DİCLE ÜNİVERSİTESİ TIP FAKÜLTESİ ARAŞTIRMA HASTANESİ ACİL SERVİSİNDE YAPILAN KAN VE KAN ÜRÜNLERİ TRANSFÜZYONLARININ DEĞERLENDİRİLMESİ

2021 ◽  
Vol 8 (16) ◽  
pp. 36-48
Author(s):  
Hüseyin Gürbüz ◽  
Yılmaz Zengin ◽  
Ercan Gündüz ◽  
Hasan Mansur Durgun ◽  
Recep Dursun ◽  
...  
Keyword(s):  
Emergency Department ◽  
Demographic Data ◽  
Fresh Frozen Plasma ◽  
Blood Product Transfusion ◽  
Blood Products ◽  
Platelet Suspension ◽  
Hospital Emergency Service ◽  
Specific Protocol ◽  
Fresh Frozen

This study was designed prospectively to investigate the demographic data of the patients who had blood and blood products in Dicle University Medical Faculty Research Hospital Emergency Service between 01 November 2014- 01 November 2015, also to investigate the indications for blood products used, the amount and the type of the products used. When we look at the diagnosis of patients who underwent transfusion in the emergency department; It was determined that 26.2% were transfused for malignancy, 32.6% for anemia, 18.3% for trauma, 12.5% for GIS bleeding, and 10.4% for other reasons. The patients who had blood product transfusion were 623; 53.8% were male and 46.2% were female. The mean age of the patients was determined 47.87±23.66. The percentage of transfused blood products were as following: 83.6% erythrocyte suspension (ES), 17.3% fresh frozen plasma (FFP), 17.3 % platelet suspension(PS), 0.6% whole blood(WB), %4.3 other blood components (OBC). As a result, we can say that in our study, a large number of transfusions were performed in the emergency department, a specific protocol was not adhered to in determining the indication, and transfusion was performed in support of patients who were mostly under outpatient follow-up. Emergency transfusion decisions should be performed with true emergency indication, follow-up with clinical response rather than laboratory response, and consciousness about the aim of transfusion.

scholarly journals Fresh Frozen Plasma versus Crystalloid Priming of Cardiopulmonary Bypass Circuit in Pediatric Surgery

2020 ◽  
Vol 132 (1) ◽  
pp. 95-106 ◽  
Author(s):  
Audrey Dieu ◽  
Maria Rosal Martins ◽  
Stephane Eeckhoudt ◽  
Amine Matta ◽  
David Kahn ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Postoperative Bleeding ◽  
Fresh Frozen Plasma ◽  
Postoperative Blood Loss ◽  
Blood Product Transfusion ◽  
Blood Products ◽  
Packed Red Blood Cells ◽  
Number Of Patients ◽  
Fresh Frozen ◽  
Frozen Plasma

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background In congenital cardiac surgery, priming cardiopulmonary bypass (CPB) with fresh frozen plasma (FFP) is performed to prevent coagulation abnormalities. The hypothesis was that CPB priming with crystalloids would be different compared with FFP in terms of bleeding and/or need for blood product transfusion. Methods In this parallel-arm double-blinded study, patients weighing between 7 and 15 kg were randomly assigned to a CPB priming with 15 ml · kg−1 PlasmaLyte or 15 ml · kg−1 FFP in addition to a predefined amount of packed red blood cells used in all patients. The decision to transfuse was clinical and guided by point-of-care tests. The primary endpoints included postoperative bleeding tracked by chest tubes, number of patients transfused with any additional blood products, and the total number of additional blood products administered intra- and postoperatively. The postoperative period included the first 6 h after intensive care unit arrival. Results Respectively, 30 and 29 patients in the FFP and in the crystalloid group were analyzed in an intention-to-treat basis. Median postoperative blood loss was 7.1 ml · kg−1 (5.1, 9.4) in the FFP group and 5.7 ml · kg−1 (3.8, 8.5) in the crystalloid group (P = 0.219); difference (95% CI): 1.2 (−0.7 to 3.2). The proportion of patients additionally transfused was 26.7% (8 of 30) and 37.9% (11 of 29) in the FFP and the crystalloid groups, respectively (P = 0.355; odds ratio [95% CI], 1.7 [0.6 to 5.1]). The median number of any blood products transfused in addition to priming was 0 (0, 1) and 0 (0, 2) in the FFP and crystalloid groups, respectively (P = 0.254; difference [95% CI], 0 [0 to 0]). There were no study-related adverse events. Conclusions The results demonstrate that in infants and children, priming CPB with crystalloids does not result in a different risk of postoperative bleeding and need for transfusion of allogeneic blood products.

