Red blood cell transfusion practice in children: current status and areas for improvement? A study of the use of red blood cell transfusions in children and infants

Transfusion ◽  
2013 ◽  
Vol 54 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Helen V. New ◽  
John Grant-Casey ◽  
Derek Lowe ◽  
Andrea Kelleher ◽  
Sylvia Hennem ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Transfusion Practice ◽  
Red Blood Cell Transfusion ◽  
Current Status ◽  
Red Blood Cell Transfusions

Retrospective Study of 122 Dogs That Were Treated with the Antifibrinolytic Drug Aminocaproic Acid: 2010–2012

2016 ◽  
Vol 52 (3) ◽  
pp. 144-148 ◽  
Author(s):  
Megan Davis ◽  
Kiko Bracker
Keyword(s):  
Retrospective Study ◽  
Adverse Effects ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Blood Cells ◽  
Medical Records ◽  
Aminocaproic Acid ◽  
Red Blood Cell Transfusion ◽  
Antifibrinolytic Drugs ◽  
Red Blood Cell Transfusions

ABSTRACT Antifibrinolytic drugs are used to promote hemostasis and decrease the need for red blood cell transfusion. Medical records of 122 dogs that were prescribed either oral or intravenous aminocaproic acid between 2010 and 2012 were evaluated retrospectively. Of the 122 dogs, three experienced possible drug-related adverse effects. No significant differences were identified between dogs that experienced adverse effects and those that did not and the possible adverse effects noted were all minor. All dogs that received packed red blood cell transfusions were evaluated for correlations between baseline packed cell volume or dose of red blood cells and aminocaproic acid dose and no correlation was identified. Dogs that received aminocaproic acid as a treatment for active bleeding were divided by cause of hemorrhage into the following groups: neoplastic, non-neoplastic, and unknown. No significant differences in aminocaproic acid dose or the percentage of patients requiring a blood transfusion were identified between groups.

Impact of minimal invasive extracorporeal circulation on the need of red blood cell transfusion

Perfusion ◽  
2019 ◽  
Vol 34 (7) ◽  
pp. 605-612 ◽  
Author(s):  
Sten Ellam ◽  
Otto Pitkänen ◽  
Pasi Lahtinen ◽  
Tadeusz Musialowicz ◽  
Mikko Hippeläinen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Extracorporeal Circulation ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Minimal Invasive ◽  
Red Blood Cell Transfusion ◽  
Red Blood Cell Transfusions ◽  
Hemoglobin Drop

Objective: Minimal invasive extracorporeal circulation may decrease the need of packed red blood cell transfusions and reduce hemodilution during cardiopulmonary bypass. However, more data are needed on the effects of minimal invasive extracorporeal circulation in more complex cardiac procedures. We compared minimal invasive extracorporeal circulation and conventional extracorporeal circulation methods of cardiopulmonary bypass. Methods: A total of 424 patients in the minimal invasive extracorporeal circulation group and 844 patients in the conventional extracorporeal circulation group undergoing coronary artery bypass grafting and more complex cardiac surgery were evaluated. Age, sex, type of surgery, and duration of perfusion were used as matching criteria. Hemoglobin <80 g/L was used as red blood cell transfusion trigger. The primary endpoint was the use of red blood cells during the day of operation and the five postoperative days. Secondary endpoints were hemodilution (hemoglobin drop after the onset of perfusion) and postoperative bleeding from the chest tubes during the first 12 hours after the operation. Results: Red blood cell transfusions were needed less often in the minimal invasive extracorporeal circulation group compared to the conventional extracorporeal circulation group (26.4% vs. 33.4%, p = 0.011, odds ratio 0.72, 95% confidence interval 0.55-0.93), especially in coronary artery bypass grafting subgroup (21.3% vs. 35.1%, p < 0.001, odds ratio 0.50, 95% confidence interval 0.35-0.73). Hemoglobin drop after onset of perfusion was also lower in the minimal invasive extracorporeal circulation group than in the conventional extracorporeal circulation group (24.2 ± 8.5% vs. 32.6 ± 12.6%, p < 0.001). Postoperative bleeding from the chest tube did not differ between the groups (p = 0.808). Conclusion: Minimal invasive extracorporeal circulation reduced the need of red blood cell transfusions and hemoglobin drop when compared to the conventional extracorporeal circulation group. This may have implications when choosing the perfusion method in cardiac surgery.

