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1.
Andreea-Iuliana Ceanga Mihai Ceanga Maria Eveslage Edwin Herrmann Dania Fischer Axel Haferkamp Maria Wittmann Stefan Müller Hugo Van Aken Andrea Ulrike Steinbicker 《Transfusion and apheresis science》2018,57(6):739-745
Background
Preoperative anemia and allogeneic blood transfusions (ABTs) may affect outcomes in cancer surgery. The prevalence of anemia, the use of ABTs, the risks of transfusions, lengths of stay and mortality of oncological patients undergoing radical cystectomy were investigated in three University Hospitals in Germany.Patients and Methods
Hospital records of 220 consecutive patients undergoing radical cystectomy from 2010 to 2012 were retrospectively analyzed for independent risk factors of ABT and unfavorable outcomes (readmission, increased length of stay (LOS) or death) using multivariate regression analysis.Results
Preoperative anemia was present in 40%. 70% of patients received blood transfusions. Low preoperative and intraoperative nadir hemoglobin levels were associated with receipt of ABT (OR 1.33, P?=?0.04 and OR 2.94, P?<?0.001 respectively). Transfusion of ten or more red blood cell units (RBCs) during the entire hospital stay was a predictor of an increased LOS (P?<?0.001) and death (OR 52, 95%CI [5.9, 461.3], P?<?0.001), compared to non-transfused patients. Preoperative ABT and ASA scores were associated with ≥10RBCs.Conclusion
Anemic patients undergoing radical cystectomy had a high risk to receive ABTs. Preoperative transfusions and transfusion of ≥10RBCs during the entire hospital stay may increase patient`s mortality.Prospective, randomized controlled studies have to follow this study. 相似文献2.
Rafael Bielza Asunción Mora Francisco Zambrana Jorge Sanjurjo David Sanz-Rosa Israel J. Thuissard Estefanía Arias Marta Neira Jorge Francisco Gómez Cerezo 《Transfusion and apheresis science》2018,57(4):517-523
Background
Patient blood management (PBM) performs multidisciplinary strategies to optimize red blood cell (RBC) transfusion. Orthogeriatric share care models (surgeon and geriatrician manage the patient together from admission) have the goal of improving outcomes in hip fracture patients.Material and methods
A prospective observational study was conducted. Patients aged ≥70 years undergoing hip fracture (HF) surgery were consecutively included. When admitted on the orthogeriatric service a PBM protocol was applied based on: perioperative antithrombotic management, intravenous iron sucrose administration and restrictive transfusion criteria. Risk factors, clinical and functional effects of transfusion and its requirements were assessed to audit our model.Results
A total of 383 patients participated (women, 78.8%; median age, 86 (82–90) years). 210 patients (54.8%) were transfused. Age (OR?=?1.055, 95% CI 1.017–1.094; p?=?0.004) and Hemoglobin (Hb) level on admission (OR?=?0.497, 95% CI 0.413–0.597; p?<?0.001) were found to be significant risk factors for transfusion. Transfusion increased length of stay (b?=?1.37, 95% CI 0.543–2.196; p?=?0.001) but did not have an effect on other variables.Discussion
The PBM program established within an orthogeriatric service showed positive outcomes in terms of clinical complications, mortality, delirium or functional recovery in transfused patients, whereas it did not impact on shorter length of stay. The risk of transfusion on admission was predicted with the lower Hb levels on admission, along with the age of the patients. New measurements as homogenous restrictive transfusion criteria, a single-unit RBC transfusion and the assessment of the intravenous iron efficacy are need to be applied as a result of the high transfusion requirements. 相似文献3.
