A Procedure for Rapid Issue of Red Cells for Emergency Use

2005 ◽  
Vol 129 (4) ◽  
pp. 492-496
Author(s):  
Richard B. Weiskopf ◽  
Mary Webb ◽  
Deena Stangle ◽  
Gunter Klinbergs ◽  
Pearl Toy
Keyword(s):  
Red Blood Cells ◽  
Operating Room ◽  
Blood Cells ◽  
Blood Bank ◽  
Red Cells ◽  
University Hospital ◽  
Delivery Time ◽  
Delivery Times ◽  
The Times ◽  
Time Required

Abstract Context.—A College of American Pathologists Q-Probe revealed that the median turnaround times for emergency requests for red blood cells from the operating room were 30 minutes to release of cells from the blood bank and 34 minutes to delivery to the operating room. These times may not be adequate to permit the red cells to provide sufficiently rapid delivery of oxygen in massively bleeding patients. Objective.—To improve the time from emergency request for red cells to delivery to the operating room. Design.—A new emergency issue program was implemented for only the operating rooms; emergency issue to all other hospital locations remained unchanged. Six units of group O Rh-negative red blood cells (RBCs) are maintained in the blood bank in a separate basket with transfusion forms containing the unit numbers and expiration dates and a bag with one blood tubing segment from each unit. The times to issue and to delivery to the operating room suite were compared with time to issue of 2 group O Rh-negative RBCs for other hospital locations using the older system during the same time period and with the time to issue of 2 units to all other hospital locations during the preceding 2 years. Setting.—A university hospital. Main Outcome Measures.—Time between emergency request for red cells and delivery to the operating room. Results.—The time between blood bank notification and arrival in the operating room of the 6 units of RBCs was significantly shorter than the time required to just issue (not including delivery time) 2 units of RBCs to other hospital locations. With the new procedure, 82% of units issued reached the operating room within 2 minutes of request, 91% arrived within 3 minutes, and 100% arrived within 4 minutes. These percentages are significantly higher than those for only issue of blood (without delivery) using the older issuing procedure for all hospital locations during the previous 2 years (37%, 49%, and 66%, respectively; P = .007, .009, and .02, respectively) and for other locations during the same 7-month period (29%, 46%, and 73%, respectively; P = .004, .01, and .09, respectively). Time (mean [95% confidence interval]) from blood bank notification to delivery of RBCs to the operating room suite (2.1 [1.6–2.6] minutes, of which approximately 50–60 seconds is attributable to delivery time) was less than issue times (not including delivery times) using the older issuing procedure for other hospital locations during the same period (4.1 [3.1–5.0] minutes; P = .007). Conclusions.—An emergency issue procedure can be used to issue several units of RBCs within 1 minute and have them delivered to the operating room within 2 minutes while maintaining sufficient controls and providing required information to satisfy patient and blood bank requirements.

scholarly journals ANALYSIS OF LACTIC AND HEMATOCRIT LEVELS OF BLOOD STORAGE IN DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL BLOOD BANK

2019 ◽  
Vol 25 (3) ◽  
pp. 318
Author(s):  
Rysna Wahyu ◽  
Asvin Nurulita ◽  
Rachmawati Muhidin
Keyword(s):  
Red Blood Cells ◽  
General Hospital ◽  
Blood Cells ◽  
Statistical Tests ◽  
Blood Bank ◽  
Red Cells ◽  
Wilcoxon Test ◽  
Hematocrit Level ◽  
Fresh Blood ◽  
Significant Difference

The components of Packed Red Cells (PRC) are transfused to patients in order to repair oxygen transportation to tissues. The blood is stored at 2-6oC to delay red blood cells metabolism during storage. Red blood cells undergo structural and functional changes biochemically which affect their viability and function. This is a prospective cohort study with time series design. Samples were taken from fresh blood PRC which were moved to transfer bag for approximately 20 mL, then stored in the refrigerator. Lactic acid and hematocrit levels were assessed with spectrophotometry and flow cytometry methods on day 1, day 4, and day 8 of storage in the Dr. Wahidin Sudirohusodo General Hospital Blood Bank. Statistical tests used were Friedman and Wilcoxon. Statistical results are significant if p < 0.05. Total samples were 15 fresh blood PRC. Friedman statistical test showed a significant difference in lactic level (p < 0.001) and hematocrit level (p=0.012) on day 1, day 4, and day 8 of storage. Wilcoxon test showed significantly higher lactic level between day 4 and day 1 (p < 0.01); day 8 and day 1 (p < 0.01); day 4 and day 1 of storage (p < 0.01). Hematocrit level between day 4 and day 1 (p < 0.05); day 8 and day 1 (p < 0.05) were significantly higher; day 8 and day 4 of storage (p > 0.05) showed insignificant difference. Results showed that lactic and hematocrit levels of PRC stored blood were increased according to storage duration. Packed red cells blood is recommended to be given in < 6 days for lower acidosis risk. Further studies are also recommended with a shorter interval of assessment and a bigger sample size.