scholarly journals Outcome of Major Hemorrhage at a Major Cardiothoracic Center in Patients with Activated Major Hemorrhage Protocol versus Nonactivated Protocol

2021 ◽  
Vol 47 (01) ◽  
pp. 074-083
Author(s):  
Kathryn W. Chang ◽  
Steve Owen ◽  
Michaela Gaspar ◽  
Mike Laffan ◽  
Deepa R. J. Arachchillage
Keyword(s):  
Fresh Frozen Plasma ◽  
Electronic Records ◽  
Blood Products ◽  
Major Hemorrhage ◽  
Fresh Frozen ◽  
Dilutional Coagulopathy ◽  
Baseline Characteristics ◽  
The Impact ◽  
Frozen Plasma ◽  
Baseline Hemoglobin

AbstractThis study aimed to determine the impact of major hemorrhage (MH) protocol (MHP) activation on blood administration and patient outcome at a UK major cardiothoracic center. MH was defined in patients (> 16 years) as those who received > 5 units of red blood cells (RBCs) in < 4 hours, or > 10 units in 24 hours. Data were collected retrospectively from patient electronic records and hospital transfusion databases recording issue of blood products from January 2016 to December 2018. Of 134 patients with MH, 24 had activated MHP and 110 did not have activated MHP. Groups were similar for age, sex, baseline hemoglobin, platelet count, coagulation screen, and renal function with no difference in the baseline clinical characteristics. The total number of red cell units (median and [IQR]) transfused was no different in the patients with activated (7.5 [5–11.75]) versus nonactivated (9 [6–12]) MHP (p = 0.35). Patients in the nonactivated MHP group received significantly higher number of platelet units (median: 3 vs. 2, p = 0.014), plasma (median: 4.5 vs. 1.5, p = 0.0007), and cryoprecipitate (median: 2 vs. 1, p = 0.008). However, activation of MHP was associated with higher mortality at 24 hours compared with patients with nonactivation of MHP (33.3 vs. 10.9%, p = 0.005) and 30 days (58.3 vs. 30.9%, p = 0.01). The total RBC and platelet (but not fresh frozen plasma [FFP]) units received were higher in deceased patients than in survivors. Increased mortality was associated with a higher RBC:FFP ratio. Only 26% of patients received tranexamic acid and these patients had higher mortality at 30 days but not at 24 hours. Deceased patients at 30 days had higher levels of fibrinogen than those who survived (median: 2.4 vs. 1.8, p = 0.01). Patients with activated MHP had significantly higher mortality at both 24 hours and 30 days despite lack of difference in the baseline characteristics of the patients with activated MHP versus nonactivated MHP groups. The increased mortality associated with a higher RBC:FFP ratio suggests dilutional coagulopathy may contribute to mortality, but higher fibrinogen at baseline was not protective.

Liver Failure in a Dog Following Suspected Ingestion of Blue-Green Algae (Microcystis spp.): A Case Report and Review of the Toxin

2013 ◽  
Vol 49 (5) ◽  
pp. 342-346 ◽  
Author(s):  
Lionel Sebbag ◽  
Nicole Smee ◽  
Deon van der Merwe ◽  
Dustin Schmid
Keyword(s):  
Green Algae ◽  
Acute Hepatic Failure ◽  
Fresh Frozen Plasma ◽  
Blue Green Algae ◽  
Fresh Frozen ◽  
Adenosyl Methionine ◽  
B Complex Vitamins ◽  
Time Of Admission ◽  
Frozen Plasma

A 2.5 yr old spayed female Weimaraner presented after ingestion of blue-green algae (Microcystis spp.). One day prior to presentation, the patient was swimming at a local lake known to be contaminated with high levels of blue-green algae that was responsible for deaths of several other dogs the same summer. The patient presented 24 hr after exposure with vomiting, inappetence, weakness, and lethargy. Blood work at the time of admission was consistent with acute hepatic failure, characteristic findings of intoxication by Microcystis spp. Diagnosis was suspected by analyzing a water sample from the location where the patient was swimming. Supportive care including fluids, fresh frozen plasma, whole blood, vitamin K, B complex vitamins, S-adenosyl methionine, and Silybum marianum were started. The patient was discharged on supportive medications, and follow-up blood work showed continued improvement. Ingestion is typically fatal for most patients. This is the first canine to be reported in the literature to survive treatment after known exposure.

