Survey of the use of whole blood in current blood transfusion practice

2001 ◽  
Vol 23 (6) ◽  
pp. 391-396 ◽  
Author(s):  
S. Maclennan ◽  
M.F. Murphy
2021 ◽  
Author(s):  
Harriet Tucker ◽  
Laura Green ◽  
Karim Brohi ◽  
Rebecca Cardigan ◽  
Ross Davenport ◽  
...  

Abstract BackgroundPre-hospital blood component transfusion poses logistical challenges. Current patterns of pre-hospital blood use across the UK are not known. A potential benefit of providing a single combined component of whole blood is reduced need for multiple steps of administering separate components and more efficient use of time and resources by medical staff. .Objectivesto undertake a detailed time-analysis of the steps of pre-hospital combined component transfusion against separate blood component transfusion, and to determine current UK pre-hospital transfusion practice and users’ optimal pre-hospital transfusion strategyMethodsA three-arm cross-over major haemorrhage simulation study compared: flow-time (time from decision-to-transfuse [DTT] to complete transfusion); touch-time (direct team ’hands on’ contact time with transfusion process); and number of steps, people and equipment required for transfusion of 2 units of RCP [arm-A], 2 RBC + 2 TP [arm-B] or RBC + 2 Lyoplas [arm-C]). A national survey of current and optimal pre-hospital transfusion strategies was sent to 22 UK Air Ambulance Services (AAS) and 27 Major Trauma Centres (MTC) in December 2019. ResultsThe simulation demonstrated that arm-A had a shorter flow-time (median 6min 31sec vs. 12min 20 sec, vs 16min 29 sec) and touch-time (median 2min 31 seconds vs. 5min 21sec vs. 15min 3sec) than arm-B and arm-C respectively, and required fewer steps, equipment and checks. 18 MTCs and 18 AAS responded to the national survey (response rates of 67 and 82%). 10 transfused RBC/plasma (5 TP/5 Lyoplas), 4 RBC only, 2 Lyoplas only, 1 RBC/Lyoplas/Fibrinogen, and 1 ’red cell and plasma’ (only available at one hospital site). 89% replied that a combined component transfusion would be desirable, as it would reduce patient mortality (83%) and tasks on scene (75%). ConclusionThe time-analysis established the benefits for combined pre-hospital component transfusion in trauma patients. The national survey demonstrates the variation in current pre-hospital transfusion practice and reiterates that combined component transfusion pre-hospital may have logistical advantages over separate components.


2020 ◽  
Vol 1 (2) ◽  
pp. 10-14
Author(s):  
Ana Antić ◽  
Sanja Živković-Đorđević ◽  
Suzana Stevanović ◽  
Marija Jelić

The preparation of blood components from whole blood collections must be standardized and compliant with recommendations, EU Directives and Standard Operative Procedures (SOPs). In order to achieve safe and efficient transfusion it is important to have automated separation of whole blood unit producing standardized blood components, good quality control and increased work efficiency. It is also very important that all blood components should be ISBT 128 labelled and properly storaged under the regulated conditions. One of the most important factors that increases transfusion safety is leucoreduction of blood components, which prevents several adverse effects following blood transfusion, as well replacement of plasma as a storage medium in red blood cells and platelet concentrates with preservative solutions, which results in the reduction of isoand HLA-antibodies and plasma proteins. Pathogen inactivation in blood products is the trend of modern blood transfusion practice and acts in the removal or inactivation of all pathogens that can be blood transmitted. It does not replace testing of blood units for transfusion-transmitted diseases, but it reduces the risk of "window phenomenon" and errors in testing, acting on the agents that are not included in routine testing. In circumstances where the pathogen reduction has not been introduced in practice routine bacteriological testing of blood components significantly decreases the occurrence of adverse reactions on contaminated blood. Processing using the most appropriate and effective methodologies and best laboratory practices, efficient inventory management system for optimum blood stocks, and effective blood cold chain for safe storage and distribution of blood and blood products are key requirements to ensure the safety of blood products.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Min Suk Chae ◽  
Mihyun Lee ◽  
Min Ho Choi ◽  
Je Uk Park ◽  
Misun Park ◽  
...  

Abstract Background Previous studies have reported the efficacy and safety of intravenous (IV) iron therapy during the perioperative period as an alternative and adjunct to allogeneic blood transfusion. Preemptive IV iron therapy provides noninferior hemoglobin levels on postoperative day (POD) 1 compared to autologous whole blood therapy (AWBT) in healthy patients who had undergone bimaxillary orthognathic surgery. Methods This was a prospective, patient-randomized, noninferiority trial. After excluding 2 patients, 64 patients were divided into two groups: the IV iron therapy group (patients received IV iron infusion 4 weeks before surgery; n = 32) and the AWBT group (2 units of autologous whole blood were collected 4 and 2 weeks before surgery; n = 32). The primary outcome was hemoglobin level on POD 1 and the prespecified noninferiority limit was − 1 g/dL. Results Baseline data were comparable, including hemoglobin and iron levels, between the two groups. Immediately before surgery, the levels of hemoglobin, iron, and ferritin were higher in the IV iron group than in the AWBT group. The mean treatment difference (iron group—whole blood group) in hemoglobin level on POD 1 between the two groups was 0.09 (95% CI = − 0.83 to 1.0). As the lower limit of the 95% CI (− 0.83) was higher than the prespecified noninferiority margin (δ = − 1), noninferiority was established. On POD 2, the hemoglobin level became lower in the iron group, which eventually led to greater requirement of allogeneic blood transfusion compared to the whole blood group. However, the iron group did not require allogeneic blood transfusion during or early after surgery, and the whole blood group showed continuously higher incidence of overt iron deficiency compared to the iron group. Conclusion As collection of autologous whole blood caused overt iron loss and anemia before surgery and intraoperative transfusion of whole blood was not able to prevent the occurrence of persistent iron deficiency after surgery, IV iron therapy was found to have potential benefits for iron homeostasis and subsequent erythropoiesis in healthy patients early after bimaxillary orthognathic surgery. Trial registration: Clinical Research Information Service, Republic of Korea, approval number: KCT0003680 on March 27, 2019. https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=15769&sLeft=2&ltype=my&rtype=my.


