Rise of Haemoglobin after Blood Transfusion in Children Without Active Bleeding

2020 ◽  
Vol 40 (2) ◽  
pp. 125-129
Author(s):  
Rupesh Shrestha ◽  
Srijana Basnet ◽  
Fakir Chandra Gami
Keyword(s):  
Blood Transfusion ◽  
Blood Product ◽  
Tertiary Care ◽  
Haemoglobin Concentration ◽  
Severe Anaemia ◽  
Active Bleeding ◽  
Care Hospital ◽  
Red Cell ◽  
Donor Blood ◽  
Before And After

Introduction: Blood transfusion is a common practice among children with severe anaemia. A common assumption among physician is that transfusion of 5 ml/kg packed red cell will increase the haemoglobin of the recipient by 1 gm/dl. This study was aimed at assessing the effect of volume of blood product and hematocrit of donor blood in the rise of haemoglobin concentration after transfusion in children without active bleeding. Methods: A prospective observational study was conducted in 32 children aged between one to 15 years without active bleeding who received blood transfusion in Paediatric ward and Paediatric Intensive Care Unit of a tertiary care hospital in Nepal from December 2013 to November 2014. Haemoglobin levels before and after transfusion were compared and any adverse reactions that occurred during transfusion were recorded. Hematocrit of each donor blood was measured. Results: The overall rise of haemoglobin after transfusion of blood product with hematocrit of 53 ± 8.9 % at the rate 14.5 ± 6.0 ml/kg was 2.7 ± 1.4 gm/dl. The rise of haemoglobin after transfusion of whole blood with hematocrit of 38.8 ± 4.4% at the rate 15.5 ± 6.9 ml/kg was 1.8 ± 1.2 gm/dl. The rise of haemoglobin after transfusion of packed cell with hematocrit 57.0 ± 4.8 % at the rate 14.2 ± 5.8 ml/kg was 2.9 ± 1.4 gm/dl. Conclusion: This study supports the general consensus of 1 gm/dl rise of haemoglobin after transfusion of packed red cell at 5 ml/kg.  

scholarly journals Pattern of utilization of blood and blood components in obstetrics at tertiary care hospital

2017 ◽  
Vol 6 (10) ◽  
pp. 4671
Author(s):  
Vidyadhar Bangal Bangal ◽  
Satyajit P. Gavhane ◽  
Kunal H. Aher ◽  
Dhruval K. Bhavsar ◽  
Priyanka R. Verma ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Donation ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Blood Bank ◽  
Care Hospital ◽  
Obstetric Haemorrhage ◽  
Obstetric Emergencies ◽  
The Common ◽  
Health Institutions

Background: Obstetric emergencies occur suddenly and unexpectedly. Blood transfusion becomes one of the live saving measures in such situations. Severe anaemia due to nutritional deficiency, obstetric haemorrhage either during pregnancy, labour or in postpartum period are the commonest indications for blood transfusion worldwide. Blood bank services play important role in saving lives in obstetric emergencies. Health institutions must carry out internal blood transfusion audits to reassure optimal and judicious use of blood and blood components.Methods: Analysis of 755 Obstetric patients requiring blood transfusion in eighteen months period was done to find out the incidence and indications for blood transfusion at tertiary care hospital.Results: Overall, 5.33% of obstetric admissions required transfusion of blood or its components. Severe anaemia (36.55%), accidental haemorrhage (20.92%), postpartum haemorrhage (8.34%), placenta praevia (5.03%) and caesarean section (10.33%) were the common indications for blood transfusion. In more than 65% cases, two or three unit of blood were transfused. In majority of cases (96%) components were used.Conclusions: Blood transfusion helped to save many lives in the present study. Severe anaemia and obstetric haemorrhage of varied aetiology were the common indications for blood transfusion. Component therapy helped to correct specific deficiency. Voluntary blood donation should be encouraged in the younger generation to keep adequate stock of blood in blood bank for emergency use. Preventive measures like improving dietary iron intake and prophylactic iron therapy will go a long way in reducing the need for blood transfusion in Obstetrics.

