Utilisation of blood products at a centre in Pakistan. Is donating better than wasting?

Author(s):  
Haya Ul Mujtaba ◽  
Nida Anwar ◽  
Naveena Fatima ◽  
Imran Naseer ◽  
Munira Borhany ◽  
...  

Abstract The study was designed to investigate the quantity and reasons of wastage of blood products. This was an observational study conducted from February 2018 to February 2019 at the National Institute of Blood Disease and Bone Marrow Transplantation (NIBD and BMT), PECHS campus. The study was approved by the institutional review board. Wastage and reasons of wastage for all the blood products were evaluated. Frequencies were calculated by using SPSS version 23.0. A total of 2,880 bags of blood products were available, including 960 each of platelets, packed red cells and fresh frozen plasma. The overall wastage rate was 3.5%. Packed red cells and platelets were fully consumed, yet shortage of supply was observed. However, highest wastage was observed in fresh frozen plasma i.e. 102 bags. Expiry of unused products 60 (59%) followed by broken bags 30 (29%) were two common modes of wastage. Continuous...  

Author(s):  
Richard Telford

This chapter discusses the anaesthetic uses of blood products and other fluids. It begins with a discussion of blood products (red cells, platelets, fresh frozen plasma, and so on). It goes on to describe blood conservation techniques such as cell salvage. Massive transfusion is discussed with its protocol. The problems posed by Jehovah’s Witnesses who refuse blood products are explored. The chapter concludes with a discussion of fluid and electrolyte therapy.


Author(s):  
Richard Telford

This chapter discusses the anaesthetic uses of blood products and other fluids. It begins with a discussion of blood products (red cells, platelets, fresh frozen plasma, and so on). It goes on to describe blood conservation techniques such as cell salvage. Massive transfusion is discussed with its protocol. The problems posed by Jehovah’s Witnesses who refuse blood products are explored. The chapter concludes with a discussion of fluid and electrolyte therapy.


2021 ◽  
Vol 47 (01) ◽  
pp. 074-083
Author(s):  
Kathryn W. Chang ◽  
Steve Owen ◽  
Michaela Gaspar ◽  
Mike Laffan ◽  
Deepa R. J. Arachchillage

AbstractThis study aimed to determine the impact of major hemorrhage (MH) protocol (MHP) activation on blood administration and patient outcome at a UK major cardiothoracic center. MH was defined in patients (> 16 years) as those who received > 5 units of red blood cells (RBCs) in < 4 hours, or > 10 units in 24 hours. Data were collected retrospectively from patient electronic records and hospital transfusion databases recording issue of blood products from January 2016 to December 2018. Of 134 patients with MH, 24 had activated MHP and 110 did not have activated MHP. Groups were similar for age, sex, baseline hemoglobin, platelet count, coagulation screen, and renal function with no difference in the baseline clinical characteristics. The total number of red cell units (median and [IQR]) transfused was no different in the patients with activated (7.5 [5–11.75]) versus nonactivated (9 [6–12]) MHP (p = 0.35). Patients in the nonactivated MHP group received significantly higher number of platelet units (median: 3 vs. 2, p = 0.014), plasma (median: 4.5 vs. 1.5, p = 0.0007), and cryoprecipitate (median: 2 vs. 1, p = 0.008). However, activation of MHP was associated with higher mortality at 24 hours compared with patients with nonactivation of MHP (33.3 vs. 10.9%, p = 0.005) and 30 days (58.3 vs. 30.9%, p = 0.01). The total RBC and platelet (but not fresh frozen plasma [FFP]) units received were higher in deceased patients than in survivors. Increased mortality was associated with a higher RBC:FFP ratio. Only 26% of patients received tranexamic acid and these patients had higher mortality at 30 days but not at 24 hours. Deceased patients at 30 days had higher levels of fibrinogen than those who survived (median: 2.4 vs. 1.8, p = 0.01). Patients with activated MHP had significantly higher mortality at both 24 hours and 30 days despite lack of difference in the baseline characteristics of the patients with activated MHP versus nonactivated MHP groups. The increased mortality associated with a higher RBC:FFP ratio suggests dilutional coagulopathy may contribute to mortality, but higher fibrinogen at baseline was not protective.


