Abstract:
:Platelet transfusions carry greater risks of infection, sepsis, and death than any other blood product, owing primarily to bacterial contamination. Many patients may be at particular risk, including critically ill patients in the intensive care unit. This narrative review provides an overview of the problem and an update on strategies for the prevention, detection, and reduction/inactivation of bacterial contaminants in platelets. Bacterial contamination and septic transfusion reactions are major sources of morbidity and mortality. Between 1:1000 and 1:2500 platelet units are bacterially contaminated. The skin bacterial microflora is a primary source of contamination, and enteric contaminants are rare but may be clinically devastating, while platelet storage conditions can support bacterial growth. Donor selection, blood diversion, and hemovigilance are effective but have limitations. Biofilm-producing species can adhere to biological and non-biological surfaces and evade detection. Primary bacterial culture testing of apheresis platelets is in routine use in the US. Pathogen reduction/inactivation technologies compatible with platelets use ultraviolet light-based mechanisms to target nucleic acids of contaminating bacteria and other pathogens. These methods have demonstrated safety and efficacy and represent a proactive approach for inactivating contaminants before transfusion to prevent transfusion-transmitted infections. One system, which combines ultraviolet A and amotosalen for broad-spectrum pathogen inactivation, is approved in both the US and Europe. Current US Food and Drug Administration recommendations advocate enhanced bacterial testing or pathogen reduction/inactivation strategies (or both) to further improve platelet safety. Risks of bacterial contamination of platelets and transfusion-transmitted infections have been significantly mitigated, but not eliminated, by improvements in prevention and detection strategies. Regulatory-approved technologies for pathogen reduction/inactivation have further enhanced the safety of platelet transfusions. Ongoing development of these technologies holds great promise.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Levy JH,Neal MD,Herman JHdoi
10.1186/s13054-018-2212-9subject
Has Abstractpub_date
2018-10-27 00:00:00pages
271issue
1eissn
1364-8535issn
1466-609Xpii
10.1186/s13054-018-2212-9journal_volume
22pub_type
杂志文章,评审相关文献
CRITICAL CARE文献大全abstract::With imprecise definitions, inexact measurement tools, and flawed study execution, our clinical science often lags behind bedside experience and simply documents what appear to be the apparent faults or validity of ongoing practices. These impressions are later confirmed, modified, or overturned by the results of the ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-017-1904-x
更新日期:2017-12-28 00:00:00
abstract:: ...
journal_title:Critical care (London, England)
pub_type: 信件
doi:10.1186/s13054-018-2244-1
更新日期:2018-11-14 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) is common among intensive care unit (ICU) patients. AKI is highly heterogeneous, with variable links to poor outcomes. Current approaches to classify AKI severity and identify patients at highest risk for poor outcomes focus on the maximum change in serum creatinine (SCr) values. Ho...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-016-1546-4
更新日期:2016-11-17 00:00:00
abstract::Percutaneous dilatation tracheostomy in the intensive care setting presents an increasingly important concept for establishing a large-bore tracheal airway with minimal surgical intervention. Over the last years, different technical solutions have been studied to assess their respective risks and benefits to determine...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc2968
更新日期:2004-10-01 00:00:00
abstract:INTRODUCTION:Myocardial dysfunction is a well-known complication in septic shock but its characteristics and frequency remains elusive. Here, we evaluate global longitudinal peak strain (GLPS) of the left ventricle as a diagnostic and prognostic tool in septic shock. METHODS:Fifty adult patients with septic shock admi...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0857-1
更新日期:2015-03-26 00:00:00
abstract:BACKGROUND:Atherosclerotic intracranial arterial stenosis is an important cause of stroke that is increasingly being treated with percutaneous transluminal angioplasty and stenting (PTAS) to prevent recurrent stroke. However, PTAS has not been compared with medical management in a randomized trial. METHODS:Objective: ...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc11326
更新日期:2012-05-09 00:00:00
abstract::Considerable progress has been made in the past few years in the development of therapeutic interventions that can reduce mortality in sepsis. However, encouraging physicians to put the results of new studies into practice is not always simple. A roundtable was thus convened to provide guidance for clinicians on the i...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc1860
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Inflammation plays an important role in the initiation and progression of acute kidney injury (AKI). However, evidence regarding the prognostic effect of the platelet-to-lymphocyte ratio (PLR), a novel systemic inflammation marker, among patients with AKI is scarce. In this study, we investigated the value o...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-017-1821-z
更新日期:2017-09-08 00:00:00
abstract:INTRODUCTION:Our understanding of septic acute kidney injury (AKI) remains incomplete. A fundamental step is the use of animal models designed to meet the criteria of human sepsis. Therefore, we dynamically assessed renal haemodynamic, microvascular and metabolic responses to, and ultrastructural sequelae of, sepsis in...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7164
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:This study pools data from the UK Intensive Care National Audit and Research Center (ICNARC) Case Mix Programme (CMP) to evaluate the case mix, outcome and activity for 17,326 patients with severe acute kidney injury (AKI) occurring during the first 24 hours of admission to intensive care units (ICU). MET...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7003
更新日期:2008-01-01 00:00:00
abstract::Patients in ICUs frequently require tracheostomy for long-term ventilator support, and the percutaneous dilatational tracheostomy (PDT) method is preferred over surgical tracheostomy. The use of ultrasound (US) imaging to guide ICU procedures and interventions has recently emerged as a simple and noninvasive tool. The...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-015-0942-5
更新日期:2015-05-18 00:00:00
abstract:INTRODUCTION:To systematically review studies evaluating the performance of Sequential Organ Failure Assessment (SOFA)-based models for predicting mortality in patients in the intensive care unit (ICU). METHODS:Medline, EMBASE and other databases were searched for English-language articles with the major objective of ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc7160