Irregular erythrocyte antibodies among antenatal women and their neonatal outcome at a tertiary care hospital in Northern India

2021 ◽  
pp. postgradmedj-2021-140497
Author(s):  
Saikat Mandal ◽  
Daljit Kaur ◽  
Gita Negi ◽  
Sriparna Basu ◽  
Jaya Chaturvedi ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Tertiary Care ◽  
Peak Systolic Velocity ◽  
Severe Anaemia ◽  
Care Hospital ◽  
Red Cell ◽  
Mortality And Morbidity ◽  
Antibody Screening ◽  
Northern India ◽  
Cell Antibody

BackgroundRed blood cell alloimmunisation during the pregnancy is a significant cause for neonatal mortality and morbidity. This study was planned to determine the prevalence and specificity of irregular erythrocyte antibodies in antenatal mothers and their neonatal outcome.MethodsIn this observational study, blood grouping and red cell antibody screening of mothers were performed at first visit and after 28 weeks of gestation and positive cases were identified and followed up monthly till delivery by repeating antibody titre and middle cerebral artery—peak systolic velocity. After delivery of alloimmunised mothers, cord blood haemoglobin, bilirubin and direct antiglobulin tests (DAT) were analysed and further outcome of neonate was recorded.ResultsAmong 652 registered antenatal cases, 18 multigravida women were found to be alloimmunised, accounting to prevalence of 2.8%. Most common alloantibody identified was anti D (>70%) followed by anti-Lea, anti-C, anti-Leb, anti-E and anti-Jka. Only 47.7% Rh D negative women received anti-D prophylaxis during previous pregnancies or whenever indicated. DAT was positive in 56.2% of neonates. Among nine DAT positive neonates, two early neonatal deaths due to severe anaemia were observed following birth resuscitation. Four antenatal mothers required intrauterine transfusion in view of fetal anaemia while three neonates received double volume exchange transfusion and top up transfusions after birth.ConclusionsThis study emphasises importance of red cell antibody screening for all multigravida antenatal women at registration of pregnancy and additionally at 28 weeks or later in high-risk cases irrespective of RhD status.

scholarly journals Impact of legalization of Medical Assistance in Dying on the Use of Palliative Sedation in a Tertiary Care Hospital: A Retrospective Chart Review

2021 ◽  
pp. 104990912110304
Author(s):  
Amy Nolen ◽  
Rawaa Olwi ◽  
Selby Debbie
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Palliative Sedation ◽  
Palliative Care Unit ◽  
Care Hospital ◽  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Before And After

Background: Patients approaching end of life may experience intractable symptoms managed with palliative sedation. The legalization of Medical Assistance in Dying (MAiD) in Canada in 2016 offers a new option for relief of intolerable suffering, and there is limited evidence examining how the use of palliative sedation has evolved with the introduction of MAiD. Objectives: To compare rates of palliative sedation at a tertiary care hospital before and after the legalization of MAiD. Methods: This study is a retrospective chart analysis of all deaths of patients followed by the palliative care consult team in acute care, or admitted to the palliative care unit. We compared the use of palliative sedation during 1-year periods before and after the legalization of MAiD, and screened charts for MAiD requests during the second time period. Results: 4.7% (n = 25) of patients who died in the palliative care unit pre-legalization of MAiD received palliative sedation compared to 14.6% (n = 82) post-MAiD, with no change in acute care. Post-MAiD, 4.1% of deaths were medically-assisted deaths in the palliative care unit (n = 23) and acute care (n = 14). For patients who requested MAiD but instead received palliative sedation, the primary reason was loss of decisional capacity to consent for MAiD. Conclusion: We believe that the mainstream presence of MAiD has resulted in an increased recognition of MAiD and palliative sedation as distinct entities, and rates of palliative sedation increased post-MAiD due to greater awareness about patient choice and increased comfort with end-of-life options.

scholarly journals 600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Intervention Group ◽  
Care Hospital ◽  
Full Time ◽  
Post Intervention ◽  
Before And After ◽  
The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p< 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

scholarly journals Study of Anaemia in Children with Severe Acute Malnutrition

2018 ◽  
Vol 37 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Deepak Dwivedi ◽  
Veerendra Singh ◽  
Jyoti Singh ◽  
Sangita Sharma
Keyword(s):  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Acute Malnutrition ◽  
Folic Acid Deficiency ◽  
Care Hospital ◽  
Macrocytic Anaemia ◽  
Normal Children ◽  
Co Morbidity ◽  
Morphologic Type

