scholarly journals A Review of Massive Blood Transfusion and its Associated Syndromes in Zimbabwe

2020 ◽  
Vol 22 (1) ◽  
pp. 23-30
Author(s):  
F. Hlatywayo ◽  
D.D. Marques ◽  
V. Chikwasha ◽  
A. Mandisodza ◽  
S. Shumbairerwa ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Blood Transfusion ◽  
Massive Transfusion ◽  
Red Cells ◽  
Full Blood Count ◽  
Massive Blood Transfusion ◽  
Taux De Mortalité ◽  
Globules Rouges ◽  
Transfusion Massive ◽  
Transfusion Sanguine

Background and objectives: Massive blood transfusion is defined as transfusion approximating or exceeding a patient's total blood volume (5-6 litres in adults) within 24-hours. This procedure is used to manage severely anaemic and bleeding patients. Negative outcomes associatedwith acidosis, hypothermia and coagulopathy may result. The study was carried out to review the management of massive transfusion in Zimbabwe.Materials and methods: A 4-year retrospective clinical laboratory-based study was carried out on patients who had massive blood transfusionat a Zimbabwean hospital, from January 2014 to December 2017. Data was collected from patients’ hospital records after permission from thehospital director.Results: Of the 180 patient records, 145 (80.6%) were from female and 35 (19.4%) from male patients. Massive blood transfusion was done mostly on obstetric patients. Full blood count was the most commonly requested laboratory test, with 155 (86%) requests. Some of the patients had severe anaemia. Routine coagulation tests were significantly abnormal. All patients received packed red cells during the first 24 hours, followed by fresh frozen plasma (57.8%). Platelets, cryoprecipitate and whole blood were infrequently transfused (22%, 3% and 2% respectively). The mortality rate was 25.6% within 24 hours after transfusion. Transfusion of packed red cells alone was significantly associated with mortality (p<0.001) which increased significantly with the use of high numbers of packed red cell units.Conclusion: Massive blood transfusion is associated with a high mortality rate in Zimbabwe. Transfusion of packed red blood cells alone resulted in highest mortality. There was an insufficient use of laboratory tests to monitor massive blood transfusion. This potentially can be addressed by establishing a national massive transfusion protocol for Zimbabwe. French Title: Une revue de la transfusion sanguine massive et de ses syndromes associés au Zimbabwe Contexte et objectifs: La transfusion sanguine massive est définie comme une transfusion se rapprochant ou dépassant le volume sanguin total d'un patient (5-6 litres chez l'adulte) dans les 24 heures. Cette procédure est utilisée pour gérer les patients gravement anémiques et hémorragiques. Des résultats négatifs associés à l'acidose, l'hypothermie et la coagulopathie peuvent en résulter. L'étude a été réalisée pourexaminer la gestion de la transfusion massive au Zimbabwe.Matériel et méthodes: Une étude rétrospective clinique en laboratoire de 4 ans a été menée sur des patients ayant subi une transfusion sanguine massive dans un hôpital du Zimbabwe, de Janvier 2014 à Décembre 2017. Les données ont été collectées à partir des dossiers des patients de l'hôpital après autorisation du Directeur de l'hôpital.Résultats: Sur les 180 dossiers de patients, 145 (80,6%) provenaient de femmes et 35 (19,4%) de patients de sexe masculin. Une transfusion  sanguine massive a été effectuée principalement sur des patientes obstétricales. L'hémogramme complet était le test de laboratoire le plus  demandé, avec 155 (86%) demandes. Certains patients souffraient d'anémie sévère. Les tests de coagulation de routine étaient significativement  anormaux. Tous les patients ont reçu des concentrés de globules rouges au cours des 24 premières heures, suivis de plasma frais congelé (57,8%). Les plaquettes, le cryoprécipité et le sang total ont été rarement transfusés (22%, 3% et 2% respectivement). Le taux de mortalité était de 25,6%  dans les 24 heures suivant la transfusion. La transfusion de concentrés de globules rouges seule était significativement associée à la mortalité (p<0,001) qui augmentait significativement avec l'utilisation d'un nombre élevé d'unités.Conclusion: La transfusion sanguine massive est associée à un taux de mortalité élevé au Zimbabwe. La transfusion de concentrés de globules rouges seule a entraîné la mortalité la plus élevée. Les tests de laboratoire étaient insuffisants pour surveiller les transfusions sanguines massives. Cela peut potentiellement être résolu en établissant un protocole national de transfusion massive pour le Zimbabwe

