Laboratory Proficiency in Blood Banking: The Variability of Blood Bank Reagents—1971 (A Follow‐up Study)

A follow‐up statistical analysis of the 1971 College of American Pathologists Comprehensive Blood Bank Survey was made to determine if the variability of blood bank reagents noted in the 1970 Survey had significantly changed between 1970 and 1971. These studies revealed discordant results only in sera used to detect B‐positive and A₁‐negative red cells. No significant differences were found in any of the Rh typing sera. However, there was significant improvement from 1970 to 1971 in all manufacturers' sera as measured by this method.     

A Positive Donor‐Recipient Identification System for a Regional Blood Transfusion Service

A positive donor recipient identification system for a transfusion service has been developed. Donor and recipient identification are established by a human and machine readable number. The recipient ID system utilizes the standard hospital ID bracelet and a series of numerical thermal encoding transfer devices for vacutainer tubes and donor unit ID bag tags. The donor identity is maintained by prenumbered vacutainer pilot tubes and a separate donor unit bag tag.     

Transfusion of Long Stored Whole Blood or Washed Red Blood Cells Incubated with Adenine and Inosine

Full unit autotransfusions of long stored ACD blood, incubated with adenine and inosine at 37 C., were given to healthy young male volunteers. Red cells of blood stored for 35 days showed, after regeneration, a significant increase in ATP and a 24-hour posttransfusion survival of 78.8 per cent (70.9–85.9%); red cells of blood stored for 42 days, thus regenerated, showed a similar increase in ATP and a 24-hour posttransfusion survival of 75.6 per cent (71.5–80.6%). These results were not significantly different from those obtained with 10-ml token autotransfusions of blood similarly treated, the posttransfusion survival of red cells in token transfusions being 78.8 per cent for blood stored 35 days prior to regeneration with adenineinosine and 74 per cent for blood stored for 42 days prior to regeneration. Available data on toxicity of adenine and inosine have been critically reviewed: Chance of direct toxic effects with the small amounts involved may be dismissed when few transfusions are involved; however, uric acid overload must be considered when multiple transfusions are required within a short period of time. A single washing with saline-glucose solution reduces by 90 per cent the concentration of un-metabolized adenine and inosine, and of the product of their metabolism, hypoxanthine. The washing procedure involves a loss of only 0.55 per cent of the total red blood cell population; washing additionally reduces the amount of free hemoglobin. Washing has no effect on the ATP or red blood cell viability, and is recommended when multiple transfusions of cells treated with adenine and inosine are required in a short period of time.     

Calcium Ion Activity During Rapid Exchange Transfusion with Citrated Blood

Measurement of ionized calcium levels by the technic of Soulier during massive transfusion of ACD blood supplemented with various quantities of calcium led to the apparently erroneous conclusion that ionized calcium levels would rise in the recipient when each unit was supplemented with 0.6 g CaCl₂, the quantity which restores normal ionized calcium levels in vitro .
Measurement of ionized calcium activity with the Orion electrode indicates that this ratio of CaCl₂ will maintain an approximately normal ionized calcium level in dog recipients if it is infused simultaneously with the blood. Based on this information, it appears reasonable to assume that heparinized ACD blood, recalcified with 0.6 g CaCl₂ per unit, may be used to prime the extracorporeal circuit for open heart surgery with the confidence that it will not alter the ionized calcium activity of the patient's blood.
Addition of calcium to the circulation following administration of ACD blood causes a sharp rise and then a fall in the recipient's level of ionized calcium. Further studies in a variety of situations are required before final guidelines can be formulated for supplementation of ACD blood with calcium in massive transfusion.     

Evaluation of Methods for the Preparation of HL‐A Antigen‐Poor Blood

More than 85 per cent of the leukocytes are removed from blood by dextran or Plasmagel sedimentation and by both high and low glycerol freeze‐thaw technics. Larger numbers of white cells and platelets remain in bloods processed by inverted centrifugation, saline washing, and agglomeration without freezing. Cytoglomeration is the least efficient method of removing HL‐A antigens from frozen blood. Units prepared by this and other freezing methods contain nonviable leukocytes which may or may not be antigenic.     