scholarly journals Concurrent Spontaneous Sublingual and Intramural Small Bowel Hematoma due to Warfarin Use

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Gül Pamukçu Günaydın ◽  
Hatice Duygu Çiftçi Sivri ◽  
Serkan Sivri ◽  
Yavuz Otal ◽  
Ayhan Özhasenekler ◽  
...  
Keyword(s):  
Emergency Department ◽  
Small Bowel ◽  
Warfarin Therapy ◽  
International Normalized Ratio ◽  
Fresh Frozen Plasma ◽  
Close Monitoring ◽  
Observation Unit ◽  
Fresh Frozen ◽  
Tomography Scan ◽  
Frozen Plasma

Introduction. We present a case of concurrent spontaneous sublingual and intramural small bowel hematoma due to warfarin anticoagulation.Case. A 71-year-old man presented to the emergency department complaining of a swollen, painful tongue. He was on warfarin therapy. Physical examination revealed sublingual hematoma. His international normalized ratio was 11.9. The computed tomography scan of the neck demonstrated sublingual hematoma. He was admitted to emergency department observation unit, monitored closely; anticoagulation was reversed with fresh frozen plasma and vitamin K. 26 hours after his arrival to the emergency department, his abdominal pain and melena started. His abdomen tomography demonstrated intestinal submucosal hemorrhage in the ileum. He was admitted to surgical floor, monitored closely, and discharged on day 4.Conclusion. Since the patient did not have airway compromise holding anticoagulant, reversing anticoagulation, close monitoring and observation were enough for management of both sublingual and spontaneous intramural small bowel hematoma.

scholarly journals Effects of implementing rotational thromboelastometry in cardiac surgery: A retrospective cohort study

2021 ◽  
pp. 175045892095066
Author(s):  
Minna Kallioinen ◽  
Mika Valtonen ◽  
Marko Peltoniemi ◽  
Ville-Veikko Hynninen ◽  
Tuukka Saarikoski ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Prothrombin Complex Concentrate ◽  
Fresh Frozen Plasma ◽  
Blood Products ◽  
Rotational Thromboelastometry ◽  
Number Of Patients ◽  
Fresh Frozen ◽  
The Mean ◽  
To Receive ◽  
Frozen Plasma

Since 2013, rotational thromboelastometry has been available in our hospital to assess coagulopathy. The aim of the study was to retrospectively evaluate the effect of thromboelastometry testing in cardiac surgery patients. Altogether 177 patients from 2012 and 177 patients from 2014 were included. In 2014, the thromboelastometry testing was performed on 56 patients. The mean blood drainage volume decreased and the number of patients receiving platelets decreased between 2012 and 2014. In addition, the use of fresh frozen plasma units decreased, and the use of prothrombin complex concentrate increased in 2014. When studied separately, the patients with a thromboelastometry testing received platelets, fresh frozen plasma, fibrinogen and prothrombin complex concentrate more often, but smaller amounts of red blood cells. In conclusion, after implementing the thromboelastometry testing to the practice, the blood products were given more cautiously overall. The use of thromboelastometry testing was associated with increased possibility to receive coagulation product transfusions. However, it appears that thromboelastometry testing was mostly used to assist in management of major bleeding.

scholarly journals DIFFERENCES IN CHANGES OF HEMOGLOBIN BETWEEN 6-12 HOURS AND 12-14 HOURS AFTER TRANSFUSION

2018 ◽  
Vol 24 (2) ◽  
pp. 108
Author(s):  
Rosita Linda ◽  
Devita Ninda
Keyword(s):  
Blood Transfusion ◽  
Secondary Data ◽  
Hemoglobin Concentration ◽  
Fresh Frozen Plasma ◽  
Blood Components ◽  
Blood Products ◽  
Fresh Frozen ◽  
Frozen Plasma ◽  
Hemoglobin Measurement ◽  
Baseline Hemoglobin

