Transfusion Therapy and Hemorrhagic Shock – Cardiovascular System Example

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"Transfusion Therapy and Hemorrhagic Shock" is a good example of a paper on the cardiovascular system.   Purpose  The review on the reference is written by Timothy C. Nunez and his colleague in the department of surgery, Bryan A. Cotton. Their work focuses on analyzing the effective resuscitation models that are suitable in a situation that follows a blood transfusion. The study is based on the adopted hematological based methodologies for addressing the resultant damages. The quest of the authors is to establish the concentration ratios that are suitable for the quest of enhancing the survival rate.

The topic on the reference is the packaging ratios plasma and platelets that should  e  incorporated with the red blood cells.   Background  The study is proposed following the observation of increased fatality rates in patients suffering from trauma. The authors are rather  categorical, and  associate the occasion to  hemorrhagic  shocks and possible cases of exsanguinations.   The review focuses on the element of packed red blood cells (PRBCs) in the resultant deaths. Apparently, the fatalities are highly reduced in patients that are not subjected to the PRBCs. The increased fatalities reported occurring during the first 24hrs upon receiving of the blood units.

The review presumes a slight interest in the proposals of other authors who peg their opinions on the preparation of pre-defined ratios. However, such proposals are time-consuming;   while in this case, time is highly limited (Nuneza, 2009, p. 536-540).   Methodology  The study on the findings established by researchers in military and civilian centers indicates the occurrence of incidents of acute cases of coagulopathy. The key aim of these researchers is the role of this development in the management of exsanguinations in patients. This leads to the  development of interest in the process of blood transfusion, with regards to the common most accepted approaches.

The authors develop an algorithm that seeks to identify the procedures of massive transfusion procedures. This algorithm is developed from the comparison of the adopted techniques and in the contribution of their additional suggestions.   Key challenges identified during the research methodology and conduct was the identification of the willing candidates for the clinical trials. The commonly adopted strategies by various researchers in identifying the appropriate candidates involve the adoption or development of a scoring system. This technique assists in the identification of the quantities desired by each patient thus can easily discriminate patients necessitating increased transfusions from those on the contrary.   In addition, the clinicians desire to understand the risks associated with each transfusion, especially with regards to allow rejection.

Prior to the commencement of the study, the authors review previously deployed techniques on the subject matter. Here they analyze several concepts utilized in both military and civilian therapy. Amongst this is the technique of liquid plasma, a concept that is founded on the storage techniques deployed in the storage of the extracted plasma.

This distinctiveness denounces it from a similar technique, Fresh Frozen Plasma (FFP) which is also discussed (Nuneza, 2009, p. 536-540).       Further analysis of the components extracted from massive transfusion reflects on the PRBCs, platelets, whole blood, among other products. Further reflection focuses on the adjuncts that can be related to such transfusion, in terms of products. This includes the focus on the recombinant factors that can be retrieved from such exercises. The authors then sink to the evaluation of the  effective ratios of the PRBCs.

This is tagged on the ability to develop large quantities of the samples within a short span of time. In this regard, the authors propose mechanisms of achieving this level of productivity which include  the  establishment of a functioning team. This  team should portray all the demands of flexibility, as well as efficiency in delivery (Nuneza, 2009, p. 536-540).   Upon this realization, the authors proceed to establish a proposal on the efficient ratios that can be deployed in the development of efficient PRBCs. On consideration is the ratio of platelets to erythrocytes and that of plasma to erythrocytes.

Further study on the available data sees the identification of several sets of ratios that have proven effective towards the exercise.   Results  The success of a given ratio to warrant it for proposal is based on various resultant effects. These effects are centered on the responses that may be associated with rejection, especially hyperacute rejection. To this, the review proposes the incorporation of a robust unit of function in the delivery of effective solutions for the resuscitation of patients on massive blood transfusion. A final proposal on the ratios indicate packages that have plasma to erythrocytes ratio exceeding 2:3.

However, this does not rule out the generally proposed ratio of equity, upon which the packaged components are added in an equal ratio (Nuneza, 2009, p. 536-540).     Conclusion  The authors have illustrated a detailed analysis of their topic of interest. They have successfully portrayed the interests coupled with their proposal with clarity. Their interest in protecting the vast number of civilians succumbing to coagulopathic based complications has been well defended. However, the review failed to identify the specific ratio for the PRBCs, irrespective of highlighting the increased concern over the matter.   A significant proportion of civilian succumb to coagulopathy upon receiving increased quantities of blood transfusion.

In this regard, it would have been essential to establish methodologies that can help in the quantification  of the precise ratios for utilization. Additionally, the proposed methods seem to be reflecting on the pre-existing data thus offering little novel solutions to the situation.  


Timothy C. Nuneza and Bryan A. Cotton, 2009. Transfusion therapy in hemorrhagic shock. Current Opinion in Critical Care, pp. 536-541.
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