Vitor Mendonça Alves Fernanda Bernadelli De Vito Paulo Roberto Juliano Martins Sheila Soares Silva Lilian Castilho Helio Moraes-Souza 《Transfusion and apheresis science》2018,57(1):71-75
Background and objectives
The frequency of red blood cell (RBC) antigens in Brazil varies due to differences in the ethnic groups in different regions; however, these studies have not been performed in Minas Gerais, where African admixture is more prevalent in comparison with other states. Due to these facts, this study aimed to determine the frequency of RBC genotypes on Rh, Kell, Duffy and Kidd systems in blood donors and multi-transfused patients from Minas Gerais, Southeast Brazil.Methods
Blood samples were collected from 170 donors and 117 patients with different diagnosis and at least three RBC transfusions. DNA was extracted from leukocytes and genotyped by PCR-SSP, Multiplex or RFLP to alleles of the referred systems. The results were compared by the Chi-Square test, with a significance level of 5%.Results
The most frequent genotypes were: RHD+, RHCE*ce/RHCE*ce, KEL*2/KEL*2, FY*B-67T/FY*B-67T and JK*A/JK*B. FY*B-67C/FY*B-67C, RHD*Ψ and JK*A/JK*A genotypes were more prevalent in sickle cell disease (SCD) patients than in donors. Many differences in RBC genotype frequencies were observed in comparison with studies from other states and countries.Conclusion
The results reinforce the importance of determining RBC genotypes of blood donors and patients in different regions of Brazil and the world, improving the transfusion safety of individuals requiring chronic RBC transfusions, especially those with SCD, due to ethnic differences in relation to donors. 相似文献4.
Yoshiaki Furuta Yuki Nakamura Miho Tokida Kayoko Ichikawa Toshiya Ohsawa Mitsuo Ohkubo Akimichi Ohsaka 《Transfusion and apheresis science》2018,57(5):651-655
Objective
The objective of this study was to determine the rate of adverse reactions to pre-operative autologous blood donation (PAD) transfusion in a single institution over a 14-year period.Study design and methods
Between January 2003 and December 2016, we investigated adverse reactions to PAD transfusion and compared them with those to allogeneic blood transfusion in Juntendo University Hospital. Adverse reactions were categorized according to the definition proposed by the International Society of Blood Transfusion (ISBT) Working Party on Haemovigilance.Results
A total of 178,014 blood components were transfused during the study period, of which PAD transfusions were 13,653 (8%), whereas allogeneic blood transfusions were 164,361 (92%). The number and rate of adverse reactions to PAD transfusion were 16 and 0.1%, whereas those of allogeneic blood transfusion were 1075 and 0.7%, respectively. The rate of adverse reactions to allogeneic blood transfusions excluding platelet transfusion was 0.3%, being significant (p?<?0.01) against PAD transfusion. Among 16 adverse reactions to PAD transfusion, the most common was febrile non-hemolytic transfusion reaction (FNHTR) at 12 (75%), followed by allergic reaction at 4 (25%). The severity of adverse reactions to PAD transfusion was Grade 1 (non-severe) in all cases. With regard to blood component types, 16 adverse reactions involved: 12 cases of whole blood PAD, 2 of frozen PAD, and 2 of autologous fresh-frozen plasma.Conclusions
Non-severe adverse reactions were observed on PAD transfusion at a rate of 0.1% at our institution. 相似文献5.
Calvin Diep Andrew W. Shih Erin Jamula Nancy M. Heddle Michael Parvizian Christopher M. Hillis 《Transfusion and apheresis science》2018,57(2):215-221
Background
With increasing global use of intravenous immunoglobulin (IVIG), there is interest in its appropriate usage. Efforts to regulate IVIG usage have primarily taken the form of organizational interventions implemented in hospitals to monitor and improve physician prescribing. Similar interventions have proven effective in reducing the inappropriate and total hospital usage of other blood products, but their efficacy on IVIG use is less understood. Thus, we performed a systematic review of studies reporting the change in inappropriate IVIG use following such interventions in hospitals or regions.Methods
A systematic search was carried out using MEDLINE and EMBASE (1966-June 2016) for English language studies if they 1) were primary research, 2) described an organizational intervention to target plasma, IVIG, or albumin, and 3) reported appropriateness of usage and total usage preand post-intervention. Review Manager v5.0 was utilized to perform a random-effects meta-analysis on eligible IVIG studies, where the risk ratio (RR) of inappropriate IVIG transfusion comparing pre- and postintervention periods was calculated with 95% confidence intervals (CI).Results
Our search retrieved three retrospective cohort studies, where metaanalysis encompassing 2100 episodes of IVIG transfusion demonstrated no decrease in inappropriate IVIG use (RR 1.55, 95% CI 0.78–3.07). Heterogeneity between studies was considerable (I2?=?89%).Conclusion
Organizational interventions were ineffective at changing inappropriate IVIG use, but more high-quality studies describing the effects of these interventions are required before any conclusions can be drawn. Futureresearch efforts should also be directed at evolving evidence-based IVIGguidelines to improve patient safety and burdens on healthcare systems 相似文献6.