Introduction: Severe anaemia is a leading cause of paediatric morbidity, hospitalization, and mortality and it is very important co morbidity in children with severe acute malnutrition. Severe Acute Malnutrition (SAM) with anaemia has been shown to have 2.62 times higher mortality as compared to SAM with no anaemia. So this study was done to evaluate this co-morbidity further. The aim of present study was to determine the prevalence and type of anaemia and to evaluate the possible aetiologies of anaemia in severe acute malnourished (SAM) children.Material and Methods: In tertiary care hospital a cross sectional study was conducted over a period of 8 month with 100 cases of SAM children and 101 cases of normal children. In both cases disorders of primary haematological problem were excluded. Auto analysers were used to measure blood counts. Blood smear was analysed by pathology consultant of institute and recorded for all patients with anaemia. Grade of anaemia and morphologic type of anaemia was analysed. Data were entered in Excel spreadsheets and analysed using SPSS 20.0.Results: Patient with SAM 42% had moderate anaemia and 19% had severe anaemia in contrast 41.6% and 16.8% in NON SAM child respectively. Predominant morphologic type in SAM patient was macrocytic anaemia (33%), while in controls microcytic anaemia (40.6%) was more prevalent.Conclusion: There was a high prevalence of anaemia in SAM children. Major morphologic type in SAM children was macrocytic anaemia which may indirectly show vitamin B12 or folic acid deficiency in these children.  

Abstract 448: Impact of Novel Healthcare Facility First Responder Training on Resuscitation Task Self-Efficacy Measures

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Les R Becker ◽  
Cheryl Camacho ◽  
Sheryl J Titus ◽  
Janet L Thorne ◽  
Munish Goyal
Keyword(s):  
Ambulatory Care ◽  
Self Efficacy ◽  
Repeated Measures ◽  
Care Center ◽  
Tertiary Care ◽  
Sudden Cardiac Arrest ◽  
Healthcare Facility ◽  
Care Hospital ◽  
Ambulatory Care Setting ◽  
Before And After

Introduction: When sudden cardiac arrest occurs in non-resuscitation focused care settings, bedside clinicians may not intervene prior to dedicated resuscitation team arrival. As perceived self-efficacy (SE) contributes to cognitive functioning, facilitating effective intervention, we developed and evaluated a mock code training approach, First Five (FF) , to enhance bedside responders’ resuscitation task SE using an entity’s defibrillator and manikin. Self-efficacy is knowing that one can perform actions in principle and envision performing the steps to reach a goal. Hypotheses: Participants’ resuscitation SE will improve after FF training; 2) Inpatient (IP) and Ambulatory Care Center (ACC) providers will differ in their pre-SE and post-SE in response to FF training. Methods: Participants enrolled from ACCs and medical-surgical IP units at a large, urban tertiary care hospital from May 2018 to April 2019 completed a de-identified 10-point Likert-scale SE survey before and after they were trained to perform initial bedside resuscitation tasks (Figure 1 x-axis labels). Matched, complete, pre/post data for 85 in-hospital and 107 ACC participants were analyzed via repeated measures multivariate analysis of variance. Results: Patterns of reported change in the seven resuscitation task SE measures of IP personnel differed significantly from those of ACC personnel [Pillai’s Trace = .222, F(7,184)=7.483, p=.0005, partial η 2 = .222]. In both settings, post-session SE measures increased significantly from pre-session SE measures [Pillai’s Trace = .588, F(7,184)=37.438, p=.0005, partial η 2 = .588]. Moreover, though ACC providers consistently reported lower pre-training SE resuscitation task scores, post-training scores from both settings were comparable (Figure 1). Conclusions: First Five training is effective in enhancing resuscitation task SE among inpatient and ambulatory care setting providers that are not resuscitation-focused.

A RETROSPECTIVE STUDY OF BLOOD TRANSFUSION PRACTICES IN A TERTIARY CARE HOSPITAL OF NORTH INDIA.

2021 ◽  
pp. 25-29
Author(s):  
Rakesh Kumar Sharma ◽  
Shahid Anjum Awan ◽  
Vijay Sawhney
Keyword(s):  
Blood Transfusion ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Transfusion Practice ◽  
Blood Bank ◽  
Control Measures ◽  
North India ◽  
Care Hospital ◽  
Important Concern ◽  
Life Saving

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.

