Some troubles and complications while using transfusion therapy

2021 ◽  
Vol 50 (2) ◽  
pp. 104-109
Author(s):  
V. V. Vetrov
Keyword(s):  
Blood Transfusion ◽  
Transfusion Therapy

In the review the literary data on some troubles and complications o f blood transfusion are drawn.

Abstract TP402: Sickle Cell Disease in Pediatric Stroke - Inpatient Resource Utilization in the Decade Following STOP

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
J. Michael Taylor ◽  
Paul Horn ◽  
Heidi Sucharew ◽  
Todd A Abruzzo ◽  
Jane Khoury
Keyword(s):  
Sickle Cell Disease ◽  
Blood Transfusion ◽  
Sickle Cell ◽  
Care Utilization ◽  
Cell Disease ◽  
Common Procedure ◽  
Transfusion Therapy ◽  
Stroke Population ◽  
Clinical Classification Software ◽  
Inpatient Database

Background: Sickle cell disease (SCD) is an important risk factor for stroke in children. Natural history studies demonstrate that greater than 10% of hemoglobin SS patients suffered ischemic stroke prior to age 20 years. In 1998, the Stroke Prevention Trial in Sickle Cell Anemia (STOP) successfully demonstrated the role for routine transfusion therapy in reducing stroke in at risk SCD patients. Fullerton and colleagues then found that first time stroke in SCD decreased in Californian children in the 2 years following STOP. We investigated the stroke rate and health care utilization of children with SCD for two calendar years in the decade following publication of the STOP trial using a national inpatient database. Methods: The 2000 and 2009 Kids’ Inpatient Database (KID) were used for analysis. SCD and stroke cases were identified by ICD-9 codes 282.6x, 430, 431, 432.9, 434.X1, 434.9, 435.9. We queried the KID procedural clinical classification software for utilization of services pertinent to SCD and stroke; transfusion, MRI, and cerebral angio. Results: In 2000, SCD was a discharge diagnosis in 34,294 children and 158 (0.46%) children had SCD and stroke. By 2009, discharges with SCD rose to 37,082 children with 212 (0.57%) children carrying both diagnoses. In 2000 and 2009, AIS is the most common stroke type at 83%, males account for 53% of stroke and black race was reported by 92% of SCD and stroke subjects. Procedure utilization is higher in the SCD and stroke population than in SCD without stroke (Figure 1). Blood transfusion is the most common procedure in both study years, significantly higher in stroke subjects. Conclusion: For pediatric inpatients with SCD, blood transfusion and diagnostic cerebrovascular procedures were significantly more common in the cohort with comorbid stroke. In the decade after STOP, children hospitalized with SCD and stroke represented less than 0.6% of the total inpatient SCD population.

Retinal microvascular analysis using Fundus Fluorescein Angiography in Egyptian sickle cell disease patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nayera H El Sherif ◽  
Mahmoud A Kenny ◽  
Waheed S Elhalfawy
Keyword(s):  
Sickle Cell Disease ◽  
Blood Transfusion ◽  
Fluorescein Angiography ◽  
Sickle Cell ◽  
Large Sample Size ◽  
Cell Disease ◽  
Fundus Fluorescein Angiography ◽  
Transfusion Therapy ◽  
Hydroxyurea Treatment ◽  
Trans Cranial Doppler