Carlo Trevisan Raymond Klumpp Laura Auriemma Riccardo Compagnoni 《Transfusion and apheresis science》2018,57(2):272-276
Introduction
Patients receiving blood transfusions after total hip arthroplasty have increased morbidity and longer lengths of stay compared to non-transfused patients. The aim of this study is to create an algorithm in order to identify patients at risk for transfusion after total hip replacement and define a safe point in hemoglobin levels after which the need for blood, transfusion can be excluded.Methods
This retrospective study analyzed hemoglobin (Hb) levels for 5?days in patients undergoing total hip replacement. An algorithm was implemented to identify the critical trends of Hb levels in the first two postoperative days, trying to identify the patients at high risk of transfusion. Specificity, sensibility and efficiency were calculated in relation to the capability of the algorithm to correctly identify transfused patients.Results
The algorithm found a pre-operative Hb?≥?13?g/dl as a cut off between patients at low-risk or high-risk for transfusion. When parameters were calculated considering the best efficiency with the least number of false negatives, the algorithm showed a specificity of 84% and a sensitivity of 70% with an efficiency of 80.6%. Hb values?>10?g/dl in the first operative day for low-risk patients and Hb level?>?11?g/dl the second post-operative day for high-risk patients led to exclusion of the need for transfusion.Conclusions
The algorithm suggested critical Hb levels to predict transfusion. In association with clinical data, the suggested critical values of Hb may be useful to schedule lab tests and a safe early discharge. 相似文献7.
Abeer Mohamed Abdelrazik Hanan Elsayed Abozaid Karim Abdelfattah Montasser 《Transfusion and apheresis science》2018,57(4):566-568
Objective
The aim of the present study was to evaluate the efficacy of hepatitis C virus [HCV] core Ag as an alternative affordable test in resource limited countries blood banks.Background
Implementing nucleic acid testing in developing countries with low resources is still unaffordable. Egypt has the highest prevalence of hepatitis C in the world and still in need to efficient affordable transfusion program that reduces the window period for the virus before implementing the complex high cost NAT.Study design and methods
HCV core Ag by ELISA in serum, in the presence or absence of anti-HCV antibodies was compared to HCV- RNA by PCR on total number of 1850 first time and repeat donations from Fayoum University Hospital and Badr University Hospital.Results
Among 1850 healthy voluntary donors, 143 donors with anti-HCV antibody positivity, 105 were determined as positive, 38 were negative for HCV core Ag, and 107 were positive for HCV RNA.Conclusion
Hepatitis C virus core antigen-ELISA can be a useful alternative in the developing nations and Greater consideration should be given to its implementation as an additional serological test for blood donors in Egypt as the most cost-effective measure for further improvement of transfusion safety. 相似文献8.
Objectives
The present study was aimed to find out the prevalence of parvovirus B19? amongst healthy blood donors and blood transfusion recipients so as to determine the feasibility of providing seronegative blood components to vulnerable recipients.Methods
A total of 1000 samples were studied which included 800 blood donors and 200 transfusion recipients.The transfusion recipients included 100 multitransfused patients and 100 non transfused controls.All samples were subjected to parvovirus B19 ELISA for IgG and IgM antibodies.Results
Of the 800 blood donors,663(82.9%) were voluntary while 137(17.1%) were replacement donors.The seroprevalence of B19V IgG antibodies among healthy blood donors was found to be 34.1% whilst that of IgM antibodies was 1.4%.The seroprevalence of B19?V IgG antibodies was found to be 28.4% in the age group 18–35 years and 42.1% in donors more than 35 years of age(p?≤?0.01). The overall seroprevalence of IgG antibodies in multitransfused patients was 34% and IgM antibodies was 7.0%.The B19?V IgG prevalence was 20% in the transfused patients aged 0–20 years and 48% in patients above 20 years of age (p?≤?0.05).Conclusion
The moderately high seroprevalence of B19 V IgG in blood donors and patients suggests endemicity of infection.However, prevalence of B19?V IgM antibodies in blood donors is low.With the widespread use of pooled plasma derived medicinal products and recognition of severe pathological effects in susceptible recipients, transfusion transmission of B19?V has become a major concern in the past few decades.We suggest screening of blood units to identify B19?V IgM negative units for transfusion to selected patients. 相似文献9.