换血治疗早产儿重度高胆红素血症94例临床分析

[目的] 探讨换血术治疗早产儿重度高胆红素血症（以下简称重度高胆）的效果.[方法] 采用经外周动静脉同步换血疗法对94例重度高胆早产儿进行治疗,比较换血前后血常规、血电解质和胆红素的差别,跟踪随访脑干听觉诱发电位（BAEP）的变化情况.[结果] 94例重度高胆早产儿总胆红素换出率为66.92%,血清总胆红素换血前的均值（495.45±154.43）μmol/L与换血后的均值（163.88±66.27）μmol/L相比较,差别有统计学意义（ P 〈0.05）.换血后血白细胞、红细胞、血红蛋白、血小板、血钙、血钾及血氯与换血前相比较,均存在显著性差别（ P 〈0.05）.换血并发症较少,临床症状明显改善.[结论] 换血治疗早产儿重度高胆红素血症安全有效.     

A Regional Computer‐based Blood Inventory Information System

A computer‐based blood inventory system for a regional blood distribution center is described. The inventory system keeps track of every unit of blood outstanding in affiliated hospital blood banks. Information recorded and updated daily for each blood unit consists of unit number, blood type, expiration date, date received by hospital, and state of availability in regard to reservation for a patient. The computer used is a time‐sharing system with teletypewriter connections. The system can be updated to reflect shipments, transfusions, transfers, etc., at any time of the day, but to keep cost down it is updated only once each day. Affiliated hospitals may contact the computer system directly to acquire their inventory reports. Alternatively, the reports can be sent to them. A variety of summary statistics are produced daily for planning and control.     

动脉置管失败后采用头皮针同步换血在临床的应用

目的：探讨动脉置管失败后采用9号头皮针进行新生儿换血疗法的方法和效果。方法：对动脉置管失败后48例重度高胆红素血症新生儿采用头皮针开放股动脉进行外周动静脉同步换血治疗。结果：用头皮针进行换血平均换血时间为2.5-3 h,换血过程中呼吸、心率、血压、血氧饱和度与用套管针换血比较无明显差异。结论：用头皮针进行换血操作方法简便、安全,是动脉置管失败后新生儿换血中较理想的替代方法。     

A Computer‐based Blood Inventory and Information System for Hospital Blood Banks as Part of a Regional Blood‐management Program

The feasibility of establishing computerized networks between hospital blood banks and regional blood distribution centers is being tested. A portion of this system is described which serves the individual hospital blood bank directly and eventually will feed its data into the total regional system. Information is entered via a teletypewriter by blood bank personnel. Reports can be generated that can serve as accession, reservation, and transfusion logs, reproduce the blood bank history of a patient or a unit of blood, indicate the status of the entire inventory or a single unit of blood, and highlight units about to outdate. Statistical summaries of various blood bank activities can be derived readily from the data base created. Analysis of a data base created from the blood bank records of two large metropolitan New York hospitals reveals significant differences in the amounts of blood used on the various services (medical, surgical, emergency, special) and for certain major medical conditions (gastrointestinal bleeding, renal dialysis). The probability that units requested actually will be transfused was calculated for one major medical category and a tentative age‐matching policy for the selection of bloods to be reserved was suggested. Attention is called to the necessity of considering standards of compatibility between present and future computer‐based systems for blood banks, that they can be merged into regional networks that will benefit the community, the donor, and the patient‐recipient.     

A Fresh Breath of Oxygen: Red Blood Cell Exchange Transfusion in Sickle Cell and COVID‐19

Red blood cell exchange transfusion may be beneficial and should be considered in the early management of patients with sickle cell disease and COVID‐19 to prevent the need for intubation and intensive care unit admission due to respiratory distress.     

换血治疗对高胆红素血症新生儿血液指标的影响和不良反应观察

目的 探讨换血治疗对新生儿高胆红素血症血液检验指标的影响.方法 选取本院2018年1月～2020年9月进行换血治疗的94例新生儿为研究对象,收集并记录新生儿的一般资料、换血前后血液检验指标及出现的不良反应情况.结果 94例换血治疗患儿,均是间接胆红素显著升高,其中ABO溶血病28例(29.8％),颅内出血和头皮血肿14...     