Abstract Background Sickle cell disease can affect retina of eye via vaso-occulsive changes that occur in micro-vessels of retina which could be analysed by using Fundus Fluorescein Angiography. Aim To analyze macular microvascular alternation in patients with SCD by Fundus Fluorescein Angiography (FFA) and to assess the role of potentially contributory Clinico-pathological factors including Trans-Cranial Doppler, genotypes, hydroxyurea, transfusion therapy and finally iron overload state on the development of macular alterations. Method This was across-sectional study which included 30 Sickle cell disease patients randomly recruited from the Paediatric Haematology clinic, children Hospital, Ain Shams University, Cairo, Egypt. Complete blood count (CBC), Trans-Cranial Doppler (TCD) and Fundus Fluorescein Angiography. Results In our study, there were 30 patients with mean age (14.1± 4.02), 5 patients had abnormal/conditional Trans-Cranial, 15 patients had Vaso-occlusive crises, 11 patients were on regular simple blood transfusion; all 30 studied sickle cell disease patients had normal Fundus Fluorescein Angiography and eye examination and only one patient hadabnormal visual acuity;A 29 years oldgirl who had five attacks of cerebral strokes last year, on regular simple blood transfusion and Hydroxyurea treatment with abnormal TCD and recurrent Vaso-occlusive crises in last two years, Although her vision is hand movement yet Fundus Fluorescein Angiography was normal. Conclusion we didn’t find any Retinal microvascular alternation in our studied SCD patients using Fundus Fluorescein Angiography, we related our results to the fact that our studied SCD patients were young and all our studied patients were on hydroxyurea therapy with fair compliance, further studies using large sample size are warranted in order to illustrate the utility of Fundus Fluorescein Angiography (FFA) as a tool for better detection of sickle retinopathy.

scholarly journals Myth: Blood transfusion is effective for sickle cell anemia—associated priapism

CJEM ◽  
2006 ◽  
Vol 8 (02) ◽  
pp. 119-122 ◽  
Author(s):  
Andrew L. Merritt ◽  
Christopher Haiman ◽  
Sean O. Henderson
Keyword(s):  
Blood Transfusion ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Conventional Therapy ◽  
Case Reports ◽  
Complete Information ◽  
Effective Therapy ◽  
Transfusion Therapy ◽  
Medline Search ◽  
Neurologic Sequelae

ABSTRACTObjective:Priapism is a recognized complication of sickle cell anemia (SCA). When initial conventional treatments fail, simple or exchange blood transfusion has been advocated as a secondary intervention. However, recent literature suggests this may not be an effective therapy and may have significant neurologic sequelae. This paper reviews and summarizes the effectiveness and risks of blood transfusion compared with conventional priapism therapy.Methods:All relevant papers identified from a MEDLINE search were systematically examined for data related to the use of blood transfusion in the setting of priapism due to SCA. The effectiveness of conventional therapy was compared with transfusion therapy using the outcome of “time to detumescence” (TTD). In addition, papers documenting adverse neurologic sequela were reviewed and summarized.Results:Forty-two case reports were identified containing complete information with regard to patient age and TTD. The mean TTD was 8.0 days with conventional therapy (n= 16) and 10.8 days with blood transfusion therapy (n= 26). Adverse neurologic sequelae from blood transfusion therapy was described in 9 cases, with long term outcomes ranging from complete resolution to severe residual deficits.Conclusion:The current literature does not support the contention that blood transfusion is an effective therapy in the treatment of priapism due to SCA, as defined by an acceleration of TTD. In fact, numerous reports suggest that serious neurologic sequelae may result from this treatment. We feel the routine use of this therapy cannot be recommended.

scholarly journals Optimal blood transfusion therapy in haemoglobinopathies

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
John Porter
Keyword(s):  
Blood Transfusion ◽  
Exchange Transfusion ◽  
Standard Of Care ◽  
Venous Access ◽  
Iron Deposition ◽  
Iron Loading ◽  
Blood Products ◽  
Transfusion Therapy ◽  
Increased Risk ◽  
Thalassaemia Intermedia