10.
Objective
Nursing students are prone to needle stick injuries (NSIs) during their practice in the hospitals. This study aimed to identify the effective NSI prevention strategies for nursing students in the clinical settings.Method
Literature review was performed using the databases of ScienceDirect, ProQuest, MEDLINE, PsycINFO, Scopus, CINAHL, SpringerLink, JSTOR, and PubMed. The search terms of “nursing students”, “NSI incidents”, “prevention”, and “clinical settings” were entered, generating 103 articles published between 1991 and 2015.Results
Our study demonstrated the high rates of NSIs in low- and middle (India, 91.85%). and high-income countries (Taiwan, 56.00%). Most injuries especially occurred when students opening the ampules (53.15%) and performing intravenous cannulation (44.50%). Our review identified four main strategies to prevent NSIs; education, trainings, safe needle use, and effective communication. Our study suggested the development of education and trainings curriculum and self- report system and culture, the provision of financial, material and manpower resources to support the prevention of NSIs.Conclusions
four main strategies to prevent NSIs were education, trainings, safe needle use and effective communication.Implications for practice
collaboration of hospitals and educational institutions is essential to develop effective NSI prevention programs. 相似文献11.
Background
The Berg Balance Scale (BBS) is often used in clinical practice to predict falls in the older adults. However, there is no consensus in research regarding its ability to predict falls.Objective
To verify whether the BBS can predict falls risk in older adults.Data source
Manual and electronic searches (Medline, EMBASE, CINAHL, Ageline, Lilacs, Web of Science, Cochrane Library and PEDro) were conducted using blocks of words (older adults, falls, BBS, study design) and their synonyms, with no language restrictions and published since 1989.Study selection criteria
Prognostic studies or clinical trials were used to assess the BBS and falls history.Data extraction and data synthesis
In this narrative synthesis, two independent assessors extracted data from articles and a third reviewer provided consensus, in case of disagreement. The methodological quality was assessed using the Quality In Prognosis Studies tool.Results
1047 studies were found and 8 studies were included in this review. The mean BBS score was high, regardless of the history of falls. Three studies presented cut-off scores for BBS, ranging from 45 to 51 points. Two studies reported a difference in the BBS score between fallers and non-fallers. Studies presented low to moderate risk of bias.Limitations
Unfeasible to conduct a meta-analysis due the heterogeneity of included studies.Conclusion
The evidence to support the use of BBS to predict falls is insufficient, and should not be used alone to determine the risk of falling in older adults.Systematic review registration number
PROSPERO CRD42016032309. 相似文献12.
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14.
Shin-ichiro Fujiwara Shuichi Kino Asashi Tanaka Yuichi Hasegawa Akihiko Yokohama Keizo Fujino Makino Shigeyoshi Mayumi Matsumoto Akihiro Takeshita Kazuo Muroi 《Transfusion and apheresis science》2017,56(5):708-712
Background
Premedication before transfusion is commonly administered in clinical practice despite a lack of evidence for its efficacy. The aim of this study was to clarify the status of premedication and evaluate expert opinions regarding its use in Japanese medical institutions.Method
Between May and July 2016, we conducted a questionnaire survey on premedication before transfusion in 252 medical institutes that were certified by an academic society or employed transfusion experts.Results
A total of 141 institutes (54.2%) responded, and hematologists (n = 113) comprised the most frequent respondents. The purpose of premedication was to prevent urticaria, pruritus, and fever, and washed blood products were used for anaphylactic shock or refractory transfusion reactions before. Drugs for premedication were intravenously administered either just before or 30 min before transfusion. Both inpatients and outpatients were premedicated in a similar manner, and institutional guidelines were not established. More than half of the experts recognized premedication as efficient and necessary, and premedication for previous transfusion reactions was frequently implemented, particularly for platelet transfusion or in patients with hematological diseases. Some institutions administered one or more drugs for premedication from the first transfusion. Antihistamines and hydrocortisone were the most frequently used as premedication.Conclusion
Our study reports the current status of premedication for transfusion in Japan. Antihistamines and hydrocortisone were most commonly used for premedication despite a lack of evidence of their use. These findings may help clarify the indications for premedication and the use of washed blood products. 相似文献15.
