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Ugeskrift For Laeger Feb 2017
Topics: Blood Transfusion; Humans
PubMed: 28397679
DOI: No ID Found -
Journal of the National Medical... Jul 1989Homologous blood transfusion without risk is an unobtainable goal. Infection with human immunodeficiency virus continues to occur at an average rate of one infection per... (Review)
Review
Homologous blood transfusion without risk is an unobtainable goal. Infection with human immunodeficiency virus continues to occur at an average rate of one infection per 100,000 transfusions, in spite of the most sensitive and specific testing available. In the past 30 years, the number of red cell antigens identified have increased from primarily ABO and Rh to some 400 antigens, which has also contributed to the hazards of blood transfusion. These risks can be minimized by the judicious use of homologous blood in conjunction with technological advances in transfusion medicine therapy and changes in attitudes of transfusionists. In the operating theater, there has been a resurgence in intraoperative autologous transfusion therapy, and patients are individualized rather than held to an arbitrary hemoglobin standard prior to anesthesia. In the preoperative period, elective surgical candidates may predeposit autologous blood or select directed donors. The prospective recipient or the directed donor may be candidate for recombinant erythropoietin therapy as a prelude to blood donation. This article discusses the uses of blood and blood products, the hazards of blood transfusion, and precautions that can be taken to minimize risks to the patient.
Topics: Blood Transfusion; Humans; Transfusion Reaction
PubMed: 2666679
DOI: No ID Found -
Transfusion Mar 2020The National Blood Collection and Utilization Survey (NBCUS) has demonstrated declines in blood collection and transfusion in the United States since 2008, including...
INTRODUCTION
The National Blood Collection and Utilization Survey (NBCUS) has demonstrated declines in blood collection and transfusion in the United States since 2008, including declines of 11.6% in red blood cell (RBC) collections and 13.9% in RBC transfusions during 2013-2015. This study described the 2017 NBCUS results.
METHODS
The 2017 NBCUS was distributed to all US blood collection centers, all hospitals performing at least 1000 surgeries annually, and a 40% random sample of hospitals performing 100 to 999 surgeries annually. Weighting and imputation were used to generate national estimates for units of blood and components collected, deferred, distributed, transfused, and outdated.
RESULTS
Response rates for the 2017 NBCUS were 88% for blood collection centers and 86% for transfusing hospitals. Compared with 2015, the number of RBC units collected during 2017 (12,211,000; 95% confidence interval [CI], 11,680,000-12,742,000) declined by 3.0%, and transfused RBC units (10,654,000, 95% CI, 10,314,000-10,995,000) declined by 6.1%. Distributed platelet (PLT) units (2,560,000; 95% CI, 2,391,000-2,730,000 units) increased by 5.1%, and transfused PLT units (1,937,000, 95% CI, 1,794,000-2,079,000) declined by 2.3%. Distributed plasma units (3,209,000; 95% CI, 2,879,000-3,539,000) declined by 13.6%, and transfused plasma units (2,374,000; 95% CI, 2,262,000-2,487,000) declined by 12.9%.
CONCLUSION
The 2017 NBCUS suggests a continued but slowing decline in demand for RBCs. The decline in blood collection and use will likely continue. Despite decreasing demand and increasing manufacturing costs of blood products, the US blood industry has met the regular and emergent needs of the country.
