Transfusion Therapy and Hemorrhagic Shock - Essay Example

Transfusion Therapy in Hemorrhagic Shock Purpose The review on reference is written by Timothy C. Nunez and his colleague in the department of surgery, Bryan A. Cotton. Their work focuses on analysing the effective resuscitation models that are suitable in a situation that follows a blood transfusion. The study is based on the adopted haematological based methodologies for addressing the resultant damages. The quest of the authors is to establish the concentration ratios that are suitable towards the quest of enhancing the survival rate. The topic on 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 patents that are not subjected to the PRBCs. The increased fatalities reported occur during the first 24hrs upon receiving of the blood units. The review presumes a slight interest on 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 centres indicates the occurrence of incidents of acute cases of coagulopathy. The key aim by these researchers is the role of this development in the management of exsanguinations in patients. This leads to the development of interest on 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 procedure. This algorithm is developed from the comparison of the adopted techniques and in the contribution of their addition 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 in the contrary. In addition, the clinicians desire to understand the risks associated by each transfusion, especially with regards to allorejection. Prior to the commencement of the study, the authors review previously deployed techniques on the subject matter. Here they analyse 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 refection 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 of developing large quantities of the samples within a short span of time. On this regard, the authors propose mechanisms of achieving this level of productivity which include the establishment of a function 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 centred on the responses that may be associated to rejection, especially hyper – acute rejection. To this, the review proposes the incorporation of a robust unit of function in the delivery of the 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 on their topic of interest. They have successfully portrayed the interests coupled to their proposal with clarity. Their interest of 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 on the increased concern over the matter. A significant proportion of civilian succumb to coagulopathy upon receiving increased quantities of blood transfusion. On 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. Reference Timothy C. Nuneza and Bryan A. Cotton, 2009. Transfusion therapy in hemorrhagic shock. Current Opinion in Critical Care, pp. 536-541. Read More