blood transfusion
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Author(s):  
Marouane El Midaoui ◽  
Mohammed Qbadou ◽  
Khalifa Mansouri

Multiple diseases require a blood transfusion on daily basis. The process of a blood transfusion is successful when the type and amount of blood is available and when the blood is transported at the right time from the blood bank to the operating room. Blood distribution has a large portion of the cost in hospital logistics. The blood bank can serve various hospitals; however, amount of blood is limited due to donor shortage. The transportation must handle several requirements such as timely delivery, vibration avoidance, temperature maintenance, to keep the blood usable. In this paper, we discuss in first section the issues with blood delivery and constraint. The second section present routing and scheduling system based on artificial intelligence to deliver blood from the blood-banks to hospitals based on single blood bank and multiple blood banks with respect of the vehicle capacity used to deliver the blood and creating the shortest path. The third section consist on solution for predicting the blood needs for each hospital based on transfusion history using machine learning and fuzzy logic. The last section we compare the results of well-known solution with our solution in several cases such as shortage and sudden changes.


2022 ◽  
Author(s):  
Jianhui Liu ◽  
Jiao Wang ◽  
Panpan Ma ◽  
Juanjing Geng ◽  
Wenyan Chen ◽  
...  

Author(s):  
Saeed Yousefian ◽  
Ghassem Miri Aliabad ◽  
Rana Saleh ◽  
Majid Khedmati

Background: Beta-thalassemia major is a type of inherited blood disease that results in variable outcomes such as severe anemia due to haemoglobin chains. Recurrent and lifelong blood transfusions as a treatment in beta-thalassemia major disease lead to iron deposition in various organs and cause the failure of multiple organs. Failure of affected organs leads to Body mass index (BMI) abnormality. This study aimed to evaluate the association between BMI and serum ferritin level as a marker for iron overload. Materials and Methods: A cross-sectional study designed and conducted with total number of 740 paediatrics, with mean age about 14.2±8.7 years old and with beta-thalassemia major requiring recurrent blood transfusion. Patient information, including demographics, serum ferritin level and percentage of BMI, was recorded and analysed by SPSS 25.0 and the statistical significant level, considered as 0.05.    Results: A total number of 740 paediatrics with beta-thalassemia major disease (mean age about 14.2±8.7 years) were included to study to examine the association between serum ferritin level and their BMI.  The total mean serum level of ferritin calculated about 3326 ± 3859 Nanogram/mililitter (ng/ml). Totally, 447 (60.4%) case of them had BMI percentile less than 5%, 274 (37.02%), 16 (2.16%) and 3 (0.4%) had BMI percentile 5%-85%, 85%-95% and more than 95%. There was no relation between gender and serum ferritin levels. The relationship between age and BMI has been positive (P=0.002). Finally, it resulted that there was a negative relationship between the BMI percentile and mean serum ferritin levels in paediatrics with beta-thalassemia major (P=0.031). Conclusion: Frequent Blood transfusion is associated with elevated serum ferritin level in paediatrics with beta-thalassemia major disease and experiencing lower percentiles of BMI in these patients.


Author(s):  
Neeti Dutt ◽  
Sushil Sharma ◽  
Meena Sidhu

Background: The COVID-19 pandemic has major implications for blood transfusion. There are uncertain patterns of demand, and transfusion institutions need to plan for reductions in donations and loss of crucial staff because of sickness and public health restrictions. A range of strategies need to be planned to maintain ongoing equitable access to blood for transfusion during the pandemic, in addition to providing new therapies such as convalescent plasma. The main role of transfusion institutions during this period, is the monitoring of supply and demand so that sufficient blood stocks are maintained to support ongoing critical needs. The main aim of our study was to study the impact of COVID-19 outbreak on blood transfusion services (BTS) and to identify the challenges faced by our blood center and mitigation strategies adopted to combat it.Methods: Total number of donations and total number of blood and its components issued were noted from the donor and issue registers respectively, both during the pre-COVID and COVID-19 pandemic and the results were compared thereafter. Various strategies were adopted during the COVID pandemic in order to maintain balance between demand and supply of blood and its products.Results: There has been sudden decrease in the number of blood donations in the month of April 2020 (35%) in the COVID pandemic as compared to pre-COVID time with percentage difference of 65%. This was followed by gradual decrease in the no. of donations in COVID pandemic when compared with donations in the pre-COVID time. The percentage difference in blood donation gradually improved over a period of time from 65% in April 2020 to 7% in April 2021. Similarly, no. of blood units issued also decreased from 1147 in April 2019 to 553 units in April 2020.Conclusions: The BTS need to provide an uninterrupted blood supply, and this stays true even in the face of a pandemic. The plan of action has to be started early so that the supply can be maintained and monitored effectively. Health-care workers being one of the main pillars in the fight against COVID-19 have to be supported and protected. 


