scholarly journals Audit of transfusion practices in pediatrics in a tertiary care hospital

2020 ◽  
Vol 7 (6) ◽  
pp. 1424
Author(s):  
Vaishnavi Iyengar ◽  
Anjali Parekh ◽  
Sanjay Natu

Background: Audit of transfusion practices in pediatric patients was performed to study indications, clinical profile and whether transfusions were in accordance to guidelines.Methods: Retrospective analysis of all episodes of transfusions from a tertiary care centre was done. The study period was from January 2018 to December 2018.Patients in the age group of 4 months to 12 years were enrolled in the study. The data was reviewed according to the British Committee for Standards in Haematology guidelines for transfusion.Results: During the study period of 12 months,168 units of hemocomponents were transfused to children, 66.07% (111/168) of the total products transfused were packed red cell units, followed by 36 units (21.42%) of fresh frozen plasma and 21 units (12.5%) platelets. Overall usage of blood components was found to be appropriate in 58.33% (98/111). Red blood cells were the most appropriately transfused (64.86 %) (72 units out of 111) blood product as compared to 42.85% of platelets (9/21) and 47.22% of FFP (17/36).Conclusions: Most frequently transfused blood components are red blood cells in pediatrics. Inappropriate transfusion of blood components is hinders the utility of this valuable resource, Thus it becomes necessary to conduct regular audit of blood component transfusion for optimum utilization.

Author(s):  
Anshika Yadav ◽  
Priyanka Tiwari ◽  
Akhil K. Sheemar

Background: Every blood Component carries inherent risk of adverse transfusion reactions and transmission of transfusion transmitted disease (TTD). The adverse transfusion reactions are unpredictable and makes transfusion services puzzled, FFP being the most common one, it is therefore necessary that appropriate and rational use of FFP is done to make transfusion safer in terms of patient safety. The objective of the study was to assess the utilisation of FFP in a tertiary care Hospital.Methods: We conducted a retrospective study on 256 patient who received FFP transfusion at our tertiary care hospital over a period of 6 months .The usage was classified as appropriate or inappropriate based on the guidelines for FFP usage by British committee for standards in haematology, 2004 and college of American pathologist, 1994.Results: There were 256 patients in the study period who received 1370 units of FFP transfusions. The male: Female ratio was 162 M & 94 F. Most of the patients belonged to Gastroenterology Department (41.75%) followed by CTVS (15.32%). 29.48% of FFP transfusions were reclassified as inappropriate either due to Lack of indication or inappropriate doses.Conclusions: The study emphasize on the need to incurate rational use of blood components which is FFP in present case for evolving safe transfusion practices in the country. This study highlights no adherence to guidelines among clinicians which is mainly due to lack of knowledge of appropriate usage.


2019 ◽  
Vol 3 (01) ◽  
pp. 12-15
Author(s):  
Farida Parvin ◽  
Mohammed Abdul Quader ◽  
Daanish Arefin Biswas ◽  
Mohammed Ali ◽  
Bepasha Naznin ◽  
...  

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.


2003 ◽  
Vol 127 (4) ◽  
pp. 415-423
Author(s):  
Randal Covin ◽  
Maureen O'Brien ◽  
Gary Grunwald ◽  
Bradley Brimhall ◽  
Gulshan Sethi ◽  
...  

Abstract Context.—The ability to predict the use of blood components during surgery will improve the blood bank's ability to provide efficient service. Objective.—Develop prediction models using preoperative risk factors to assess blood component usage during elective coronary artery bypass graft surgery (CABG). Design.—Eighty-three preoperative, multidimensional risk variables were evaluated for patients undergoing elective CABG-only surgery. Main Outcome Measures.—The study endpoints included transfusion of fresh frozen plasma (FFP), platelets, and red blood cells (RBC). Multivariate logistic regression models were built to assess the predictors related to each of these endpoints. Setting.—Department of Veterans Affairs (VA) health care system. Patients.—Records for 3034 patients undergoing elective CABG-only procedures; 1033 patients received a blood component transfusion during CABG. Results.—Previous heart surgery and decreased ejection fraction were significant predictors of transfusion for all blood components. Platelet count was predictive of platelet transfusion and FFP utilization. Baseline hemoglobin was a predictive factor for more than 2 units of RBC. Some significant hospital variation was noted beyond that predicted by patient risk factors alone. Conclusions.—Prediction models based on preoperative variables may facilitate blood component management for patients undergoing elective CABG. Algorithms are available to predict transfusion resources to assist blood banks in improving responsiveness to clinical needs. Predictors for use of each blood component may be identified prior to elective CABG for VA patients.