新生儿高胆红素血症换血治疗用血情况分析

目的通过调查单病种临床用血量,对我院新生儿高胆红素血症接受换血治疗的用血情况进行统计和分析,为临床合理用血提供有价值的依据。方法对我院2016年1月~2019年12月新生儿高胆红素血症接受换血治疗的389例患儿的临床资料进行回顾性分析,分别统计患儿的一般情况,并对换血治疗中用血量进行分析统计。结果389例患儿中男212例,女177例,性别差异无统计学意义(P>0.05);A型155例,B型128例,O型80例,AB型26例,患儿血型比较有统计学差异(P<0.001),高胆红素血症患者中O型血患儿换血最少,A型与B型无统计学差异(P>0.05);换血治疗多选用新鲜O型红细胞悬液和AB型新鲜冰冻血浆,O型红细胞用量共计1060 U,占红细胞总量86.14%,AB型血浆49050 mL,占血浆用量的75.81%,平均每例用血量为红细胞悬液3.13 U,新鲜冰冻血浆165 mL。结论通过对新生儿换血用血的分析,总结出用血经验,为优化用血方案提供依据,有效治疗的同时合理用血,节约用血。     

高胆红素血症新生儿换血前后血生化和甲状腺功能变化的研究

目的：通过对高胆红素血症新生儿换血前后血生化、甲状腺功能变化的检测,探讨其原因。方法：分别对17例高胆红素血症新生儿换血前后血常规、电解质、血糖及甲状腺功能等指标进行检测。结果：本组血清总胆红素和间接胆红素换血前、后有明显下降。换血后血电解质血钾降低,血钠、血钙升高,血糖暂时性升高,但在24h内自行恢复至正常。可有贫血,白细胞及血小板明显下降,甲状腺功能变化没有显著性意义（P〉0．05）,无明显并发症发生。结论：换血后可出现低钾、高钙、高钠、高血糖、低白细胞和血小板血症的发生,应预防感染、出血和电解质紊乱的发生。     

Therapeutic drug monitoring of gentamicin: a 6‐year follow‐up audit

Background and objective : In 1984 a therapeutic drug monitoring (TDM) service was established in Hospital Universiti Sains Malaysia (HUSM) and gentamicin concentrations were measured and used to design optimal regimens for the antibiotic. In this study we report on a 6‐year follow‐up audit since our first assessment of the service. Method : Records of 733 requests for gentamicin monitoring were reviewed. Results : Of the 592 patients involved, 39% were neonates and 42% were adults. Peak gentamicin concentrations were within the therapeutic range in 65% of the patients at first monitoring and 79% of the corresponding trough concentrations were within the non‐toxic range. After dosage adjustment, 81% of the peak concentrations were within the therapeutic range and trough concentrations rose to levels regarded as toxic in 7% of patients. In patients with therapeutic peak concentrations at the first monitoring point, the average duration of gentamicin therapy was statistically shorter than in those patients who failed to achieve a therapeutic peak concentration. The distribution of gentamicin peak and trough concentrations in terms of therapeutic ranges were also better than those found in 1990. Conclusion : TDM for gentamicin is well accepted in HUSM and its application has contributed to improved gentamicin administration. Furthermore, our physicians are now able to choose more appropriate dosage regimens for their patients because the majority of gentamicin concentrations attained even at the first monitoring were within the therapeutic range.     

军字一号输血管理子系统在输血科的应用体会

自1998年《中华人民共和国献血法》和《医疗机构临床用血管理办法》(试行)颁布实施以来,北京市除少数几家医院有采血资格外,多数医院输血科由以前采供一体的工作模式转换为由市血液中心供应血液的单纯的配／发血工作模式。本科于2001年7月将军字一号输血管理分系统3．0版本中的配／发血管理、统计与查询子系统应用于日常工作,现将近3年的应用体会分述如下。     

Regional Automated Data‐processing System for Blood Banks

There is significant advantage to be gained through a regional system for automatic data‐processing for blood banks. To achieve maximum savings there must be close cooperation between facilities, and the supply and demand problem must be monitored closely. The cost of operating a system allocated to inventory control must be justifiable but, if savings equal cost, the benefits of knowing the location of needed blood and of reducing commercial purchases also must be considered. The BIMACS system is modular and can be adapted to many computer configurations. Prototypes include inventory control, donor files, rare donor files, invoicing and billing, payroll, and special reports useful for administration, technical controls, and research. The protoype system will be installed June 1970. Details and documentation probably will be available November 1970.