2022 ◽  
Vol 12 ◽  
Author(s):  
Yanfei Lu ◽  
Zhenbin Wei ◽  
Gaohui Yang ◽  
Yongrong Lai ◽  
Rongrong Liu

At present, the main therapies for ß-thalassemia patients include regular blood transfusion and iron chelation, associating with a number of limitations. Thalidomide, a fetal hemoglobin (HbF) inducer that promotes γ-globin gene expression, has been reported to be effective for ß-thalassemia. Thus, this meta-analysis was conducted to assess the efficacy and safety of thalidomide for treating patients with ß-thalassemia. We searched the related studies from eight databases published from inception until December 1, 2021. The R 4.0.5 language programming was used to perform meta-analysis. After screening of retrieved articles, 12 articles were included that enrolled a total of 451 patients. The Cochrane Collaboration risk assessment tool was used to evaluate the quality and the bias risk of the randomized controlled trials (RCTs), and non randomized trials were assessed using Newcastle-Ottawa Scale (NOS). After treatment with thalidomide, the pooled overall response rate (ORR) was 85% (95% confidence interval (CI): 80–90%), and the pooled complete response rate (CRR) was 54% (95% confidence interval: 31–76%). Compared with the placebo group, the thalidomide group had higher odds of overall response rate (odds ratio = 20.4; 95% CI: 6.75–61.64) and complete response rate (odds ratio = 20.4; 95% CI: 6.75–61.64). A statistically significant increase in hemoglobin level and HbF level after treatment, while there was no statistically significant difference in adult hemoglobin (HbA) level, spleen size, and serum ferritin. According to the results of ORR and CRR, transfusion-dependent thalassemia (TDT) patients showed remarkable efficacy of thalidomide, 83 and 52% respectively. So we analyzed 30 transfusion-dependent thalassemia patients from three studies and found that the most frequent ß-globin gene mutations were CD41-42 (-TCTT), while response to thalidomide did not show any statistically significant relationship with XmnI polymorphism or CD41-42 (-TCTT) mutation. About 30% of patients experienced mild adverse effects of thalidomide. Collectively, thalidomide is a relatively safe and effective therapy to reduce the blood transfusion requirements and to increase Hb level in patients with ß-thalassemia.


Physiology ◽  
2022 ◽  
Author(s):  
Carmen Hinojosa-Laborde ◽  
Ian L. Hudson ◽  
Evan Ross ◽  
Lusha Xiang ◽  
Kathy L. Ryan

Saving lives of wounded military Warfighters often depends on the ability to resolve or mitigate the pathophysiology of hemorrhage, specifically diminished oxygen delivery to vital organs that leads to multi-organ failure and death. However, caring for hemorrhaging patients on the battlefield presents unique challenges that extend beyond applying a tourniquet and giving a blood transfusion, especially when battlefield care must be provided for a prolonged period. This review will describe these challenges and potential strategies for treating hemorrhage on the battlefield in a prolonged casualty care situation.


2022 ◽  
Vol 9 (1) ◽  
pp. 20-23
Author(s):  
Nadia Kashif ◽  
Aneela Ambreen ◽  
Afshan Ahsan