Each year more than 41,000 blood donations are needed every day and 30 million blood components are transfused. Blood products that can be transfused include Packed Red Cells (PRC), Whole Blood (WB), Thrombocyte Concentrate (TC), Fresh Frozen Plasma (FFP). Monitoring Hemoglobin (Hb) after transfusion is essential for assessing the success of a transfusion. The time factor after transfusion for Hemoglobin (Hb) examination needs to be established, analyze to judge the success of a blood transfusion which is performed. The aim of this study was to analyze the differences in changes of hemoglobin between 6-12 hours, and 12-24 hours after-transfusion. This study was retrospective observational using secondary data. The subjects were patients who received PRC, and WBC transfusion. At 6-12, and 12-24 hours after-transfusion, hemoglobin, RBC, and hematocrit were measured. Then the data were analyzed by unpaired t-test. The collected data included the results of the Hb pre-transfusion, 6-12, and 12-24 hours after-transfusion. The subjects of this study were 98 people. The administration of transfusion increased by 10-30% in hemoglobin concentration at 6-12 hours after-transfusion. While at 12-24 hours after-transfusion, hemoglobin after-transfusion increased 15-37% from the baseline. Hemoglobin values were not different at any of the defined after-transfusion times (p = 0.76 (p>0.05)). Hemoglobin values were not different at 6-12 hours, and 12-24 hours after-transfusion.    Keywords: Hemoglobin, measurement, after-transfusion 

Identification of Wasted Blood Products at Staten Island University Hospital in 2020 and Institutional Efforts to Reduce Wastage

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S156-S157
Author(s):  
M Toprak ◽  
I M Asuzu ◽  
G Morvillo ◽  
F Kiran ◽  
B Chae ◽  
...  
Keyword(s):  
Shelf Life ◽  
Blood Product ◽  
Low Cost ◽  
Fresh Frozen Plasma ◽  
University Hospital ◽  
Blood Component ◽  
Blood Products ◽  
Staten Island ◽  
Team Members ◽  
Fresh Frozen

Abstract Introduction/Objective Blood products are precious resources obtained from donors who donate with the intention to help people. These blood products however do not always go to the patients, instead sometimes ending up in the waste. It is inevitable to have some degree of the wastage due to limited blood product shelf life, the inherent need to have stock on hand at all times, and the often unpredictable demand of these products. However, it is possible to minimize the wastage of blood products with careful management of inventories, proper documentation, and education1. In this study, we aim to identify the amount and cost of wasted blood products at Staten Island University Hospital in 2020, the reasons behind the wastage, and solutions to reduce the wastage. Methods/Case Report A retrospective statistical analysis of blood product waste data in 2020 was performed manually with Microsoft Excel. Wastage rate and average cost was calculated, the reasons behind the wastage were identified, and low cost interventions to reduce wastage were planned. Results (if a Case Study enter NA) Total number of the wasted blood product is 425 which represents 3.8% of the total inventory at a total cost of $ 97,309.46 which does not include the hours spend by the lab personnel for the wasted products. The most wasted blood component is fresh frozen plasma (FFP) (Table 1). Thawing the frozen blood products (FFP and cryoprecipitate) significantly shortens the shelf life and triggers a lot of wastage through expiration (Table 2). 32.5 % of the wasted products are wasted due to expiration on the shelf (Diagram 1). Other reasons for the wastage includes patient unreadiness, patient refusal, late return of unused products etc. (Graph 1). Conclusion Educating clinical and laboratory team members about the reasons for wasted blood products and strategies to reduce it might significantly reduce the wastage. Appropriate activation and immediate deactivation of massive transfusion protocol (MTP) would be one of the most important aspect of this education. Expired thawed blood product is the largest contributor to wastage, and MTP is the main reason for thawing. Preventing unnecessary MTP activation minimizes over-thawing and therefore minimizes the expiration and wastage. Documentation of the wasted blood product should be improved to better identify the reasons behind wastage.

Transfusion of blood products

2016 ◽  
Author(s):  
Alison Smith
Keyword(s):  
Blood Transfusion ◽  
Carrying Capacity ◽  
Blood Cells ◽  
Fresh Frozen Plasma ◽  
Major Haemorrhage ◽  
Blood Products ◽  
Unlimited Supply ◽  
Fresh Frozen ◽  
Oxygen Carrying Capacity ◽  
Frozen Plasma

The transfusion of blood products may be required in the pre- and post-operative periods. However, there are inherent risks associated with blood transfusion, and there is not an unlimited supply of blood donations available. When a patient is anaemic, red blood cells should be transfused to maintain the oxygen-carrying capacity of blood. Blood products, such as platelets and fresh frozen plasma, are transfused to correct a coagulopathy and during major haemorrhage. This chapter reviews the physiology of blood, including ABO compatibility and rhesus status, the main blood products available for transfusion, and transfusion policy, including the treatment of major haemorrhage and the refusal of blood products.