Topics: Blood Banks; Blood Donors; Blood Transfusion; Erythrocyte Transfusion; Hospitals; Humans; Platelet Transfusion; Surveys and Questionnaires; Transplantation, Homologous; United States
PubMed: 32086817
DOI: 10.1111/trf.15604 -
A Systematic Review and Meta-Analysis of the Clinical Appropriateness of Blood Transfusion in China.Medicine Dec 2015The issue of the clinical appropriateness of blood transfusion has become a focus of transfusion medicine worldwide. In China, irrational uses of blood have often been... (Meta-Analysis)
Meta-Analysis Review
The issue of the clinical appropriateness of blood transfusion has become a focus of transfusion medicine worldwide. In China, irrational uses of blood have often been reported in recent years. However, to date there lacks a systematic review of the rational uses of blood. This study aimed to determine the clinical appropriateness of blood transfusion in China. We searched PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, WanFang Database, and Chinese BioMedical Literature Database, and the retrieval cut-off date was June 31, 2015. SPSS 17.0 and MetaAnalyst 3.13 were employed as the statistics tools in this review. A pooled rate of clinical inappropriateness of transfusion was analyzed by DerSimonian-Laird method. In this study, a total of 39 observational studies were included, which related to 75,132 cases of blood transfusion. According to the meta-analysis results, the overall incidence of clinical inappropriateness of transfusion in China was estimated to be 37.3% (95% confidence interval [CI] [32.1, 42.8]). The subgroup analyses revealed that the pooled rates of clinical inappropriateness of transfusion of plasma, red blood cells (RBCs), cryoprecipitate, and platelets were 56.3% (95% CI [45.8, 66.2]), 30.9% (95% CI [27.1, 35.0]), 25.2% (95% CI [13.2, 42.7]), and 14.1% (95% CI [8.8, 21.9]), respectively. However, the pooled incidence of inappropriateness of transfusion in operative departments was 47.5% (95% CI [36.8, 58.3]), which was significantly higher than that in nonoperative departments, 25.8% (95% CI [18.7, 34.4], P < 0.05). The overall rates of inappropriate use were 36.7% (95% CI [30.2, 43.6]) in major cities and 37.5% (95% CI [31.2, 44.3]) in other cities, respectively; there was no statistically significant difference (P > 0.05). In conclusion, China has suffered from a disadvantage in the clinical appropriateness of blood transfusion, especially in plasma and RBC use. In future, comprehensive measures should be implemented in order to improve the clinical appropriateness of blood transfusion.
Topics: Blood Component Transfusion; Blood Transfusion; China; Humans; Observational Studies as Topic; Practice Patterns, Physicians'; Quality of Health Care
PubMed: 26683925
DOI: 10.1097/MD.0000000000002164 -
Journal of Global Health Apr 2021
Review
Topics: Blood Banks; Blood Donors; Blood Transfusion; COVID-19; Humans
PubMed: 33884188
DOI: 10.7189/jogh.11.03053 -
British Journal of Haematology Apr 2013Resuscitation of children and neonates with severe or refractory bleeding due to surgery or trauma often requires massive transfusion (MT). Findings from recent studies... (Review)
Review
Resuscitation of children and neonates with severe or refractory bleeding due to surgery or trauma often requires massive transfusion (MT). Findings from recent studies have led to a better understanding of the complex pathophysiology in massive haemorrhage and the effects of MT on haemostasis. Current management of the massively bleeding adult patient has evolved over the past few decades, shifting to early transfusion of products in a balanced ratio as part of MT protocols (MTPs). Paediatric data on successful management of MT are limited and the optimal transfusion approach is currently unknown, leading to practice variability among institutions, depending on resource availability and patients' needs. Here, we review new important concepts in the biology of massive bleeding and MT, outline important management principles and current practices, and highlight available relevant adult and paediatric data.
Topics: Blood Transfusion; Child; Child, Preschool; Clinical Protocols; Hemorrhage; Hemostasis; Hemostatic Disorders; Humans; Infant; Infant, Newborn; Transfusion Reaction
PubMed: 23432321
DOI: 10.1111/bjh.12247 -
Archives of Disease in Childhood. Fetal... Mar 2004Many previously widely accepted neonatal transfusion practices are changing as neonatologists become more aware of the risks to their patients of multiple blood product... (Review)
Review
Many previously widely accepted neonatal transfusion practices are changing as neonatologists become more aware of the risks to their patients of multiple blood product transfusions. Recent literature and research on neonatal transfusion practice are here reviewed, and practical guidelines and trigger thresholds for blood products commonly used in neonatal medicine are proposed.
Topics: Albumins; Blood Transfusion; Erythrocyte Transfusion; Erythropoietin; Exchange Transfusion, Whole Blood; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Immunoglobulins, Intravenous; Infant, Newborn; Infant, Newborn, Diseases; Patient Selection; Plasma Substitutes; Platelet Transfusion; Recombinant Proteins
PubMed: 14977890
DOI: 10.1136/adc.2002.019760 -
BMC Health Services Research Nov 2019Requesting blood prior to a surgical procedure for perioperative transfusion is a common practice in surgical patients. More unit of blood is requested than used by... (Review)
Review
BACKGROUND
Requesting blood prior to a surgical procedure for perioperative transfusion is a common practice in surgical patients. More unit of blood is requested than used by anticipating the patient will be transfused to provide a safety margin in an event of unexpected haemorrhage. Over requesting with minimal utilization results in significant wastage of blood, reagents and human resource. This study was conducted to assess blood utilization practice of the largest tertiary hospital in Ethiopia.