Elias Kyriakou Nikolaos Nearchakos Stefanos Bonovas Efstathia Makri Katerina Pantavou Georgios K. Nikolopoulos Christine Kottaridi Argyri Gialeraki Panagiota Douramani Maria Taichert Violetta Kapsimali Argirios E. Tsantes 《Transfusion and apheresis science》2018,57(4):544-548
Background
Flow cytometry (FC) and Nageotte hemocytometry represent the most widely accepted methods for counting residual white blood cells (rWBCs) in leucocyte-reduced (LR) blood components. Our aim was to study the agreement between the two methods, under real working blood bank conditions.Materials and methods
94 freshly produced LR red blood cell (RBC) units were tested for rWBC concentrations by FC and Nageotte. To assess the precision of each method, we calculated the intra-assay coefficients of variation (CV), and followed the Bland-Altman methodology to study the agreement between the two methods.Results
CV was 18.5% and 26.2% for the Nageotte and the FC, respectively. However, the agreement between the duplicate observations, using the binary cut-off threshold of 1?×?106 WBCs per unit to define the results as “pass/fail”, was 71.9% for the Nageotte and 93.3% for the FC. Linear regression analysis did not show any correlation (R-squared?=?0.01, p?=?0.35) between the two methods, while the Bland-Altman analysis for the measuring agreement showed a bias toward a higher Nageotte count of 0.77?×?106 leucocytes per unit (p?<?0.001) with the 95% limits of agreement (d ± 2?sd) ranging from –0.40?×?106 to 1.94?×?106 leucocytes per unit.Conclusion
The absence of agreement between Nageotte and FC method, with the differences within d ± 2?sd being of high clinical importance, suggests that the two methods cannot be used for clinical purposes interchangeably. The Nageotte seems unsuitable for quality control even with a pass-fail criterion, under real working blood bank conditions. 相似文献16.
Arezoo Darbandi Pargol Mashati Amir Yami Arshia Gharehbaghian Mehdi Tabrizi Namini Ahmad Gharehbaghian 《Transfusion and apheresis science》2017,56(3):448-453
Background
Blood products are used for patient treatment and survival in the cases of major surgery, hematological disorders or cancer therapy. Presently the main blood components are not yet replaceable by artificial products and all activities related to blood transfusion is highly dependent on the healthcare development of each country. The World Health Organization Eastern Mediterranean Region (WHO-EMR) comprises of 21 member states with variable socio-economic status effective on blood transfusion activities. The fundamental motivation behind this research was to accumulate some data of blood practices in this region and to have an appropriate image of the WHO-EMR region.Material and methods
The data were collected through the published papers or data, blood transfusion services websites, and the other health official websites like WHO.Results
Among WHO-EMR countries there are some with a nationally organized blood transfusion establishment such as Egypt, Iran, Iraq, Kuwait, Morocco, Oman, Pakistan, and Syria. In a few, blood transfusion administrations are hospital-based like Saudi Arabia. The others are run by Red Crescent such as Bahrain, Tunisia and UEA or by Red Cross like Lebanon. Only Iran and UAE succeed to have 100% voluntary non-remunerated blood donors; however, most of them are still under the weight of family/replacement blood donation such as Afghanistan, Egypt, Iraq, Lebanon, Morocco, Saudi Arabia and Sudan or even paid donors like Pakistan and Yemen. The haemovigilance and training programs have been implemented in some countries including Bahrain, Iran, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Tunisia and UAE. Unfortunately, there are rare and inaccessible information about some EMR states like Djibouti, Palestine and Somalia so that little data can be independently discovered.Conclusion
In these countries different measures ought to be additionally designated to ensure blood products adequacy and safety such as the development of well-coordinated national blood transfusion centers with the increased government commitment, the establishment of a well-organized system for voluntary non-remunerated blood donor recruitment, the establishment of well-equipped laboratories for screening donor samples for transfusion transmitted infections (TTIs) for at least mandatory tests recommended by WHO, the implementation of an educational/training program for professionals working in the blood transfusion establishments or hospitals, the regular audit on the quality and the integrity of the blood transfusion chain, and the development of a regional network of collaboration to bolster the neighboring nations in the EMR through effective communication tools. 相似文献17.