For reasons of time, this short talk will be confined to the optimal frequency, timing, indications and dosing of blood transfusion. Blood transfusion protocols in thalassaemia syndromes are more widely agreed (1) than for sickle disorders but questions still remain about optimal Hb levels, timing and frequency. In transfusion thalassaemia thalassaemias (TDT) , the purpose of blood transfusion is to maximise quality of life by correcting anaemia and suppressing ineffective erythropoiesis, whilst minimising the complications of the transfusion itself. Under-transfusion will limit growth and physical activity while increasing intramedullary and extra-medullary erythroid expansion. Over transfusion may cause unnecessary iron loading and increased risk of extra-hepatic iron deposition however. Although guidelines imply a ‘one size fits all’ approach to transfusion, in reality this is not be the case. Indeed a flexible approach crafted to the patient’s individual requirements and to the local availability of safe blood products is needed for optimal outcomes. For example in HbEβ thalassaemias, the right shifted oxygen dissociation curve tends to lead to better oxygen delivery per gram of Hb than in β thalassaemia intermedia with high Hb F. Patients with Eβthal therefore tend to tolerate lower Hb values than β thalassaemia intermedia. Guidelines aim to balance the benefits of oxygenation and suppression of extra-medullary expansion with those of excessive iron accumulation from overtransfusion. In an Italian TDT population, this balance was optimised with pre-transfusion values of 9.5-10.5g/dl (2). However this may not be universally optimal because of different levels of endogenous erythropoiesis with different genotypes in different populations. Recent work by our group (3) suggests that patients with higher levels of endogenous erythropoiesis, marked by higher levels of soluble transferrin receptors, at significantly lower risk of cardiac iron deposition than in those where endogenous erythropoiesis is less active, as would be the case in transfusion regimes achieving higher levels of pre-transfusion Hb. In sickle cell disorders, the variability in the phenotype between patients and also within a single patient at any given time means that the need for transfusion also varies. A consideration in sickle disorders, not usually applicable to thalassaemia syndromes, is that of exchange transfusion versus simple top up transfusion. Exchanges have the advantages of lower iron loading rates and more rapid lowering of HbS%. Disadvantages of exchange transfusion are of increased exposure to blood products with inherent increased risk of allo-immunisation or infection, requirement for better venous access for adequate blood flow, and requirements for team of operators capable of performing either manual or automated apheresis, often at short notice. Some indications for transfusion in sickle disorders are backed up by randomised controlled data, such as for primary and secondary stroke prevention, or prophylaxis of sickle related complications for high-risk operations (4). Others are widely practiced as standard of care without randomised data, such as treatment of acute sickle chest syndrome. Other indications for transfusion, not backed up by randomised studies, but still widely practiced in selected cases, include the management of pregnancy, leg ulceration or priapism and repeaed vaso-occlusive crises. Allo-immunisation is more common in sickle patients than in thalassaemia disorders and hyper-haemolysis is a rare but growing serious problem in sickle disorders. It is arguable that increased use of transfusion early in life, is indicated to decrease silent stroke rates and that early exposure to blood will decease red cell allo-immunisation rates.

scholarly journals Development of an Automated Device for the Procedure of Blood Transfusion in Newborns

2020 ◽  
Vol 3 (3) ◽  
pp. 279-287
Author(s):  
Patrícia Quariguazy da Frota ◽  
Josiane Dantas Viana Barbosa ◽  
Paulo Roberto Freitas Neves
Keyword(s):  
Blood Transfusion ◽  
Literature Review ◽  
Medical Device ◽  
Neonatal Jaundice ◽  
Maternal Antibodies ◽  
Volume Replacement ◽  
Hemolytic Disease ◽  
Transfusion Therapy ◽  
Erythrocyte Hemolysis ◽  
First Choice

Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, is a problem of fetal erythrocyte hemolysis. This may happen due to the sensitization of maternal antibodies through the placental route. It is the pathology most frequently found in neonatal patients. Approximately 98% of maternal alloimmunization cases by erythrocyte antigens are due to the RhD factor. Phototherapy is the first choice in the treatment of neonatal jaundice. Blood transfusion is the therapy instituted for the treatment of severe neonatal disease. This study aimed to develop an automated device for performing the blood transfusion procedure. The method was developed in four stages: (1) Literature review about the search for theoretical references based on scientific articles and textbooks on transfusion therapy in the newborn; (2) Elaboration of the device consisted of items related to its assembly and structuring; (3) Operation of the medical device, including specific schedules related to the execution of the procedure; (4) Performing tests with simulating the purpose of volume replacement in the total cycle performed in the exsanguine transfusion procedure. The results showed that it was possible to assemble, reproduce, and implement the automation of the device developed for the exsanguine transfusion procedure in a practical. Also, the procedure presented security and effectiveness in the clinical treatment related to HDN.  

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