METHODS
A cross-sectional prospective study method was used. Data was collected using a Proforma questionnaire by perusal of each individual patient's records from December 1, 2017 to February 28, 2018.patient age, sex, department requesting the blood, level of operating surgeon, hemodynamic status, number of unit requested, number of unit crossed matched and number of unit transfused were collected. Efficiency of blood utilization was calculated with three indices: Crossmatch to transfusion ratio, transfusion probability, and transfusion index indices.
RESULTS
Blood was requested for 406 patients and a total of 898 units were crossmatched for this patients. Overall Crossmatch to transfusion ration, transfusion probability and transfusion index were 7.6, 15.3% and 0.29 respectively. Results showed insignificant blood usage. Among different departments and units, better blood utilization was seen in neurosurgical unit with C/T ratio, TP and TI of 4.9, 24.4 and 0.6% respectively, while worst indices were from obstetrics unit with C/T ratio, TP and TI of 31.0, 6.5% and 0.06.
CONCLUSION
Using all the three parameters for evaluation of efficiency of blood utilization, the practice in our hospital shows ineffective blood utilization in elective surgical procedure. Blood requesting physician should order the minimum blood anticipated to be used as much as possible.
Topics: Blood Grouping and Crossmatching; Blood Transfusion; Cost-Benefit Analysis; Cross-Sectional Studies; Elective Surgical Procedures; Humans; Practice Guidelines as Topic; Preoperative Care; Prospective Studies
PubMed: 31694644
DOI: 10.1186/s12913-019-4584-1 -
Transfusion Jun 2017In 2011 and 2013, the National Blood Collection and Utilization Survey (NBCUS) revealed declines in blood collection and transfusion in the United States. The objective...
BACKGROUND
In 2011 and 2013, the National Blood Collection and Utilization Survey (NBCUS) revealed declines in blood collection and transfusion in the United States. The objective of this study was to describe blood services in 2015.
STUDY DESIGN AND METHODS
The 2015 NBCUS was distributed to all US blood collection centers, all hospitals performing at least 1000 surgeries annually, and a 40% random sample of hospitals performing 100 to 999 surgeries annually. Weighting and imputation were used to generate national estimates for units of blood and components collected, deferred, distributed, transfused, and outdated.
RESULTS
Response rates for the 2015 NBCUS were 78.4% for blood collection centers and 73.9% for transfusing hospitals. In 2015, 12,591,000 units of red blood cells (RBCs) (95% confidence interval [CI], 11,985,000-13,197,000 units of RBCs) were collected, and 11,349,000 (95% CI, 10,592,000-11,747,000) were transfused, representing declines since 2013 of 11.6% and 13.9%, respectively. Total platelet units distributed (2,436,000; 95% CI, 2,230,000-2,642,000) and transfused (1,983,000; 95% CI, 1,816,000 = 2,151,000) declined by 0.5% and 13.1%, respectively, since 2013. Plasma distributions (3,714,000; 95% CI, 3,306,000-4,121,000) and transfusions (2,727,000; 95% CI, 2,594,000-2,859,000) in 2015 declined since 2013. The median price paid per unit in 2015-$211 for leukocyte-reduced RBCs, $524 for apheresis platelets, and $54 for fresh frozen plasma-was less for all components than in 2013.
CONCLUSIONS
The 2015 NBCUS findings suggest that continued declines in demand for blood products resulted in fewer units collected and distributed Maintaining a blood inventory sufficient to meet routine and emergent demands will require further monitoring and understanding of these trends.
Topics: Blood Banks; Blood Transfusion; Hospitals; Humans; Surveys and Questionnaires; United States
PubMed: 28591469
DOI: 10.1111/trf.14165 -
Anesthesiology Jul 2020
Review
Topics: Blood Transfusion; Humans; Intraoperative Care; Patient Care Management; Postoperative Care; Preoperative Care
PubMed: 32108683
DOI: 10.1097/ALN.0000000000003198