Risks of blood transfusion

This article discusses advances in blood safety during the last 20 years, particularly for prevention of transfusion-transmitted viral infections. Although the most serious known risks from blood transfusion are administrative errors, transfusion-related acute lung injury, and bacterial contamination in platelet products, infection from emerging pathogens such as West Nile virus emphasizes the need for implementing proactive strategies. Pathogen inactivation technologies and reactive strategies such as nucleic acid testing ensure continued advances in blood safety.     

输血输液加温仪在库存红细胞悬液输注过程中的应用效果

目的观察输血输液加温仪应用于库存红细胞悬液输注过程的临床效果。方法 80例择期手术的成年患者,男42例,女38例,年龄32~60岁,ASAⅠ或Ⅱ级,随机分为加温组和对照组,每组40例,术中均输注3单位的库存红细胞悬液。加温组库存红细胞悬液通过输血器连接加温仪进行输注,对照组库存红细胞悬液放置于室温中自然复温30min再进行输注。测定加温仪加温前后和对照组复温前后红细胞(RBC)计数、红细胞压积(Hct)及血清K+、Na+、Cl-离子变化;观察输注前、输注后30min的体温变化,输注速度,以及麻醉苏醒期寒战情况。结果两组间及加温/复温前后库存红细胞悬液红细胞计数、HCT、血清K+、Na+、Cl-离子的变化差异均无统计学意义。输注后30min对照组体温降低幅度明显大于加温组(P0.05)。输注过程中加温组均未发生输注速度明显减慢,而对照组有16例(40%)(P0.01)。加温组麻醉苏醒期寒战发生率(5%)明显低于对照组(30%)(P0.01)。所有患者均未发生严重输血不良反应。结论库存红细胞悬液输注过程应用输血输液加温仪临床效果良好,值得临床推广应用。     

术中自体血回输与输注异体血对脊柱手术术后血液流变学的影响

目的 对比术中自体血回输和输注异体血对脊柱手术病人血液流变学（凝血功能）的影响,进一步探讨术中血液回收的安全性和可行性。方法 选择2015年1月至2016年12月我院收治的术前实验室检验正常、无凝血功能异常且未接受抗凝治疗、非恶性肿瘤、术中血液无污染的骨科脊柱开放性手术病人100例。严格遵守献血与输血的伦理准则分组：①自体血液回输组（自体组）,即术中回输经洗涤处理的自体血,男22例,女28例;②异体输血组（异体组）,即行异体输血,男23例,女27例。两组病人一般资料比较,差异均无统计学意义（均P＞0.05）。同时进行血液流变学项目监测,并对比输血对病人凝血功能的影响。结果 自体组的术中回输自体血量为（289.4±55.7） ml,少于异体组的异体输血量［（396.5±141.1） ml］,两者比较差异有统计学意义（t=4.992,P＜0.05）。术后第3天两组病人的红细胞压积,自体组为31.00%±5.84%,小于异体组的34.25%±6.15%,两组比较差异具有统计学意义（t=2.710,P=0.007）;两组病人其余血液流变学参数比较,差异均无统计学意义（均P＞0.05）。术后第7、14天,两组病人各项血液流变学参数比较,差异均无统计学意义（均P＞0.05）。结论 自体血回输对血液流变学参数的影响与输注异体血相比无显著差异,可广泛应用于临床。     

输血不良反应情况分析

目的:通过对我院临床输血不良反应的回顾性分析,探讨降低和预防输血不良反应的措施。方法:收集我院2009年8月～2012年6月输血不良反应病例,进行分类分析。结果:在10684人次输血中,发生非溶血性输血反应29例,发生率为0.27%,其中过敏反应12例(0.11%),发热反应14例(0.13%),其他反应3例(0.03%)。结论:严格掌握输血指征,选择合适的血液制品,降低输血不良反应,才能达到科学、安全、有效的输血。     

输血感染与输血安全

输血感染严重威胁输血安全。虽然随着人们自愿无偿献血观念的增强、新的更高效的致病原检测和灭活技术的推广以及临床正规、合理用血的开展,输血安全性在不断提高。但是一些已发现并证实的血液传播病原体还未能完全检出和清除;而一些新的经血传播的病原体又不断被发现,这无疑都对输血安全造成威胁。     

回收式自体输血与异体输血对机体炎症反应的影响

背景 自体血回输在围术期应用日益广泛.自体血和异体血输注均会对机体的炎症反应产生一定的影响.目的 对两种输血方式后机体炎症因子的变化进行对比,阐述围术期两种输血方式对患者的影响. 内容 异体血在输注过程中产生大量炎症因子,如白细胞介素(interleukin,IL)-2、IL-6、IL-8、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)等,引起机体炎症反应,可能是术后并发症的重要原因.自体血在回收、过滤的过程中同样会产生一定量的炎症因子. 趋向 对骨科自体血及异体血应用进行对比,研究两种输血方式对机体炎症反应的影响.     

Anaemia and blood transfusion

Anaemia is a common diagnosis in surgical practice. It may impair oxygen delivery to tissues and cause significant complications. This article discusses definitions, critical levels of anaemia, along with transfusion triggers. An overview of the manufacture provision, and use of various blood products along with novel agents and research areas is also covered.     

Complications of blood transfusion

The first 150 words of the full text of this article appear below. Key points

• Complications of blood transfusion are rare but canbe life-threatening.
• Since 2005, it has been a legal requirementthat all serious adverse reactions attributable to the safetyor quality of blood are reported.
• Most reported complicationsare because of transfusion of mismatched blood products andare avoidable through clinical vigilance.
• Massive blood transfusionsresult in abnormalities of coagulation status, serum biochemistry,acid–base balance and temperature homeostasis.
• Transfusion-relatedacute lung injury is the most common cause of major morbidityand death after transfusion.

  The serious hazards of transfusion (SHOT) scheme has collecteddata on significant adverse events resulting from transfusionof blood components from volunteer organizations since 1996.However, after the implementation of the European Union Directiveon Blood Safety and Quality in 2005, it is now a requirementthat all ‘Blood Establishments and Hospital Blood Banksreport to the Secretary of State for Health all serious adversereactions . . . [Full Text of this Article]