The Effects of Ramadan Fasting on Heart Transplant Recipients

2021 ◽  
Author(s):  
Bandar Al-Ghamdi
Keyword(s):  
Heart Transplant ◽  
Tertiary Care ◽  
Case Report Form ◽  
Care Hospital ◽  
Transplant Recipients ◽  
Cross Sectional ◽  
Standard Case ◽  
Ramadan Fasting ◽  
Before And After ◽  
Heart Transplant Recipients

Background: Fasting during Ramadan is considered one of the most sacred Islamic rituals. To our knowledge, there is no data about Ramadan fasting in heart transplant recipients. Objectives: To assess the ability of heart transplant recipients to fast the month of Ramadan and to study the fasting effects on their clinical condition Design: A cross-sectional study of heart transplant recipients attending the heart transplant clinic in the three months following Ramadan in 1439 and 1440 Hijri (May-June 2018 and 2019). Setting: Heart transplant clinic in a tertiary care hospital in the Kingdom of Saudi Arabia. Patients and Methods: Heart transplant recipients attending the heart transplant clinic in the Heart Center at King Faisal Specialist Hospital & Research Center (KFSH&RC), Riyadh. Data about Ramadan fasting was documented using standard case report form (CRF), and data were collected from the medical records about their clinical and laboratory findings before and after Ramadan. Main Outcome Measures: Ability of heart transplant receipts to fast during Ramadan and the effect of fasting on their medical condition. Sample Size: One hundred twenty heart transplant recipients were approached to participate in this study. Ninety-two patients agreed to participate in the study with seventy-eight patients fasted during Ramadan. Results: Seventy-eight patients were able to fast Ramadan (84.8%). In comparison to the months before and after Ramadan, 44 of the fasting patients (56.4%) reported no change in their overall health, 29 patients (37.2%) reported feeling better, and 5 patients (6.4%) reported feeling worse during fasting. Sixty patients (76.9%) reported no significant new symptoms, and 18 patients (23.08%) reported one or more new symptoms. Conclusions: It seems that the majority of heart transplant recipients beyond one year of transplantation can fast Ramadan without having significant medical issues Limitations: The small number of participants and the limitations of cross-sectional design.

scholarly journals EVALUATION OF RATIONAL USE OF ANTIBIOTIC DRUGS IN SURGERY DEPARTMENT AT A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 145-149
Author(s):  
SREEJA NYAYAKAR ◽  
MANDARA MS ◽  
HEMALATHA M ◽  
LALLAWMAWMI ◽  
MOHAMMED SALAHUDDIN ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Care Hospital ◽  
Rational Use ◽  
Post Surgery ◽  
Antibiotic Drugs ◽  
Before And After ◽  
Hospital Patients ◽  
Surgery Department

Objective: Antibiotics are the only drug where use in one patient can impact the effectiveness in another, so antibiotic misuse adversely impacts the patients and society. Improving antibiotic use improves patient outcomes and saves money. Antibiotic resistance has been identified as a major threat by the WHO due to the lack of development of new antibiotics and the increasing infections caused by multidrug resistance pathogens became untreatable. Methods: A prospective observational study was conducted for a period of 6 months. Data were collected from prescriptions and inpatient record files at the surgery department of the tertiary care hospital. Patients above age of 18 years of either gender whose prescription containing the antibiotics and patients who are willing to participate in the study were included in the study. Microsoft Excel was used for recording and analyzing the data of recruited subjects. Results: During our study period, we have collected 100 cases as per inclusion criteria, in total collected 100 cases, 52% are male and 48% are female. The mean age and standard deviation of the study population were found to be 46.61±16.12. The most commonly prescribed classification before and after the surgery is cephalosporin’s that is 57%. Results show that in pre-surgery, almost 93% of prescriptions have chosen the drugs as per ASHP guidelines, whereas in post-surgery, 95% of drugs have selected the drug as per ASHP guidelines. Conclusion: Our study has observed that some of the prescriptions are irrationally prescribed so the pharmacist has to take the responsibility to improve the awareness regarding rational prescribing of antibiotics. The national wide monitoring of antibiotics use, national schemes to obtain rational use of antibiotics, reassessing the prescriptions, education to practitioners, and surveys on antibiotics should be implemented.

scholarly journals Prevalence of anaemia among children under five years in tertiary care hospital of Nepal.

2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Care Hospital ◽  
Cross Sectional ◽  
Children Under Five ◽  
Group Iii ◽  
Under Five ◽  
Group I ◽  
Group Ii

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998

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