2021 ◽  
pp. 175045892095066
Author(s):  
Minna Kallioinen ◽  
Mika Valtonen ◽  
Marko Peltoniemi ◽  
Ville-Veikko Hynninen ◽  
Tuukka Saarikoski ◽  
...  

Since 2013, rotational thromboelastometry has been available in our hospital to assess coagulopathy. The aim of the study was to retrospectively evaluate the effect of thromboelastometry testing in cardiac surgery patients. Altogether 177 patients from 2012 and 177 patients from 2014 were included. In 2014, the thromboelastometry testing was performed on 56 patients. The mean blood drainage volume decreased and the number of patients receiving platelets decreased between 2012 and 2014. In addition, the use of fresh frozen plasma units decreased, and the use of prothrombin complex concentrate increased in 2014. When studied separately, the patients with a thromboelastometry testing received platelets, fresh frozen plasma, fibrinogen and prothrombin complex concentrate more often, but smaller amounts of red blood cells. In conclusion, after implementing the thromboelastometry testing to the practice, the blood products were given more cautiously overall. The use of thromboelastometry testing was associated with increased possibility to receive coagulation product transfusions. However, it appears that thromboelastometry testing was mostly used to assist in management of major bleeding.


Author(s):  
Rosita Linda ◽  
Devita Ninda

Each year more than 41,000 blood donations are needed every day and 30 million blood components are transfused. Blood products that can be transfused include Packed Red Cells (PRC), Whole Blood (WB), Thrombocyte Concentrate (TC), Fresh Frozen Plasma (FFP). Monitoring Hemoglobin (Hb) after transfusion is essential for assessing the success of a transfusion. The time factor after transfusion for Hemoglobin (Hb) examination needs to be established, analyze to judge the success of a blood transfusion which is performed. The aim of this study was to analyze the differences in changes of hemoglobin between 6-12 hours, and 12-24 hours after-transfusion. This study was retrospective observational using secondary data. The subjects were patients who received PRC, and WBC transfusion. At 6-12, and 12-24 hours after-transfusion, hemoglobin, RBC, and hematocrit were measured. Then the data were analyzed by unpaired t-test. The collected data included the results of the Hb pre-transfusion, 6-12, and 12-24 hours after-transfusion. The subjects of this study were 98 people. The administration of transfusion increased by 10-30% in hemoglobin concentration at 6-12 hours after-transfusion. While at 12-24 hours after-transfusion, hemoglobin after-transfusion increased 15-37% from the baseline. Hemoglobin values were not different at any of the defined after-transfusion times (p = 0.76 (p>0.05)). Hemoglobin values were not different at 6-12 hours, and 12-24 hours after-transfusion.    Keywords: Hemoglobin, measurement, after-transfusion 


Author(s):  
Alison Smith

The transfusion of blood products may be required in the pre- and post-operative periods. However, there are inherent risks associated with blood transfusion, and there is not an unlimited supply of blood donations available. When a patient is anaemic, red blood cells should be transfused to maintain the oxygen-carrying capacity of blood. Blood products, such as platelets and fresh frozen plasma, are transfused to correct a coagulopathy and during major haemorrhage. This chapter reviews the physiology of blood, including ABO compatibility and rhesus status, the main blood products available for transfusion, and transfusion policy, including the treatment of major haemorrhage and the refusal of blood products.