HEMOLYTIC DISEASE OF THE NEWBORN DUE TO ANTI-A AND ANTI-B

PEDIATRICS ◽  
1955 ◽  
Vol 15 (1) ◽  
pp. 54-62
Author(s):  
Clare N. Shumway ◽  
Gerald Miller ◽  
Lawrence E. Young
Keyword(s):  
B Cells ◽  
Red Blood Cells ◽  
Blood Group ◽  
Newborn Infant ◽  
Blood Cells ◽  
Osmotic Fragility ◽  
Red Cells ◽  
Hemolytic Disease ◽  
Abo Incompatibility

Ten infants with hemolytic disease of the newborn due to ABO incompatibility were studied. In every case the investigations were undertaken because of jaundice occurring in the first 24 hours of life. The clinical, hematologic and serologic observations in the infants and the serologic findings in the maternal sera are described. Evidence is presented to show that the diagnosis of the disorder rests largely upon the demonstration of spherocytosis, increased osmotic fragility of the red cells, reticulocytosis, and hyperbilirubinemia in a newborn infant whose red blood cells are incompatible with the maternal major blood group isoantibody and against whose cells no other maternal isoantibody is demonstrable. The anti-A or anti-B in each of the maternal sera tested in this series hemolyzed A or B cells in the presence of complement. Other serologic findings in the maternal sera were less consistently demonstrated.

scholarly journals Sensing of red blood cells with decreased membrane deformability by the human spleen

2018 ◽  
Vol 2 (20) ◽  
pp. 2581-2587 ◽  
Author(s):  
Innocent Safeukui ◽  
Pierre A. Buffet ◽  
Guillaume Deplaine ◽  
Sylvie Perrot ◽  
Valentine Brousse ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Ex Vivo ◽  
Volume Ratio ◽  
Red Cells ◽  
Human Spleen ◽  
Rbc Membrane ◽  
Membrane Rigidity ◽  
Cellular Deformability ◽  
Distinct Features

Abstract The current paradigm in the pathogenesis of several hemolytic red blood cell disorders is that reduced cellular deformability is a key determinant of splenic sequestration of affected red cells. Three distinct features regulate cellular deformability: membrane deformability, surface area-to-volume ratio (cell sphericity), and cytoplasmic viscosity. By perfusing normal human spleens ex vivo, we had previously showed that red cells with increased sphericity are rapidly sequestered by the spleen. Here, we assessed the retention kinetics of red cells with decreased membrane deformability but without marked shape changes. A controlled decrease in membrane deformability (increased membrane rigidity) was induced by treating normal red cells with increasing concentrations of diamide. Following perfusion, diamide-treated red blood cells (RBCs) were rapidly retained in the spleen with a mean clearance half-time of 5.9 minutes (range, 4.0-13.0). Splenic clearance correlated positively with increased membrane rigidity (r = 0.93; P &lt; .0001). To determine to what extent this increased retention was related to mechanical blockade in the spleen, diamide-treated red cells were filtered through microsphere layers that mimic the mechanical sensing of red cells by the spleen. Diamide-treated red cells were retained in the microsphilters (median, 7.5%; range, 0%-38.6%), although to a lesser extent compared with the spleen (median, 44.1%; range, 7.3%-64.0%; P &lt; .0001). Taken together, these results have implications for understanding the sensitivity of the human spleen to sequester red cells with altered cellular deformability due to various cellular alterations and for explaining clinical heterogeneity of RBC membrane disorders.

scholarly journals CELLS INVOLVED IN THE IMMUNE RESPONSE

1969 ◽  
Vol 129 (4) ◽  
pp. 757-774 ◽  
Author(s):  
Nabih I. Abdou ◽  
Maxwell Richter
Keyword(s):  
Bone Marrow ◽  
Immune Response ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Bone Marrow Cells ◽  
Allogeneic Bone Marrow ◽  
Red Cells ◽  
Allogeneic Bone ◽  
Sheep Red Blood Cells ◽  
Sheep Red Cells

