Neonatal Transfusion Practice

Background: Transfusion of blood components and derivatives in day care unit is an eminent part of management of transfusion dependent patients. Day care transfusion service is an alternative to hospital admission and beneficial for those patients who receive blood more frequently for their survival. Objective: The aim of present study is to assess Transfusion Services provided in a Day Care Unit (DCU) of a tertiary care hospital. Methodology: This study was carried out in DCU of Transfusion Medicine Department, Bangabandhu Sheikh Mujib Medical University, (BSMMU) at Dhaka during January 2014 to December 2014. Data were collected from record registers. Recorded retrospective data were analyzed as percentage and proportion. Results: Total recipients were 718. Among those 424 (59.05%) were male and 294 (40.95%) were female and 562 (78.27%) were between 10 to 40 years. A total of 8587 units of blood components were used during this period. Red Cell Concentrate was most commonly utilized product 6388 (74.39%) followed by Fresh Frozen Plasma (FFP) 1360 (15.83%), Platelet Concentrate 544 (6.33%), Whole blood 260 (3.05%) and Cryoprecipitate 35 (0.40%). Transfusion was required more frequently in thalassaemic 365(50.88%) patients. Haemophilia 77(10.72%) and aplastic anaemia patients 49 (6.82%) were next high. The main transfusion reaction observed during transfusion was febrile non-haemolytic reactions. Conclusion: For increasing use of specific blood product and hassle-free transfusion services this kind of day care unit services should be strengthened. Long term study of this kind will help us to develop safe clinical transfusion practice.

Download Full-text

Platelet storage and functional integrity

LaboratoriumsMedizin ◽

10.1515/labmed-2020-0067 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Gianmatteo Vit ◽

Harald Klüter ◽

Patrick Wuchter

Keyword(s):

Platelet Transfusion ◽

Structural Characteristics ◽

Storage Conditions ◽

Transfusion Practice ◽

Common Interest ◽

Laboratory Staff ◽

German Medical Association ◽

Platelet Storage ◽

Technological Advances ◽

Assessment Procedures

AbstractPlatelet transfusion is a topic of common interest for many specialists involved in patient care, from laboratory staff to clinical physicians. Various aspects make this type of transfusion different from those of other blood components. In this review, the challenges in platelet transfusion practice that are relevant for laboratory colleagues will be discussed, highlighting how the biochemical and structural characteristics of these blood elements directly affect their function and consequently the clinical outcome. More than 1,300 platelet concentrates are transfused in Germany every day, and several types are offered by their respective manufacturers. We describe the technological advances in platelet concentrate production, with a focus on how the storage conditions of platelets can be improved. Laboratory quality assessment procedures for a safe transfusion are discussed in detail. For this purpose, we will refer to the Hemotherapy Directives (Richtlinie Hämotherapie) of the German Medical Association.

Download Full-text

Seeking Strategies to Optimize Blood Utilization: The Preliminary Experience with Implementing a Patient Blood Management Program in a Greek Tertiary Hospital

Journal of Clinical Medicine ◽

10.3390/jcm10102141 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2141

Author(s):

Aimilia Tsante ◽

Anastasia Papandreadi ◽

Andreas G. Tsantes ◽

Elias Kyriakou ◽

Panagiota Douramani ◽

...

Keyword(s):

Tertiary Hospital ◽

Management Program ◽

Transfusion Practice ◽

Patient Blood Management ◽

Medical Patients ◽

Blood Management ◽

Transfusion Threshold ◽

Restrictive Transfusion ◽

Implementation Period ◽

Blood Utilization

Objectives: Our aim was to assess blood utilization after implementation of a patient blood management (PBM) program in a Greek tertiary hospital. Methods: An electronic transfusion request form and a prospective audit of transfusion practice were implemented. After the one-year implementation period, a retrospective review was performed to assess transfusion practice in medical patients. Results: Pre-PBM, a total of 9478 RBC units were transfused (mean: 1.75 units per patient) compared with 9289 transfused units (mean: 1.57 units per patient) post-PBM. Regarding the post-PBM period, the mean hemoglobin (Hb) level of the 3099 medical patients without comorbidities transfused was 7.19 ± 0.79 gr/dL. Among them, 2065 (66.6%) had Hb levels >7.0 gr/dL, while 167 (5.3%) had Hb levels >8.0 gr/dL. In addition, 331 (25.3%) of the transfused patients with comorbidities had Hb >8.0 gr/dL. The Hb transfusion thresholds significantly differed across the clinics (p < 0.001), while 21.8% of all medical non-bleeding patients received more than one RBC unit transfusion. Conclusion: A poor adherence with the restrictive transfusion threshold of 7.0 gr/dL was observed. The adoption of a less strict threshold might be a temporary step to allow physicians to become familiar with the program and be informed on the safety and advantages of the restrictive transfusion strategy.

Download Full-text

Massive transfusion experience, current practice and decision support: A survey of Australian and New Zealand anaesthetists

Anaesthesia and Intensive Care ◽

10.1177/0310057x20974035 ◽

2021 ◽

pp. 0310057X2097403

Author(s):

Brenton J Sanderson ◽

Jeremy D Field ◽

Lise J Estcourt ◽

Erica M Wood ◽

Enrico W Coiera

Keyword(s):

Decision Support ◽

Decision Support System ◽

Clinical Decision Support ◽

Support System ◽

Clinical Decision Support System ◽

Response Rate ◽

Massive Transfusion ◽

Clinical Decision Support Systems ◽

Clinical Decision ◽

Transfusion Practice

Massive transfusions guided by massive transfusion protocols are commonly used to manage critical bleeding, when the patient is at significant risk of morbidity and mortality, and multiple timely decisions must be made by clinicians. Clinical decision support systems are increasingly used to provide patient-specific recommendations by comparing patient information to a knowledge base, and have been shown to improve patient outcomes. To investigate current massive transfusion practice and the experiences and attitudes of anaesthetists towards massive transfusion and clinical decision support systems, we anonymously surveyed 1000 anaesthetists and anaesthesia trainees across Australia and New Zealand. A total of 228 surveys (23.6%) were successfully completed and 227 were analysed for a 23.3% response rate. Most respondents were involved in massive transfusions infrequently (88.1% managed five or fewer massive transfusion protocols per year) and worked at hospitals which have massive transfusion protocols (89.4%). Massive transfusion management was predominantly limited by timely access to point-of-care coagulation assessment and by competition with other tasks, with trainees reporting more significant limitations compared to specialists. The majority of respondents reported that they were likely, or very likely, both to use (73.1%) and to trust (85%) a clinical decision support system for massive transfusions, with no significant difference between anaesthesia trainees and specialists ( P = 0.375 and P = 0.73, respectively). While the response rate to our survey was poor, there was still a wide range of massive transfusion experience among respondents, with multiple subjective factors identified limiting massive transfusion practice. We identified several potential design features and barriers to implementation to assist with the future development of a clinical decision support system for massive transfusion, and overall wide support for a clinical decision support system for massive transfusion among respondents.

Download Full-text