1990 ◽  
Vol 63 (01) ◽  
pp. 027-030 ◽  
Author(s):  
Maureen Andrew ◽  
Barbara Schmidt ◽  
Lesley Mitchell ◽  
Bosco Paes ◽  
Frederick Ofosu

SummaryThe ability to generate thrombin is decreased and delayed in plasma from the healthy newborn infant compared to the adult. Only 30 to 50% of peak adult thrombin activity can be produced in neonatal plasma. To test whether this observation can be explained by the low neonatal levels of the contact or vitamin K dependent factors, we measured neonatal thrombin generation after raising the concentration of these factors to adult values. We also determined whether the addition of a variety of blood products to neonatal plasma improved thrombin generation. An amidolytic method was used to quantitate intrinsic (APTT) and extrinsic (PT) pathway thrombin generation in defibrinated pooled cord plasma from healthy term infants. Added individually, factors VII, IX, X or the contact factors (CF) failed to alter the rate or the total amount of thrombin generated in neonatal plasma. In contrast, the addition of prothrombin increased the total amount of thrombin generated to above adult values in both the APTT and the PT systems but did not alter the rate of thrombin generation. The rate of thrombin generation in cord plasma shortened after a combination of II, IX, X and CF was added to the APTT system or II, VII and X to the PT system. In both systems, the total amount of thrombin generated was linearly related to the initial prothrombin concentration. Each of fresh frozen plasma, cryoprecipitate, plasma from platelet concentrates, or factor IX concentrate (in amounts used therapeutically) caused an increase in the total amount of thrombin generated which was related to the increase in prothrombin concentration. Thus, the total amount of thrombin generated in newborn plasma is critically dependent on the prothrombin concentration whereas the rate at which thrombin is generated is dependent on the levels of many other coagulation proteins in combination.


1998 ◽  
Vol 89 (Supplement) ◽  
pp. 1333A
Author(s):  
Thomas Frietsch ◽  
Heiko Fessler ◽  
Arnulf Lorentz ◽  
Michael Kirschfink ◽  
Klaus F. Waschke

2019 ◽  
Vol 28 (11-12) ◽  
pp. 233-30
Author(s):  
C. S. Matondang ◽  
Arwin Akib ◽  
Syawitri P. Siregar ◽  
Maria Abdulsalam ◽  
Jeanne Latu ◽  
...  

From March 1987 till February 1988, 350 serological examinations to HJV antibodies have been carried out. Sera were taken from children visiting the Department of. Child Health Faculty of Medicine University of Indonesia I Dr. Cipto Mangunkusumo General Hospital, Jakarta, who had received blood or blood products transfusions more than three times. All blood or blood products were made locally by the Jndonesian Red Cross in Jakarta, except for Human immunoglobulin and Koate. The age ranged from 9 months Ia 22 years with a mean age of 8,02 years. They consisted of 207 males and 143 females; 33 patients with hemophilia, 250 patients with thalassemia, 41 patients with blood malignancy, and 26 patients with other diseases. Sera were tested by a commercially available ELISA HIV assay produced by Abbott (macro ELISA) and Behring (micro ELISA). Repeatable positive sera were confirmed by Western blatt. The majority of patients in this study got their first transfusion on more than 5 years ago with a high consumption of blood components, namely 16.252 units of packed red cells, 6111 units of cryoprecipitate, 537 units of thrombocyte suspension, 96 units of fresh frozen plasma, 35 units of human immunoglobulin, and 15 vials of Koate. Two out of 350 sera were repeatable positive for HIV antibody but confirmatory test by Western blatt were negative. One sera was from a 17-year-o/d gM with thalassemia who had received 129 units of packed red cells transfusions since 1979, and the other was from a 2-year-o/d girl with chronic myelocytic leukemia who had received 24 units of packed red cells. The rest of the sera were negative. This zero prevalence finding suggests that in Indonesia transfusion of blood or blood products still plays a limited role in the epidemic of AIDS in children.


Author(s):  
Drew Provan ◽  
Trevor Baglin ◽  
Inderjeet Dokal ◽  
Johannes de Vos

Introduction - Using the blood transfusion laboratory - Transfusion of red blood cells - Platelet transfusion - Fresh frozen plasma - Intravenous immunoglobulin - Transfusion transmitted infections - Irradiated blood products - Strategies for reducing blood transfusion in surgery - Maximum surgical blood ordering schedule (MSBOS) - Patients refusing blood transfusion for religious reasons, i.e. Jehovah’s Witnesses


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