Massive Transfusion in a Child

2018 ◽  
Author(s):  
Rachel Chapman ◽  
Stefano Sabato
Keyword(s):  
At Risk ◽  
Liver Transplantation ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Massive Transfusion ◽  
Vascular Structure ◽  
Blood Products ◽  
Process Knowledge ◽  
Massive Blood Transfusion ◽  
Laboratory Results

Massive transfusion in a child is likely to occur in cases of trauma or during surgeries that are at risk for severe blood loss such as liver transplantation and craniofacial procedures. It may also occur when least expected, if inadvertent injury to a vascular structure occurs during surgery. Ability to enlist assistance with administration of the various blood products required and also with checking frequent laboratory results will facilitate the process. Knowledge of the different factors that rapidly become depleted as well as lab values that need to be closely monitored is necessary to avoid further complications during massive blood transfusion.

Massive blood transfusion exceeding 50 units of plasma poor red cells or whole blood: the survival rate and the occurrence of leukopenia and acidosis

Injury ◽  
1999 ◽  
Vol 30 (9) ◽  
pp. 619-622 ◽  
Author(s):  
Pertti Hakala ◽  
Seppo Hiippala ◽  
Martti Syrjälä ◽  
Tarja Randell
Keyword(s):  
Survival Rate ◽  
Blood Transfusion ◽  
Whole Blood ◽  
Red Cells ◽  
Massive Blood Transfusion

scholarly journals Massive Transfusion Protocol Over-Activation

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S164-S165
Author(s):  
M Abdelmonem ◽  
H Wasim ◽  
M Abdelmonem
Keyword(s):  
Blood Transfusion ◽  
Blood Cells ◽  
Blood Product ◽  
Massive Transfusion ◽  
Labor And Delivery ◽  
Massive Blood Transfusion ◽  
Packed Red Blood Cells ◽  
Massive Transfusion Protocol ◽  
The Difference ◽  
Transfusion Protocol

Abstract Introduction/Objective Massive blood transfusion protocol (MTP) is revealed in many cases, such as massive hemorrhage after surgeries, trauma settings, and labor and delivery. Patients who require blood transfusion of more than ten units of packed red blood cells in 24 hours or transfusion of more than four units of packed red blood cells (PRBCs) in one hour are the massive blood transfusion protocol candidates. Methods/Case Report A retrospective study was performed at a 225-bed level III trauma center in California. The overall massive blood transfusion protocol utilization, blood product emergency release, and blood product waste were recorded twelve months before and after launching an educational and collaboration program between blood banks and clinicians about the difference between massive transfusion protocol and blood emergency release. Results (if a Case Study enter NA) MTP utilization for the 12 months (June 2017 to June 2018) was demonstrated as 59 MTP activations: 32 MTPs from the emergency department, 4 MTPs from inpatient floors, 3 MTPs from labor and delivery, and 4 MTPs from operating rooms while the blood product emergency releases were 7 emergency releases. MTP utilization from (June 2018 to June 2019) was demonstrated as 15 MTP activations: 11 MTPs from the emergency department, 2 MTPs from inpatient floors, 1 MTPs from labor and delivery, and 1 MTPs from operating rooms, while the blood product emergency releases were 43 emergency releases. The blood product waste was reduced by 44.6% in 2018. Conclusion There was a significant reduction in MTP activation and blood product waste after implementing the educational program for the clinicians. The collaboration between the blood bank and the clinicians and coordinating educational sessions for clinicians about the difference between MTP and emergency release and the negative impact of the MTP over-activation on the blood product waste and the clinical laboratory scientists in the blood bank is vital in MTP utilization.

scholarly journals ABC of transfusion. Massive blood transfusion.