1987 ◽  
Author(s):  
S D Blair ◽  
S B Javanvrin ◽  
C N McCollum ◽  
R M Greenhalgh

It has been suggested that mortality due to upper gastrointestinal haemorrhage may be reduced by restricting blood transfusion [1], We have assessed whether this is due to an anticoagulant effect in a prospective randomised trial.One hundred patients with severe, acute gastrointestinal haemorrhage were randomised to receive either at least 2 units of blood during the first 24 hours of admission, or no blood unless their haemaglobin was lessthan 8g/dl or they were shocked. Minor bleeds and varices were excluded As hypercoagulation cannot be measured using conventional coagulation tests, fresh whole blood coagulation was measured by the Biobridge Impedance Clotting Time (ICT). Coagulation was assessed at 24 hour intervals and compared to age matched controls with the results expressed as mean ± sem.The ICT on admission for the transfusion group (n=50) was 3.2±0.2 mins compared to 10±0.2 mins in controls. This hyper-coagulable state was partially reversed to 6.4±0.3 mins at 24 hours (p<0.001). The 50 allocated to receive no blood had a similar ICT on admission of 4.4±0.4 mins but the hypercoagulable state was maintained with ICT at 24 hours of 4.320.4 mins. Only 2 patients not transfused rebled compared to 15 in the early transfusion group (p<0.001). Five patients died, and they were all in the early transfusion group.These findings show there is a hypercoagulable response to haemorrhage which is partially reversed by blood transfusion leading to rebleeding


2018 ◽  
Vol 8 (2) ◽  
pp. 1374-1377 ◽  
Author(s):  
Santosh Upadhyaya Kafle ◽  
Krishna Kumar Jha ◽  
Mrinalini Singh ◽  
Shilpi Shaukin

Background: Blood transfusion unit collection, storage and dispatching on Birat Medical College and Teaching Hospital began from 19 June 2016 via blood bank. After which, many blood distribution were made accessible via this service. This study analyzes the blood transfusion request and utilization pattern and also to monitor for managing the bloodstocks meeting present and future demand in hospital. Materials and Methods: This is descriptive cross-sectional study conducted for all the requests of whole blood dispatched from 19th June, 2016 to 04th July, 2018. Whole blood requisitions from various departments were reviewed regarding the number of requisition, total blood unit replaced, blood group and socio-demographic profile of patients.Results: Of 648 transfusion units dispatched, 131 and 324 patients were male and female respectively, B positive blood group were most common, followed by A positive, O positive, AB positive, A negative, O negative and AB negative respectively. The largest numbers of requisitions were from Gynecology and Obstetric department in the hospital of 258 requisitions followed by internal medicine, surgery department, postoperative ward and orthopaedic department. Majority of the requisitions were for 20-29 years age group from the local district Morang. The total blood units replaced were 75, of which 29 and 46 of male and female respectively. Conclusions: B Positive was the predominant requested blood group with Gynecology and Obstetrics department making the most requests, among 20-29 years age group from Morang district. The total replaced blood units were less in number with some requisition forms even lacked essential details.


2021 ◽  
pp. 25-29
Author(s):  
Rakesh Kumar Sharma ◽  
Shahid Anjum Awan ◽  
Vijay Sawhney

INTRODUCTION: Blood transfusion is an important concern for the society, as it is life saving for patients with bleeding disorders, accidents, surgeries, inherited/acquired hematological diseases and malignancies. Generally, donors are classied into the following categories: voluntary, family replacement, remunerated or paid donors, and autologous donor. AIMS & OBJECTIVES:To understand the importance of Blood & its safe Transfusion practice in a Teaching Hospital. METHODOLOGY: An Observational study was conducted over a period of 12 months from January 2019 to December 2019 in a 750 –bedded Tertiary Care Hospital of Jammu(UT). OBSERVATIONS: In addition to providing Blood-Transfusion Services to the patients admitted in SMGS Hospital Jammu & Other Associated Hospitals of GMC Jammu, the Blood-Bank is also catering to the needs of Registered Private Nursing Homes & Hospitals of Jammu(UT).This Blood-Bank has exceptionally maintained a record of consuming the whole stock of Blood without wasting even a single pint of blood. DISCUSSION: The Aim of Blood Transfusion Services is to supply good Quality of Blood & its Components to the Patients & avoid any risk to the Donors as well as Recepients. Hence it is extremely essential to institute strict Quality Control Measures RECOMMENDATIONS: Recommended that Upgradation of Blood-Bank is essential to cater with the needs of Additional bed-strength that SMGS Hospital is going to acquire in the coming future.


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