2021 ◽  
Vol Volume 13 ◽  
pp. 29-35
Author(s):  
Mahteme Bekele Muleta ◽  
Etsehiwot Haileselassie Yisak ◽  
Hana Abebe Gebreselassie ◽  
Tsega Terefe ◽  
Eden Berhanu ◽  
...  

2020 ◽  
Vol 7 (9) ◽  
pp. A478-482
Author(s):  
Deepika Mani ◽  
Megala C ◽  
Thamil Selvi R

Background: Blood transfusion is an important and essential constituent of present health-care delivery system. Millions of lives are saved every year in regular and emergency situations by the accessibility of safe blood transfusion services. This emphasizes the need for proper utilization of blood and its components with preferably “NO” or minimal wastage. The aim of this study was to find out causes for discarding blood and blood components.   Methods: Retrospective analysis was carried out at Vinayaka Missions Medical College and Hospital Blood Bank from October 1st, 2018 to October 31st, 2019.   Results: The total number of donors from whom blood was collected during this study period was 2522. Out of which 2507 units of components were prepared. The overall discard rate of blood and its components was 5.95%. Among those 5 (33.33%) whole blood, 28 (1.25%) packed red blood cell concentrate, 93 (4.16%) fresh frozen plasma, 157 (57.51%) platelet concentrate were discarded. The common causes of discarding blood components were due to expiry date 211 (74.56%), 30 (10.60%) were due to sero-reactivity for transfusion transmitted infections, 23 (8.13%) due to leakage of components, 13 (4.59%) due to low volume and other causes were 6 (2.12%).   Conclusion: Blood being irreplaceable source, discard rate can be reduced by proper counselling of blood donors, conducting donor screening, adhering to strict donor deferral criteria, notification and counselling of permanently deferred donors. Properly implementing blood transfusion policies will help to utilize the blood components in a proper way, thus resulting in discarding a smaller number of blood bags due to expiry. Continued medical education for technicians with regards to maintenance of proper stock, quality indicators, review of blood management system will further help in reducing discard rate.


Author(s):  
Irm Yasmeen ◽  
Ibrar Ahmed ◽  
Meena Sidhu

Background: Transfusion of donated blood remains the mainstay of treatment for a wide range of medical and surgical conditions. Although it can save life, but transfusion of blood is not without risk. Clinicians should cautiously assess the appropriateness of indications before requesting various blood components thereby preventing misuse of blood and unnecessary exposure of patient to various transfusion transmitted infections and antibodies production. This study was conducted to determine the pattern of whole blood (WB) and blood component cross-matching and their utilization and to minimize the inappropriate use of blood and its components.Methods: This cross-sectional prospective study was performed at SMGS Hospital Blood Bank, Jammu from April 2016 to September 2016. The requisition forms were analysed at the reception counter and inside the pre-transfusion testing laboratory for any error. The department wise utilization of blood and its components, Crossmatching to transfusion (C/T) ratio, transfusion probability (T%) and transfusion index (TI) were calculated.Results: A total of 14376 requests for cross-matching of blood and its components were received. All the units were cross-matched. Out of these, 12766(88.8%) units of blood and its components were issued to various departments. The most common indication for using packed red cells and whole blood was anemia and bleeding (APH/PPH/Trauma). The total C/T Ratio, transfusion probability (T%) and Transfusion index(TI)  of various blood components were 1.12:1, 88.8% and 0.88 respectively.Conclusions: Our study indicates efficient usage of blood and its component. However, awareness is still needed amongst the clinicians and residents to ensure the appropriate use of blood and its components in the future as well. Hospital transfusion committee has to develop transfusion guidelines and subsequent implementation of such guidelines to assure effective blood utilization. MSBOS (maximum surgical blood ordering schedule) should be formulated for elective procedures with regular auditing, feedback, and modifications to improve blood ordering and utilization.