BMJ ◽  
1990 ◽  
Vol 300 (6717) ◽  
pp. 107-109 ◽  
Author(s):  
P E Hewitt ◽  
S J Machin
Keyword(s):  
Blood Transfusion ◽  
Massive Blood Transfusion ◽  
Transfusion Massive

scholarly journals Red Cell Storage Duration Does Not Affect Outcome after Massive Blood Transfusion in Trauma and Nontrauma Patients: A Retrospective Analysis of 305 Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Alexander Bautista ◽  
Theodore B. Wright ◽  
Janice Meany ◽  
Sunitha K. Kandadai ◽  
Benjamin Brown ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Mortality ◽  
Massive Transfusion ◽  
Prolonged Storage ◽  
Storage Duration ◽  
Massive Blood Transfusion ◽  
Packed Red Blood Cells ◽  
Storage Effects ◽  
Secondary Hypothesis ◽  
The Relationship

Background. Prolonged storage of packed red blood cells (PRBCs) may increase morbidity and mortality, and patients having massive transfusion might be especially susceptible. We therefore tested the hypothesis that prolonged storage increases mortality in patients receiving massive transfusion after trauma or nontrauma surgery. Secondarily, we considered the extent to which storage effects differ for trauma and nontrauma surgery.Methods. We considered surgical patients given more than 10 units of PRBC within 24 hours and evaluated the relationship between mean PRBC storage duration and in-hospital mortality using multivariable logistic regression. Potential nonlinearities in the relationship were assessed via restricted cubic splines. The secondary hypothesis was evaluated by considering whether there was an interaction between the type of surgery (trauma versus nontrauma) and the effect of storage duration on outcomes.Results. 305 patients were given a total of 8,046 units of PRBCs, with duration ranging from 8 to 36 days (mean ± SD:22±6days). The odds ratio [95% confidence interval (CI)] for in-hospital mortality corresponding to a one-day in mean PRBC storage duration was 0.99 (0.95, 1.03,P=0.77). The relationship did not differ for trauma and nontrauma patients (P=0.75). Results were similar after adjusting for multiple potential confounders.Conclusions. Mortality after massive blood transfusion was no worse in patients transfused with PRBC stored for long periods. Trauma and nontrauma patients did not differ in their susceptibility to prolonged PRBC storage.

scholarly journals Peripartum cardiomyopathy and massive transfusion due to postpartum hemorrhage: was it associated with each other?    

2021 ◽  
Author(s):  
Raissa Virgy Rianda ◽  
Amelya Armadani ◽  
Rama Azalix Rianda ◽  
Eka Prasetya Budi Mulia ◽  
M Sukmana
Keyword(s):  
Pleural Effusion ◽  
Blood Transfusion ◽  
Postpartum Hemorrhage ◽  
Massive Transfusion ◽  
Systolic Function ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Lung Edema ◽  
Massive Blood Transfusion ◽  
History Of

Background: Peripartum cardiomyopathy (PPCM) is a potentially life-threatening pregnancy-associated disease marked by left ventricular dysfunction and heart failure (HF). Clinical findings of HF are often masked by the normal physiological changes seen in pregnancy, making the diagnosis challenging. Furthermore, postpartum hemorrhage followed by massive blood transfusion may mask the diagnosis of PPCM or worsen the decompensated HF. Case Description: We report a 35-year-old postpartum gemelli woman with a history of massive postpartum hemorrhage due to atonia uteri and Disseminated Intravascular Coagulation, complain of shortness of breath and fever. The patient received a massive blood transfusion for her massive postpartum hemorrhage. Physical examination revealed tachypnea and bilateral rales at lung bases. Chest radiographs showed cardiomegaly, right pleural effusion, and early lung edema. The echocardiography showed a decrease in left ventricular systolic function with ejection fraction of 41%, diastolic dysfunction, and global hypokinetic. She was diagnosed with PPCM, acute lung edema, pleural effusion, and pneumonia. Patient was treated with Furosemide continuous pump, Spironolactone, Bisoprolol, Valsartan. Her dyspnea greatly decrased with diuresis and antibiotic. She was discharged with HF medication continued. Discussion: Women with PPCM typically present with symptoms of HF and signs of congestion. History of massive blood transfusion at first can mask the diagnosis of PPCM due to the possibility of Transfusion Associated Circulatory Overload, which also has signs of congestion. Massive blood transfusion can increase preload and may worsen the decompensated HF. Conclusion: The presence of massive transfusion in a patient with PPCM can be challenging in diagnosing PPCM itself and the unpredictable course of decompensated HF in peripartum mothers. Due to its high mortality rate without proper treatment, prompt investigation is essential in improving maternal survival.