scholarly journals Safety of Red Blood Cell Transfusion Using Small Central Lines in Neonates: An in vitro Non-inferiority Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Flavia Rosa-Mangeret ◽  
Sophie Waldvogel-Abramowski ◽  
Riccardo E. Pfister ◽  
Olivier Baud ◽  
Sébastien Fau
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Transfusion Practice ◽  
Red Blood Cell Transfusion ◽  
Central Lines ◽  
Catheter Occlusion ◽  
Prospective Assessment ◽  
Secondary Endpoints ◽  
Central Catheters

Aim: This study aimed to investigate the safety of transfusing red blood cell concentrates (RBCCs) through small [24 gauge (24G)] and extra-small [28 gauge [28G)] peripherally inserted central catheters (PICCs), according to guidelines of transfusion practice in Switzerland.Methods: We performed a non-inferiority in vitro study to assess the safety of transfusing RBCC for 4 h at a 4 ml/h speed through 24G silicone and 28G polyurethane PICC lines, compared with a peripheral 24G short catheter. The primary endpoint was hemolysis percentage. Secondary endpoints were catheter occlusion, inline pressure, and potassium and lactate values.Results: For the primary outcome, hemolysis values were not statistically different among catheter groups (0.06% variation, p = 0.95) or over time (2.75% variation, p = 0.72). The highest hemolysis values in both 24G and 28G PICCs were below the non-inferiority predefined margin. We did not observe catheter occlusion. Inline pressure varied between catheters but followed the same pattern of rapid increase followed by stabilization. Potassium and lactate measurements were not statistically different among tested catheters (0.139% variation, p = 0.98 for potassium and 0.062%, p = 0.96 for lactates).Conclusions: This study shows that RBCC transfusion performed in vitro through 24G silicone and 28G polyurethane PICC lines is feasible without detectable hemolysis or pressure concerns. Also, it adds that, concerning hemolysis, transfusion of RBCC in small and extra-small PICC lines is non-inferior to peripheral short 24G catheters. Clinical prospective assessment in preterm infants is needed to confirm these data further.

Adequacy of Physician Documentation of Red Blood Cell Transfusion and Correlation With Assessment of Transfusion Appropriateness

2006 ◽  
Vol 130 (4) ◽  
pp. 474-479 ◽  
Author(s):  
Mark T. Friedman ◽  
Amber Ebrahim
Keyword(s):  
Blood Cell ◽  
Red Blood Cells ◽  
Red Blood Cell ◽  
Blood Cells ◽  
Assessment Process ◽  
Red Blood Cell Transfusion ◽  
Major Function ◽  
Red Blood Cell Transfusions ◽  
Enhance Efficiency ◽  
Transfusion Guidelines

Abstract Context.—A major function of the hospital transfusion service is to assess the appropriateness of blood transfusion. Inadequate documentation of transfusions may hamper this assessment process. Objective.—To correlate the level of physician documentation of transfusion with the ability to justify transfusion. Design.—Retrospective review of red blood cell transfusions in adult patients in 2 hospital facilities during 1-week audit periods of each month from April 2001 to March 2003. Assessment forms were used to classify the level of physician documentation of transfusions into 3 groups: adequately, intermediately, and inadequately documented. Transfusions were deemed justified or not via comparison with hospital transfusion guidelines. Results.—There were 5062 audited red blood cells transfused to 2044 adult (≥18 years) patients. Medical records from 154 patients transfused with 257 units of red blood cells during 172 transfusion events were reviewed after initial screenings of hemoglobin/hematocrit values failed to justify the transfusions. Nine percent of adequately documented, 50% of intermediately documented, and 73% of inadequately documented transfusion events could not be justified. Transfusion events with suboptimal (intermediate and inadequate) documentation accounted for 49% of all medical record–reviewed transfusion events and 62% could not be justified. The correlation between inadequate documentation and failure to justify transfusion was significant (P &lt; .001), as was the correlation between suboptimal documentation and failure to justify transfusion (P = .03). Conclusions.—There is a significant correlation between suboptimal documentation and failure to justify transfusions. Educating clinicians to improve documentation along with appropriate indications for transfusions may enhance efficiency of blood utilization assessment and lead to reduced rates of unjustifiable transfusions.

