bloodhealth.bsky.social
Blood🩸health enthusiast, anesthesiologist, intensivist, clinical researcher, patient blood management director, father, husband, music lover, big believer in kindness. #MedSky #AnSky #emimcc #anemia #blood #anemia
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Great quote! Unfortunately 🚨nerd alert🚨 we are no longer in the Third Age. Sauron already has the ring. In fact, we the peoples of Middle Earth just rolled over and gave it to him. Only a new “Last Alliance of Elves and Men” will save us now…
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An all-time favorite place of mine…
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đź“Ś
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Practical Anemia Bundle for SusTained Blood Recovery (PABST-BR) trial results below: @criticalcarereviews.com
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The stably unstable patient is the best kind of unstable patient
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In summary, the Practical Anemia Bundle for SusTained Blood Recovery (PABST-BR) improves Hb recovery in predominantly post-surgical critical illness. Now, we need to see if that translates to improvements in outcomes that matter to patients.
#emimcc #ansky #heme
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We explored a variety of functional outcomes in pilot fashion. In general, estimates hint at potential beneficial effects of anemia treatment on fatigue, quality of life, cognition, anxiety, and depressive symptoms… but these need formal evaluation in an adequately powered RCT.
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IV iron was well-tolerated without any infusion reactions. There were no differences in adverse events between groups. All AEs were deemed unrelated or unlikely related to study procedures. In other words, IV iron can be safely given during acute illness.
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As expected, the intervention group had lower phlebotomy burden: 32 (22-54) mL vs 142 (68-195) mL after randomization, without differences in lab redraws. This confirms that optimizing phlebotomy practice is a no-brainer and should be implemented for all patients.
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3-month clinical outcomes were not significantly different b/t groups: RBC transfusion occurred in 1 patient (2%) intervention vs 6 patients (12%) in standard care (p=.09). Hospital readmission occurred in 12 pts (25%) in intervention vs 16 (31%) standard care (p=.48).
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We enrolled 100 critically ill patients: 65% surgical, 35% medical. Median age 68 (61, 72) years. Hb 8.9 (8.4, 9.4) g/dL. 46% transfused prior to enrollment.
The intervention improved Hb recovery at 1-month (primary outcome) by 0.7 (0.1, 1.2) g/dL, with effects persisting at 3-months.
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The intervention consisted of 3 components: optimized phlebotomy practice (low volume draws, bundled timings, closed loop sampling), clinical decision support/rounding checklist (decrease labs, ensure nutrition, bleeding prophylaxis), and pharmacological anemia treatment (1000 mg IV iron dextran)
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Minnesota
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Update: this fairy egg did have a tiny yolk, an extra rare event. And made the most delicious egg morsel (or so my kids say).
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This hits hard. My literal job is putting people to sleep, keeping them safe and warm…
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May be of interest if not perfectly aligned with your question. My better half has a lot of expertise in this area and they some new guidelines coming out shortly.
pubmed.ncbi.nlm.nih.gov/32061413/
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Our precious babies have God-given skeletal systems, why do they need car seats?
Our precious babies have God-given dermatological systems, why do they need clothes?
Our precious babies have God-given gastrointestinal systems, why do they need diapers?
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Where’s the gofundme link so we can shrinkwrap the entire school in a huge everyone is welcome here banner?
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Science is good for humanity
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Grifters gonna grift
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So tired of seeing patients not get indicated imaging due to this concern…
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The amount of energy required to refute bullshit is infinitely greater than that required to create it.