OBJECTIVES: To evaluate the indications of blood transfusion in the Obstetrics and Gynecology Department of Government NaseerUllah Khan Babar Memorial Hospital. METHODOLOGY: This retrospective observational study was performed on indoor gynecology and obstetrics patients for the period of one year, a total of 100 patients were included in this study that received blood transfusion. Samples were collected by non-random convenience sampling after getting approval from the hospital ethical committee. Data was analyzed by using SPSS version 20. RESULTS: In this study a total of 100 patients who received blood transfusion were analyzed, out of 100 patients 78% of patients received transfusion due to obstetrical causes and 22% patients got transfused for gynecological causes. Most common blood group transfused was B+ and O+ and mean hemoglobin level at which patients received blood transfusion was 9.7g/dl. Blood components preparation can provide components to treat two to three patients from a single donor. The use of packed cell transfusion should be promoted instead of whole blood transfusion that is not even needed in most of the cases. CONCLUSION: Blood transfusion practice has been used aggressively in gynecology and obstetrics in some cases even without proper indications. There is a need to modify this practice by correcting anemia through drugs to avoid the inappropriate use of blood. Use of blood components should be encouraged.


2022 ◽  
Author(s):  
Doohyun Hwang ◽  
Hyuk-Soo Han ◽  
Myung Chul Lee ◽  
Du Hyun Ro

Abstract Background: Sarcopenia, an age-related loss of skeletal muscle mass and function, is correlated with adverse outcomes after some surgeries. This study examined the incidence and characteristics of sarcopenic patients undergoing primary total knee arthroplasty (TKA), and identified sarcopenia as an independent risk factor for postoperative TKA complications.Methods: A retrospective cohort study examined 452 patients who underwent TKA. The skeletal muscle index (SMI) was obtained via bioelectrical impedance analysis (BIA), along with demographics, the Charlson Comorbidity Index, and medication, laboratory and operative data for 2018–2021. Patients were categorized into non-sarcopenia (n = 417) and sarcopenia (n = 35) groups using the SMI cut-off suggested by the Asian Working Group for Sarcopenia 2019 (males, < 7.0 kg/m2; females, < 5.7 kg/m2). Three postoperative complications were analyzed: blood transfusion, delirium, and acute kidney injury (AKI). Baseline characteristics were propensity score-matched to address potential bias and confounding factors.Results: The incidence of sarcopenia in primary TKA was 7.7% (35/452). The sarcopenia group had a lower preoperative hemoglobin (12.18±1.20 vs. 13.04±1.73 g/dL, p=0.004) and total protein (6.73±0.42 vs. 7.06±0.44 mg/dL, p=0.001). Propensity scoring matching and logistic regression showed that more patients in the sarcopenia group received postoperative blood transfusions (OR = 6.60, 95% CI: 1.57–45.5, p=0.021); there was no significant difference in AKI or delirium. Univariate receiver operating characteristic curve analysis of the propensity-matched group, to determine the predictive value of SMI for postoperative transfusion, gave an AUC of 0.797 (0.633–0.96) and SMI cut-off of 5.6 kg/m2.Conclusions: Sarcopenia determined by BIA was an independent risk factor for postoperative transfusion in TKA. Multifrequency BIA can serve as a screening tool for sarcopenia. Orthopedic surgeons should be aware of this, as it could influence the decision-making process or treatment plan of patients with sarcopenia undergoing primary TKA.Level of evidence: III, retrospective cohort study


2022 ◽  
Author(s):  
monireh Ahmadimanesh ◽  
Alireza Pooya ◽  
Hamidreza Safabakhsh ◽  
Sedigheh Sadeghi

Abstract Inventory managers in the blood supply chain always seek timely and proper response to their customers, which is essential because of the perishability and uncertainty of blood demand and the direct relationship of its presence or non-presence with human life. On the other hand, timely and regular delivery of blood to consumers is vital, as the weakness in delivery and transportation policies results in increased shortages, returns, blood loss and significant decrease in the quality of blood required by patients. Given the significance of this for the blood transfusion network, the paper tried to design a comprehensive and integrated optimal model of blood transfusion network logistics management by blood group to reduce the cost of losses, returns and blood shortages. This model is divided into two parts: Inventory management and routing. A combination of simulation techniques and neural network with several recurrent layers was used to evaluate the optimal inventory management and a multi-objective planning model was designed to determine the delivery and distribution of blood to consumers. The model designed was implemented in Khorasan Razavi Blood Transfusion Network with a main base, six central bases and 54 hospitals. Solving the model led to estimating the f consumer demand, the optimal value of target inventory and re-ordering point of central bases and hospitals, and blood distribution from the supplier to its consumers that decreased the units of blood returned to bases, increased inventory availability, and reduced costs significantly.


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