更新日期:2008-01-01 00:00:00
abstract::Emergency departments (EDs) face several challenges in maintaining consistent quality care in the face of steadily increasing public demand. Improvements in the survival rate of critically ill patients in the ED are directly related to the advancement of early recognition and treatment. Frequent episodes of overcrowdi...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0692-9
更新日期:2014-12-08 00:00:00
abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) has become a public health emergency of global concern. We aimed to explore the risk factors of 14-day and 28-day mortality and develop a model for predicting 14-day and 28-day survival probability among adult hospitalized patients with COVID-19. METHODS:In this multicent...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-020-03123-x
更新日期:2020-07-16 00:00:00
abstract::Severe burn injury remains a major burden on patients and healthcare systems. Following severe burns, the injured tissues mount a local inflammatory response aiming to restore homeostasis. With excessive burn load, the immune response becomes disproportionate and patients may develop an overshooting systemic inflammat...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc7794
更新日期:2009-01-01 00:00:00
abstract::A new randomised controlled trial suggested that plasma exchange hastened removal from the ventilator in mechanically ventilated children with Guillain-Barré syndrome compared with intravenous immunoglobulin. Two larger trials in adults showed the opposite result. ...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc10312
更新日期:2011-07-28 00:00:00
abstract:BACKGROUND:Post-cardiac arrest (CA) patients are at risk of secondary ischemic damage in the case of suboptimal brain oxygenation during an ICU stay. We hypothesized that elevated central venous pressures (CVP) would impair cerebral perfusion and oxygenation (venous cerebral congestion). The aim of the present study wa...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1297-2
更新日期:2016-05-15 00:00:00
abstract:INTRODUCTION:Bacterial meningitis (BM) is a severe complication in patients with aneurysmal subarachnoid haemorrhage (SAH). Clinical signs of meningitis are often masked by SAH-related symptoms, and routine cerebrospinal fluid (CSF) analysis fails to indicate BM. Microdialysis (MD) is a technique for monitoring cerebra...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7689
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Sepsis, severe sepsis and septic shock are common conditions with high mortality. Their early diagnosis in the Emergency Department (ED) is one of the keys to improving survival. Procalcitonin (PCT) has been used as a biomarker in septic patients but has limited specificity and can be elevated in other sce...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/cc12847
更新日期:2013-07-30 00:00:00
abstract:INTRODUCTION:Stimulation of beta2-adrenergic receptors (beta2-ARs) inhibits tumor necrosis factor-alpha (TNF-alpha) release in monocytes. In septic shock, endogenous catecholamines induce beta2-AR downregulation, leading to an increased TNF-alpha release. The aims of this study were to analyze the molecular mechanisms ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7158
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:Mechanical ventilation with even moderate-sized tidal volumes synergistically increases lung injury in sepsis and has been associated with proinflammatory low-molecular-weight hyaluronan production. High-molecular-weight hyaluronan (HMW HA), in contrast, has been found to be anti-inflammatory. We hypothesi...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc6982
更新日期:2008-01-01 00:00:00
abstract::A relative immunosuppression is observed in patients after sepsis, trauma, burns, or any severe insults. It is currently proposed that selected patients will benefit from treatment aimed at boosting their immune systems. However, the host immune response needs to be considered in context with pathogen-type, timing,and...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc13787
更新日期:2014-03-24 00:00:00
abstract:PURPOSE:Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven. METHODS:The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03109-9
更新日期:2020-07-14 00:00:00
abstract:BACKGROUND:Our objective was to evaluate the impact of gastric versus post-pyloric feeding on the incidence of pneumonia, caloric intake, intensive care unit (ICU) length of stay (LOS), and mortality in critically ill and injured ICU patients. METHOD:Data sources were Medline, Embase, Healthstar, citation review of re...
journal_title:Critical care (London, England)
pub_type: 杂志文章,meta分析,评审
doi:10.1186/cc2190
更新日期:2003-06-01 00:00:00
abstract::Sepsis is a major contributor to the global burden of disease. The majority of sepsis cases and deaths are estimated to occur in low and middle-income countries. Barriers to reducing the global burden of sepsis include difficulty quantifying attributable morbidity and mortality, low awareness, poverty and health inequ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-018-2157-z
更新日期:2018-09-23 00:00:00
abstract::Outcomes studies of infections with resistant bacteria often do not account appropriately for intermediate variables--events in the causal pathway between the exposure and the outcome--when controlling for confounders. We discuss how failure to distinguish between confounders and intermediate variables can bias the an...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc5019
更新日期:2006-01-01 00:00:00
abstract::Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-015-0961-2
更新日期:2015-06-12 00:00:00
abstract::Hemodynamic monitoring is a central component of intensive care. Patterns of hemodynamic variables often suggest cardiogenic, hypovolemic, obstructive, or distributive (septic) etiologies to cardiovascular insufficiency, thus defining the specific treatments required. Monitoring increases in invasiveness, as required,...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc3927
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:Fever is associated with a poor outcome in severely brain-injured patients, and its control is one of the therapies used in this condition. But, fever suppression may promote infection, and severely brain-injured patients are frequently exposed to infectious diseases, particularly ventilator-associated pne...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0689-4
更新日期:2014-12-15 00:00:00
abstract:BACKGROUND:Biomarkers can be of help to understand critical illness and to identify and stratify sepsis. Adrenomedullin is a vasoactive hormone, with reported prognostic and potentially therapeutic value in sepsis. The primary aim of this study was to investigate the association of circulating bioactive adrenomedullin ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03351-1
更新日期:2020-11-04 00:00:00