Irradiated rabbits given allogeneic bone marrow cells from normal adult donors responded to an injection of sheep red blood cells by forming circulating antibodies. Their spleen cells were also capable of forming many plaques using the hemolysis in gel technique, and were also capable of undergoing blastogenesis and mitosis and of incorporating tritiated thymidine upon exposure to the specific antigen in vitro. However, irradiated rabbits injected with allogeneic bone marrow obtained from rabbits injected with sheep red blood cells 24 hr prior to sacrifice (primed donors) were incapable of mounting an immune response after stimulation with sheep red cells. This loss of reactivity by the bone marrow from primed donors is specific for the antigen injected, since the immune response of the irradiated recipients to a non-cross-reacting antigen, the horse red blood cell, is unimpaired. Treatment of the bone marrow donors with high-titered specific antiserum to sheep red cells for 24 hr prior to sacrifice did not result in any diminished ability of their bone marrow cells to transfer antibody-forming capacity to sheep red blood cells. The significance of these results, with respect to the origin of the antigen-reactive and antibody-forming cells in the rabbit, is discussed.

MODIFICATION OF THE TECHNIC OF TREATING ERYTHROBLASTOSIS FETALIS BY EXCHANGE TRANSFUSION

PEDIATRICS ◽  
1951 ◽  
Vol 8 (1) ◽  
pp. 117-127
Author(s):  
ALEXANDER S. WIENER ◽  
IRVING B. WEXLER
Keyword(s):  
Statistical Analysis ◽  
Mortality Rate ◽  
Red Blood Cells ◽  
Clinical Features ◽  
Blood Cells ◽  
Exchange Transfusion ◽  
Red Cells ◽  
Simplified Method ◽  
Adult Plasma

A simplified method of treating erythroblastosis by exchange transfusion is described in which the patient is bled and simultaneously transfused with compatible packed red cells. A table is presented which gives the final hematocrit and percentage of inagglutinable red blood cells in the patient's body at the termination of the exchange transfusion, in relation to the patient's initial hematocrit and the amount of blood exchanged. An exchange transfusion with 100 to 150 cc. of packed cells appears to be adequate regardless of the severity of the anemia. Statistical analysis of the result of 106 exchange transfusions shows a progressive drop in mortality rate from 23.7% in 38 cases treated with 500 cc. of whole citrated blood, to 14.6 cc. in 48 cases treated with 1,000 cc. of whole citrated blood, and to 10.0% in 20 cases treated with 120 cc. of packed cells. While the improvement may be accidental, there is no doubt that exchange transfusion with packed cells is a simpler procedure which avoids the introduction into the patient's body of large amounts of adult plasma, and potentially toxic doses of citrate and calcium. Two cases are described in detail which have unusual serologic and clinical features and illustrate the types of problems which may arise when treating erythroblastotic babies.

Operating Room Blood Delivery Turnaround Time

2002 ◽  
Vol 126 (8) ◽  
pp. 909-914 ◽  
Author(s):  
David A. Novis ◽  
Richard C. Friedberg ◽  
Stephen W. Renner ◽  
Frederick A. Meier ◽  
Molly K. Walsh
Keyword(s):  
United States ◽  
Operating Room ◽  
Median Time ◽  
The United States ◽  
Blood Bank ◽  
Blood Component ◽  
Blood Components ◽  
Improvement Program ◽  
Delivery Times ◽  
Blood Banks