scholarly journals Indication and Outcomes of Paediatric Blood Transfusion at Three Hospitals in Gabon, Africa

2020 ◽  
Vol 22 (1) ◽  
pp. 10-13
Author(s):  
M.M. Mimbila ◽  
R.S. Minto’o ◽  
M.N.E. Mintsa ◽  
K.E. Kuissi ◽  
U. Bisvigou ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Severe Anaemia ◽  
World Health ◽  
Cell Disease ◽  
Packed Red Blood Cells ◽  
Life Saving ◽  
The Mean ◽  
Globules Rouges ◽  
Health Organization ◽  
Transfusion Sanguine

Introduction: Blood transfusion is a life-saving treatment for severely anaemic children both in developed and developing countries. In this study we describe transfusions in paediatric settings of Gabon, Africa including clinical indications and subsequent outcomes.Methods: This prospective descriptive study was conducted in the cities of Libreville and Lambaréné from 1 January to 30 September 2016.Children between the ages of 1 month and 15 years, who were hospitalised and transfused were included in the study.Results: We included 287 children who represented 17.1% of all hospitalised children. The male:female ratio was 0.95 and the average age was 3.7 years. Packed red blood cells (PRBC) were administered to 99.3% of anaemic patients. World Health Organization (WHO) defined severe anaemia (haemoglobin (Haemoglobin) <7 g/dL) was the main indication (95.1%) with the mean haemoglobin (Hb) level pretransfusion being 5.1 g/dL ± 2.7 g/dL, and post-transfusion haemoglobin gain being 2.9 g/dL ± 1.2 g/dL. Malaria was present in 79% of transfused patients and 46.9% of children screened were homozygous for sickle cell disease. No post-transfusion incident was reported although reporting may have been incomplete.Conclusion: Blood transfusion is frequent in our context; the clinical outcome is mostly favourable. French Title: Indication et Résultats de la Transfusion Sanguine Pédiatrique Dans Trois Hôpitaux au Gabon, en Afrique Introduction: La transfusion sanguine est un traitement salvateur pour les enfants gravement anémiés dans les pays développés ou endéveloppement. Dans cette étude, nous décrivons les transfusions en milieu pédiatrique du Gabon, en Afrique, y compris les indicationscliniques et les résultats.Méthodes: Cette étude descriptive prospective a été réalisée dans les villes de Libreville et Lambaréné du 1er janvier au 30 septembre 2016.Les enfants âgés de 1 mois à 15 ans, hospitalisés et transfusés ont été inclus dans l'étude.Résultats: Nous avons inclus 287 enfants qui représentaient 17.1% de tous les enfants hospitalisés. Le rapport garçons/filles était de 0.95 etl'âge moyen était de 3.7 ans. Des concentrés de globules rouges (CGR) ont été administrés à 99.3% des patients anémiques. L’anémie définiepar l’Organisation Mondiale de la Santé (OMS) (hémoglobine <7 g/dL) était la principale indication (95.1%), le taux moyen d'hémoglobine(Hb) avant transfusion étant de 5.1 g/dL ± 2.7 g/dL, et le gain d'hémoglobine après transfusion était de 2.9 g/dL ± 1.2 g/dL. Le paludisme étaitprésent chez 79% des patients transfusés et 46.9% des enfants dépistés étaient homozygotes pour la drépanocytose. Aucun incident post transfusionnel n'a été signalé, bien que le signalement ait pu être incomplet.Conclusion: La transfusion sanguine est fréquente dans notre contexte; l'issue clinique est généralement favorable.  

Massive Blood Transfusion after the First Cut in Liver Transplantation Predicts Renal Outcome and Survival after Transplantation

2012 ◽  
Vol 94 (10S) ◽  
pp. 420
Author(s):  
B. Reichert ◽  
T. Becker ◽  
M. Kleine ◽  
L. Zachau ◽  
C. Schumacher ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Blood Transfusion ◽  
Renal Outcome ◽  
Massive Blood Transfusion
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