2018 ◽  
Vol 9 (2) ◽  
pp. 142-147
Author(s):  
Shanaz Karim ◽  
Ehteshamul Hoque ◽  
Md Mazharul Hoque ◽  
Syeda Masooma Rahman ◽  
Kashfia Islam

Transfusion medicine has undergone advancements since its initiation in the early 20th century. One of these was the discovery that blood can be divided into individual components and delivered separately. Today, blood transfusions nearly always consist of the ad-ministration of 1 or more components of blood. Whole blood transfusion is now limited to situations involving massive resuscitation (trauma ) The most familiar cellular components include packed red blood cells (PRBC), washed PRBC, leukoreduced PRBC and pooled or aphaeresis platelets. Plasma products such as FFP or cryoprecipitate, ant hemophilic factor (CRYO). The transfusion of red blood cells (RBCs), platelets, fresh-frozen plasma (FFP), and cryoprecipitate has the potential of improving clinical outcomes in perioperative and peripartum settings. These benefits include improved tissue oxygenation and decreased bleeding. However, transfusions are not without risks or costs. With the advent of blood component therapy, each unit of whole blood collected serves the specific needs of several, rather than a single patient.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 142-147


2021 ◽  
Vol 33 (1) ◽  
pp. 27-33
Author(s):  
Naylla Islam ◽  
- Amiruzzaman ◽  
Mohammad Ehasun Uddin Khan ◽  
Ashim Chakrabarty ◽  
Md Arifuzzaman ◽  
...  

Background:Transfusion of blood and blood products if employed safely, with intensive care can save manyvaluable lives. But a number of transfusion reactions may develop that are sometimesmore serious and life threatening.So this study was done to find out the most frequent and life threatening reactions that develop during transfusion. Methods: A Cross sectional descriptive observational study was performed at a tertiary care centre. Patients of 18 years and older irrespective of sexes who received blood and blood products due to different reasons between April 2020 to September 2020 were included in this study. A total of 96 patients were included in the study. Results:In thisstudy 11(11.5%) out of 96 patients had transfusion reactions of different types .Febrile non haemolytic reaction was the highest with 8 patients (8.33%),followed by Allergic reaction in 2 patients(2.08%) and Acute haemolytic transfusion reaction in 1 patient (1.04%).Among them 7(63.6%) reactions occurred with whole blood , 2(18.2%) reactions occurred with red cell concentrate and 1 reaction occurred with Apheresis platelet (9.1%) and fresh frozen plasma(9.1%).Statistically significant association was found between duration of storage of blood and transfusion reaction. Conclusion: Febrile non haemolytic reaction was the commonest type of transfusion reaction found in this study and there was also statistically significant association between duration of storage of blood and transfusion reaction. Bangladesh J Medicine July 2022; 33(1) : 27-33


2019 ◽  
Vol 7 (1) ◽  
pp. 97
Author(s):  
Varsha P. Patel ◽  
Archana U. Gandhi ◽  
Chineen Shah

Background: Sickle cell disorders are structural hemoglobinopathies, rendering red blood cells sickle shaped, less deformable and sticky leading to microvascular vaso-occlusion and premature red blood cells destruction which leads to varied clinical manifestations. It leads to lifelong morbidity thus affecting quality of life and contributes to early mortality thereby reducing the key national resources- the healthy workforce. This study was done to evaluate epidemiological and clinical profile of sickle cell disease attending the centre.Methods: This study was cross-sectional, observational study conducted at tertiary care hospital in Gujarat. After taking ethical clearance patients were enrolled as per inclusion and exclusion criteria and epidemiological and clinical profile of sickle cell disease patients was studied.Results: Mean age of sickle cell disease was 22.58 years. It was found in tribal communities of Gujarat like Rathwa, Baria, Tadvi etc. Commonest symptom was musculoskeletal pain (86.84%), followed by jaundice (71.05%), fever, dyspnoea, abdominal pain and chest pain. Most common systemic manifestation was pain crises (60.66%), followed by hemolytic anemia (31.15%), acute chest syndrome (30%), consolidation (11.67%), hepatopathy (10%) and avascular necrosis of hip. (6.56%).Conclusions: Sickle cell disease is seen in younger patients. In Gujarat mainly tribal communities are affected. Major systemic manifestations of sickle cell disease include pain crisis followed by hemolytic crisis, acute chest syndrome, hepatopathy and AVN of hip.    


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