Canine red blood cell transfusion practice

1996 ◽  
Vol 32 (4) ◽  
pp. 303-311 ◽  
Author(s):  
MB Callan ◽  
DA Oakley ◽  
FS Shofer ◽  
U Giger
Keyword(s):  
Adverse Events ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Blood Cells ◽  
Transfusion Practice ◽  
Red Blood Cell Transfusion ◽  
Ineffective Erythropoiesis ◽  
Packed Red Blood Cells ◽  
The Mean ◽  
Rbc Transfusion

Red blood cell (RBC) transfusions in 307 dogs were reviewed. A total of 658 units of RBCs, including 474 (72%) units of packed red blood cells (PRBCs) and 184 (28%) units of whole blood (WB), were administered. Reasons for transfusion included hemorrhage (n = 222), hemolysis (n = 43), and ineffective erythropoiesis (n = 42). The mean pretransfusion packed cell volume (PCV) of dogs with hemolysis (13%) was significantly lower (p less than 0.0001) than the mean pretransfusion PCVs of dogs with hemorrhage (21%) or ineffective erythropoiesis (18%). The mean total volume of PRBCs transfused was significantly greater (p less than 0.03) in dogs with hemolysis. Overall, 187 (61%) of 307 dogs were discharged from the hospital. Cause of anemia, pretransfusion PCV, and total volume of blood administered did not appear to influence survival. However, the mean adjusted posttransfusion PCV of dogs with hemorrhage was significantly higher (p less than 0.001) in dogs that survived. Possible adverse events were observed during or shortly after RBC transfusion in 10 (3.3%) dogs; all reactions were mild and self-limiting, and none were hemolytic.

Packed Red Blood Cell Transfusions in Critically Ill Patients

2011 ◽  
Vol 31 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Tara Ann Collins
Keyword(s):  
Blood Cell ◽  
Critically Ill ◽  
Red Blood Cell ◽  
Critically Ill Patients ◽  
Critical Review ◽  
Red Blood Cell Transfusion ◽  
Blood Transfusions ◽  
Change In Practice ◽  
Red Blood Cell Transfusions ◽  
Stored Blood

Anemia, which is prevalent in critically ill patients, often requires frequent blood transfusions. These blood transfusions are not without risks. A critical review of 6 studies shows an association between red blood cell transfusion and increased mortality. However, when disease state was adjusted for in 2 studies, researchers found that red blood cell transfusion correlated with decreased mortality. Thus further research, particularly on leukoreduction and age of stored blood, must be done before a change in practice can be implemented. It is vital that nurses stay current on this research in order to improve patients’ outcomes.

Red Blood Cell Transfusions in Patients Undergoing Lower Extremity Artery Bypass Surgery

2006 ◽  
Vol 95 (1) ◽  
pp. 39-43 ◽  
Author(s):  
T. T. Niemi ◽  
A. H. Kuitunen ◽  
J. Haukka ◽  
M. Lepäntalo
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Small Body ◽  
University Hospital ◽  
Red Blood Cell Transfusion ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Red Blood Cell Transfusions

Background and Aims: The purpose of this study was to search predictors of red blood cell transfusions in peripheral vascular surgical patients. Material and Methods: All the patients who undergone infrainguinal bypass surgery at Helsinki University Hospital in the year 2000 were included. Of 266 records 261 (98%) were available for data review. Multiple stepwise regression model was created to identify independent predictors of blood use. Results and Conclusions: 174 (67%) of the patients received red blood cell transfusion. The lowest measured mean (SD) haemoglobin was 94 (11) g/l intraoperatively and 92 (± 10) g/l on the first two postoperative days. The median (range) number of units was 3 (1–19). Multivariate analysis showed that high age (p = 0.019), small body surface area (p = 0.017), low preoperative haemoglobin (p<0.001), blood loss (p<0.001), long lasting surgery (p<0.001), reoperation (p = 0.018), femoro-distal reconstruction (p = 0.048) and chronic obstructive pulmonary disease (p = 0.023) increased the risk to receive red blood cell transfusion. The frequent use of antithrombotic medication (72% of the patients) did not significantly increase red blood cell administration. The generous use of red blood cells despite relative safe haemoglobin levels indicates a need for a standardized multidisciplinary transfusion strategy in this patient population. Otherwise, most of the predictors for red blood cell administration were nonmodifiable.

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