Abstract Objectives.—To determine the normative distribution of time elapsed for blood bank personnel to fill nonscheduled operating room (OR) blood component orders in hospital communities throughout the United States, and to examine hospital blood bank practices associated with faster blood component delivery times. Design.—Participants in the College of American Pathologists Q-Probes laboratory quality improvement program collected data prospectively on the times elapsed for blood bank personnel to fill nonscheduled emergent orders from hospital ORs for red blood cell (RBC) products, fresh frozen plasma (FFP), and platelets (PLTs). Participants also completed questionnaires describing their hospitals' and blood banks' laboratory and transfusion practices. Setting and Participants.—Four hundred sixty-six public and private institutions located in 48 states in the United States (n = 444), Canada (n = 9), Australia (n = 8), the United Kingdom (n = 4), and Spain (n = 1). Main Outcome Measures.—The median time elapsed between requests for blood components by OR personnel and the retrieval of those components by blood component transport personnel, and the median time elapsed between requests for blood components by OR personnel and the arrival of those components in ORs. Results.—Participants submitted data on 12 647 units of RBCs, FFP, and PLTs. The median aggregate request-to-retrieval turnaround times (TATs) for RBCs, FFP, and PLTs ranged from 30 to 35 minutes, and the median aggregate request-to-arrival TATs for RBCs, FFP, and PLTs ranged from 33 to 39 minutes. Most of the TAT was consumed by events occurring prior to, rather than after release of components from blood banks. Shorter prerelease TATs were associated with having surgical schedules that listed patients' names and procedures available to blood bank personnel prior to surgeries, and having adequate clotted specimens in the blood bank and completed type-and-screen procedures performed before requests for blood components were submitted to blood banks. Among the fastest-performing 10% of participants (90th percentile and above), request-to-retrieval TATs ranged from 12 to 24 minutes for the 3 blood components, whereas among the slowest-performing 10% of participants (10th percentile and below), request-to-retrieval TATs ranged from 63 to 115 minutes for the 3 components. Median TATs ranged from 33 to 37 minutes for the 3 components. Institutions with TATs in the fastest-performing 25th percentile more frequently stored cross-matched RBCs in the OR daily, stocked PLTs for unexpected surgical use, stored PLTs in or near the OR, and had laboratory rather than nonlaboratory personnel deliver components to the OR than did those institutions with TATs in the slowest-performing 25th percentile. Conclusions.—Hospital blood bank personnel can deliver blood components to the OR in slightly longer than 30 minutes, measured from the time that those units are requested by OR personnel. Practices aimed at saving time before components are released from blood banks will be more efficient in reducing overall TAT than those practices aimed at saving time after components are released from blood banks. Specific practices associated with shorter blood delivery TATs included providing blood bank personnel with access to the names of surgical patients potentially requiring blood components, having pretransfusion testing completed on those patients prior to surgery, having ample blood products on hand, and having laboratory personnel control blood product delivery.

scholarly journals Concentration of Fetal Red Blood Cells From a Mixture of Maternal and Fetal Blood by Anti-i Serum—An Aid to Prenatal Diagnosis of Hemoglobinopathies

Blood ◽  
1974 ◽  
Vol 43 (3) ◽  
pp. 411-415 ◽  
Author(s):  
Yuet Wai Kan ◽  
David G. Nathan ◽  
Gabriel Cividalli ◽  
Marie C. Crookston
Keyword(s):  
Prenatal Diagnosis ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Red Cells ◽  
Fetal Blood ◽  
Fetal Cells

Abstract Fetal red blood cells were concentrated from mixtures of maternal and fetal cells by differential agglutination with anti-i serum. This method will be useful for prenatal diagnosis of hemoglobinopathies when blood obtained from the fetus is heavily contaminated by maternal cells. The method is practical, except in very rare cases in which the maternal red cells are strongly agglutinated by anti-i.

Outdated Red Blood Cells from the Blood Bank, for Determination of Antistreptolysin O Titers

1961 ◽  
Vol 35 (3_ts) ◽  
pp. 279-283
Author(s):  
Y. E. Crawford ◽  
R.P. Skinner ◽  
W.J. Lind ◽  
A. E. Heimann ◽  
D.E. Hutchings ◽  
...  
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Blood Bank

THE PRODUCTION OF PURPURA BY DERIVATIVES OF PNEUMOCOCCUS

1926 ◽  
Vol 43 (1) ◽  
pp. 111-106
Author(s):  
Hobart A. Reimann ◽  
Louis A. Julianelle
Keyword(s):  
Red Blood Cells ◽  
Hemolytic Activity ◽  
Blood Cells ◽  
Blood Platelets ◽  
White Blood Cells ◽  
Red Cells ◽  
Severe Anemia ◽  
Marked Diminution ◽  
Derivatives Of

A study has been made of the variation in number of the blood platelets, and the red and white blood cells of white mice injected with pneumococcus extract. The blood platelets were greatly diminished after the injection, the greatest decrease usually occurring after 24 hours. Purpuric lesions usually developed when the number of blood platelets became less than 500,000 per c.mm. Regeneration of the platelets was accomplished by the 4th to the 9th day but there was an overregeneration and the return to normal did not take place until 2 weeks had elapsed. The red cells were also greatly reduced in number, but the rate of their destruction and regeneration was somewhat slower than that of the platelets. The leucocytes were slightly if at all influenced by the pneumococcus extract. Pneumococcus extracts were shown to be thrombolytic and hemolytic. Heat destroyed the activity of both the lysins in vitro. Heated extract produced purpura in mice but did not cause a severe anemia. Extracts adsorbed with either blood platelets or red blood cells showed a marked diminution in their thrombolytic and hemolytic activity in vitro. Such extracts, however, produced purpura as well as severe anemia and thrombopenia in mice.

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