Thrombin Generation in Newborn Plasma Is Critically Dependent on the Concentration of Prothrombin

1990 ◽  
Vol 63 (01) ◽  
pp. 027-030 ◽  
Author(s):  
Maureen Andrew ◽  
Barbara Schmidt ◽  
Lesley Mitchell ◽  
Bosco Paes ◽  
Frederick Ofosu
Keyword(s):  
Thrombin Generation ◽  
Fresh Frozen Plasma ◽  
Factor Ix ◽  
Blood Products ◽  
Platelet Concentrates ◽  
Term Infants ◽  
Cord Plasma ◽  
Coagulation Proteins ◽  
Fresh Frozen ◽  
Frozen Plasma

SummaryThe ability to generate thrombin is decreased and delayed in plasma from the healthy newborn infant compared to the adult. Only 30 to 50% of peak adult thrombin activity can be produced in neonatal plasma. To test whether this observation can be explained by the low neonatal levels of the contact or vitamin K dependent factors, we measured neonatal thrombin generation after raising the concentration of these factors to adult values. We also determined whether the addition of a variety of blood products to neonatal plasma improved thrombin generation. An amidolytic method was used to quantitate intrinsic (APTT) and extrinsic (PT) pathway thrombin generation in defibrinated pooled cord plasma from healthy term infants. Added individually, factors VII, IX, X or the contact factors (CF) failed to alter the rate or the total amount of thrombin generated in neonatal plasma. In contrast, the addition of prothrombin increased the total amount of thrombin generated to above adult values in both the APTT and the PT systems but did not alter the rate of thrombin generation. The rate of thrombin generation in cord plasma shortened after a combination of II, IX, X and CF was added to the APTT system or II, VII and X to the PT system. In both systems, the total amount of thrombin generated was linearly related to the initial prothrombin concentration. Each of fresh frozen plasma, cryoprecipitate, plasma from platelet concentrates, or factor IX concentrate (in amounts used therapeutically) caused an increase in the total amount of thrombin generated which was related to the increase in prothrombin concentration. Thus, the total amount of thrombin generated in newborn plasma is critically dependent on the prothrombin concentration whereas the rate at which thrombin is generated is dependent on the levels of many other coagulation proteins in combination.

IVH in VLBW Preterm Babies – Therapy with Recombinant Activated F VII?

2017 ◽  
Vol 229 (06) ◽  
pp. 335-341 ◽  
Author(s):  
Matthias Knüpfer ◽  
Jenny Ritter ◽  
Ferdinand Pulzer ◽  
Corinna Gebauer ◽  
Nadine Wolf ◽  
...  
Keyword(s):  
Very Low Birth Weight ◽  
Demographic Data ◽  
Fresh Frozen Plasma ◽  
Coagulation Cascade ◽  
Factor Vii ◽  
Control Group ◽  
Posthemorrhagic Hydrocephalus ◽  
Activated Factor Vii ◽  
Fresh Frozen ◽  
Group A

Abstract Backround Intraventricular hemorrhage (IVH) remains a dangerous and frequent complication in very low birth weight (VLBW) infants. Activated factor VII (aFVII) activates the coagulation cascade and is a potential tool for stopping active bleeding, including limiting the extent of an IVH. This retrospective treatment observation compared data for infants with IVH progression treated with fresh frozen plasma (FFP) alone or with a combination of FFP and aFVII. Methods/Intervention All infants were subject to cranial ultrasonography at least twice daily. When an IVH was detected, treatment with FFP (5–20 ml/kg every 4–6 h) was commenced and the parents were informed. If the parents endorsed aFVII treatment and the IVH showed progress, aFVII (30–50 µg/kg body weight 4–6 times within 16–24 h) was given. Otherwise, infants were treated with FFP only. We compared the course of IVH between the aFVII+FFP treated infants and a control group (FFP only). Results 35 patients throughout were included in the analysis (17 control and 18 aFVII group). Demographic data was not different between groups. The progress of IVH was significantly less in the aFVII group (p<0.01). During the hospital stay, 2 of the infants in the aFVII group died compared to 4 in the control group. A posthemorrhagic hydrocephalus developed in 3 aFVII and 6 control infants. All other outcome parameters and follow-up-results 2 years after treatment did not differ significantly. Conclusion These data show that in the case of a progressing IVH, aFVII may be a candidate for limiting its extent. A prospective randomized trial is warranted.

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