B., additional, Heal, Joanna M., additional, Hébert, Paul C., additional, Heddle, Nancy, additional, Hess, John R., additional, Hillyer, Christopher D., additional, Hillyer, Krista L., additional, Holland, Paul V., additional, Janatpour, Kim A., additional, Johnson, Viviana V., additional, Josephson, Cassandra D., additional, Kaufman, Richard M., additional, Kickler, Thomas S., additional, Killion, Diane, additional, King, Karen E., additional, Kleinman, Steven H., additional, Kunicki, Thomas J., additional, Lee, Tzong-Hae, additional, Lipton, Karen Shoos, additional, Lögdberg, Lennart E., additional, Luban, Naomi L.C., additional, Manno, Catherine S., additional, Mantha, Simon, additional, Marincola, Francesco M., additional, McLeod, Bruce C., additional, Menitove, Jay E., additional, Millward, Peter A., additional, Murphy, Edward L., additional, Ness, Paul M., additional, Nugent, Diane J., additional, Perrotta, Peter L., additional, Pisciotto, Patricia T., additional, Price, Thomas H., additional, Ramasethu, Jayashree, additional, Ramirez-Arcos, Sandra M., additional, Reed, William, additional, Reid, Marion E., additional, Roback, John D., additional, Rowley, Scott D., additional, Sandler, S. Gerald, additional, Schuetz, Audrey N., additional, Selogie, Eileen, additional, Shaz, Beth, additional, Shirey, R. Sue, additional, Shulman, Ira A., additional, Shusterman, Suzanne, additional, Silberstein, Leslie E., additional, Sloan, Steven R., additional, Snyder, Edward L., additional, Strauss, Ronald G., additional, Stroncek, David F., additional, Strong, D. Michael, additional, Su, Leon L., additional, Szczepiorkowski, Zbigniew M., additional, Tegtmeier, Gary E., additional, Tinmouth, Alan, additional, Wang, Ena, additional, Webert, Kathryn E., additional, Westhoff, Connie M., additional, Winslow, Robert M., additional, Wong, Edward C.C., additional, Zeger, Gary, additional, and Zimring, James C., additional

Published
2007
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46. Verification and Implementation of HIV Antibody Differentiation Testing to Improve Turnaround Time for the HIV Diagnostic Algorithm.

Author

Chambliss, Allison B and Shulman, Ira A

Subjects
*DIAGNOSIS of HIV infections, *IMMUNOASSAY, *HOSPITAL laboratories, *TURNAROUND time, *VIRAL antibodies, *ALGORITHMS
Abstract

Background Relying on reference laboratories for HIV confirmation testing may lead to delays in treatment and can cause stress for patients who have positive HIV screening results. Objective To internalize HIV-1/HIV-2 antibody differentiation testing within the hospital laboratory. Methods We analytically verified an HIV antibody differentiation immunoassay and subsequently compared result turnaround times (TATs) for HIV antibody differentiation and HIV-1 qualitative RNA in the months before and after the test internalization. Results HIV antibody differentiation was successfully verified. TATs for HIV antibody differentiation and HIV-1 RNA significantly improved, from medians of 40.4 hours and 156.5 hours to medians of 17.7 hours and 56.5 hours, respectively, after the internalization. The 90th-percentile turnaround times declined by 72% and 44%, respectively. Conclusions It is feasible for a hospital laboratory to verify HIV antibody-differentiation testing. Its implementation may considerably improve result TATs for the HIV diagnostic algorithm. [ABSTRACT FROM AUTHOR]

Published
2021
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48. Transfusion practice in medical patients

Author

Saxena, Sunita, Weiner, John M., Rabinowitz, Arthur, Fridey, Joy, Shulman, Ira A., and Carmel, Ralph

Subjects
Blood transfusion -- Evaluation, Medical care -- Evaluation, Health
Abstract

Objective: Blood transfusion raises serious issues of safety and economics. We therefore examined blood usage and its characteristics in medical inpatients, given the relative scarcity of existing data. Design: During a 1-year period, transfusion episodes on two medical services were reviewed by five specialists for justifiability on the basis of generally agreed on guidelines. Setting: The study was conducted at two institutions, a municipal teaching hospital where house staff deliver care and a community hospital where patients are under the direct care of private physicians. Patients: Four hundred thirty-eight randomly selected transfusion episodes on the medical services of the two institutions were reviewed. Main Outcome Measures: The prevalence of unjustifiable transfusions based only on the information available to the managing physician at the time of transfusion. Results: Eighteen percent of the 438 randomly selected transfusion episodes were viewed as not justifiable by at least four of five reviewers; another 17% were classified as equivocal because two or three reviewers judged them to be not justifiable. The most striking observation was the greater prevalence of nonjustifiable transfusion episodes at the community hospital (26% vs 16% at the teaching institution; P=.0121). Other observations included a tendency for physicians to prescribe transfusions by the numbers (at least 11% of nonjustifiable transfusions) and to overtransfuse. The routineness with which transfusion was viewed by managing physicians was also identifiable by the absence of written transfusion notes in 39% of all episodes reviewed, which incidentally raises questions about the adequacy of the medical chart's documentary functions today. Conclusions: The rate of nonjustifiable or equivocal transfusion on medical services may be as high as 35%. Reliance on numbers rather than clinical status seems to be a major problem. Education is obviously a critical issue and should also target private practitioners, who seemed to perform less well than physicians in training. Transfusion guidelines that use specific hematocrit values also need to be reexamined.

Published
1993

49. Iron-deficiency anemia: a medically treatable chronic anemia as a model for transfusion overuse

Author

Saxena, Sunita, Rabinowitz, Arthur P., Johnson, Cage, and Shulman, Ira A.

Subjects
Blood transfusion -- Health aspects, Iron deficiency anemia -- Care and treatment, Health, Health care industry
Abstract

PURPOSE: Transfusion practice m patients with iron deficiency was reviewed. PATIENTS AND METHODS: During the study period, records of 265 consecutive patients with an unsaturated iron-binding capacity of greater than 53.7 [micro]mol/L were evaluated for possible iron-deficiency anemia. RESULTS: Two hundred sixty-three patients met the study criteria for iron deficiency. Of these patients, 50 received 1 or more units of red blood cells (RBCs). The transfusion therapy of 12 patients could not be justified; physicians used laboratory results rather than the clinical status of the patients to initiate transfusion therapy. As a result, units of RBCs were transfused to raise the hematocrit to an arbitrarily chosen level. Furthermore, iron therapy was not prescribed for 97 of the 263 iron-deficient patients, including 11 of the patients for whom transfusion was justifiable and 2 patients for whom transfusion could not be justified. Based on records reviewed, no work-up was initiated to identify the cause of iron deficiency in 13 patients, including 4 patients who received transfusions. CONCLUSION: These Findings suggest that the evaluation and treatment of iron deficiency, including transfusion therapy for that condition, may be problem file. In view of the risks of blood transfusion therapy, improvement in transfusion practices for iron deficiency should be emphasized.

Published
1993

50. Parasitic infection from blood transfusions

Author

Shulman, Ira A.

Subjects
Blood transfusion -- Health aspects, Parasitic diseases -- Physiological aspects
Abstract

Is your blood bank following traditional and recent recommendations for excluding donors to prevent rare parasitic infections from entering the blood supply? Parasitic infection is an uncommon complication of blood [...]

Published
1992

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