![nikki cross weight loss nikki cross weight loss](http://cdn01.cdn.justjared.com/wp-content/uploads/2008/01/blonsky-rising/nikki-blonsky-rising-star-01.jpg)
The following sections consider the evidence for practice by components, major haemorrhage protocols (MHPs) and specific clinical settings. 5 This guideline mandates a multidisciplinary approach involving the close working between laboratories, and clinical departments enabling a timely, targeted approach to transfusion support.
![nikki cross weight loss nikki cross weight loss](https://www.tonicweightlosssurgery.co.uk/wp-content/uploads/2019/03/Nikki-1.jpg)
Delayed recognition of bleeding continues to be one factor for adverse outcomes in the management of major haemorrhage, as described in a recent SHOT report. Major haemorrhage is a clinical emergency that results in morbidity and mortality: practice guidance is important to reduce these risks. Readers are referred to linked BSH guidelines on transfusion support in children and the use of viscoelastic haemostatic assays (VHAs). 6 The guideline was reviewed by the BSH Guidelines Committee Transfusion Task Force, and Thrombosis & Haemostasis Task Force, and placed on the members section of the BSH website for comments. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate levels of evidence and to assess the strength of recommendations ( ). The scope of this guideline included the emerging practice of pre-hospital transfusion and emergency transfusion in the context of mass casualty events (MCEs). Recommendations on thromboprophylaxis were also not considered in this guideline, but the authors recognised the importance of this topic, noting that trauma patients have high rate of hospital-acquired venous thromboembolism. The following areas were considered beyond the scope of this guideline: techniques for resuscitation, surgical, radiological and endoscopic interventions to control and monitor bleeding, the use of crystalloids and colloids for fluid resuscitation. In areas where the evidence base was limited, the writing group presented pragmatic guidance. 5 The writing group focused on systematic reviews and randomised controlled trials (RCTs) to formulate recommendations, although recognising that the literature underpinning laboratory and organisational aspects would likely be based on observational studies and descriptions of practice, rather than interventional trials. We reviewed a recent clinical practice guideline from the European Society of Intensive Care Medicine, 4 and recent UK Serious Hazards of Transfusion (SHOT) haemovigilance reports. A total of 96 citations were included and reviewed by the members of the writing group.
NIKKI CROSS WEIGHT LOSS TRIAL
A total of 530 citations were screened (L.G., S.J.S.) of which, 365 citations were excluded as they were narrative reviews, case-reports, case series (without comparator groups), and studies of anticoagulation reversal 65 citations were trial protocols and four citations were duplicates. Systematic reviews were identified 3 and cross-checked by searching the National Health Service Blood and Transplant Systematic Review Initiative Transfusion Evidence Library. 2 An updated search (PubMed and Embase) for articles (in English, only human studies) published from July 2014 up to March 2020 was undertaken by the BSH information specialist using the terms 'bleeding' and 'haemorrhage' combined with 'management' and 'trials'. This updated guideline 1 was compiled by a writing group selected to be representative of UK haematology/transfusion experts, according to the British Society for Haematology (BSH) process at.