Background
A number of factors cause increases in the number of cell-derived microparticles (MPs) in blood components. However, the overall effects of these factors on the concentration of MPs during routine blood-component preparation have not fully been elucidated.Aim
To evaluate the effects of donor age, donor sex, blood-component preparation, and storage on MP concentrations.Methods
Flow cytometry was used to quantitate the number of whole blood-derived MPs.Results
The total MP concentration was similar in male and female donors (26,044?±?1254 particles/μL vs. 27,696?±?1584 particles/μL). The total MP concentration did not differ significantly among the different age groups: 18–30 years (28,730?±?1600 particles/μL), 31–40 years (24,972?±?5947 particles/μL), and 41–58 years (25,195?±?1727 particles/μL). However, the total number of MPs in fresh plasma (152,110?±?46,716 particles/μL) was significantly higher (p?<? 0.05) than that in unprocessed whole blood (26,752 ± 985 particles/μL), fresh packed red blood cells (PRBCs) (28,574 ± 1028 particles/μL), and platelet concentrate (PC) (33,072 ± 1858 particles/μL). Furthermore, the total numbers of MPs in stored PRBCs and fresh-frozen plasma (FFP) were significantly higher (p?<? 0.05) than those in fresh PRBCs and fresh plasma, respectively.Conclusions
The study suggests that donor factors, blood-component processing and storage contribute to the MP concentration in routine blood-product preparation. The findings can improve quality control and management of blood-product manufacturing in routine transfusion laboratories. 相似文献18.
Jaehyup Kim Amena Usmani Nicole De Simone Ravi Sarode 《Transfusion and apheresis science》2018,57(1):46-49
Background
Transfusion of donor red blood cells (RBCs) remains an important part of management of sickle cell disease (SCD). However, the survival characteristics of transfused donor RBCs in SCD patients have not been well studied. We sought to calculate survival kinetics of transfused RBCs in SCD patients since it is unclear whether transfused RBCs get destroyed at faster rate as innocent bystander or persist longer due to decreased destruction capacity such as functional splenectomy.Study design
and methods Forty-one SCD patients who had undergone at least 3 RBC exchange procedures were inlcuded. Interval between the procedures, both pre-procedure and post procedure hematocrits, HbA% and HbS% were collected. We developed a mathematical model to calculate RBC lifespan for donor RBCs.Results
Donor RBCs exhibited average lifespan of about 120 days (121.1 ± 13.9 days), which was similar to reported survival of RBCs in normal recipients. However, significant variation between patients were observed with lifespan ranging from 75.6-148.5 days. Intrapersonal variations were small in most cases.Conclusion
The calculated survival of donor RBCs in SCD recipient, based on certain laboratory values, appears to be similar to that of normal recipient. However, inter-personal variations were large, suggesting different RBC kinetics in a subset of patients, which calls for further research to better understand underlying pathophysiology. This knowledge of RBC survival would be very helpful in individualized management of patients on chronic RBCx. 相似文献19.
Objective
To identify the correlation between nurse's perception of the continuing professional development (CPD) and the satisfaction of nursing career ladder system (NCLS) implementation.Method
A non-experimental survey design was used for this study. The respondents were selected using proportional random sampling technique with the total sample size of 149 nurses. Data were measured using proportion, central tendency and Pearson product-moment correlation.Results
There was a moderate, positive correlation between the CPD and the NCLS satisfaction (R: 0.42, p= 0.0001).Conclusions
The results of this research should be used as recommendation for improving CPD at the hospitals in Indonesia. 相似文献20.