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Biomedical subjects

B A Myhre

Publications and source records attributed to B A Myhre.

At least 19 recordsLinked to original sources
PubMed1997

Effectiveness of a prospective physician self-audit transfusion-monitoring system.

BACKGROUND: The purpose of this study was to search for a more effective transfusion-monitoring system than the existing system of retrospective peer review. STUDY DESIGN AND METHODS: This research used a study-control, preintervention and postintervention design, to evaluate the effectiveness of a prospective physician self-audit transfusion-monitoring system that functioned without the direct involvement of transfusion service physicians. This research also evaluated the effectiveness of issuing to physicians a memo with transfusion guidelines. Three process indicators were used to assess physician behavior at various stages of the blood-ordering process: 1) the number of crossmatches ordered per admission, 2) the transfusion-to-crossmatch ratio, and 3) the number of blood units returned to the laboratory after physician self-auditing. The study used two outcome indicators to reflect overall blood utilization: 1) the percentage of patients who received red cell transfusions and 2) the number of blood units transfused per recipient each month. RESULTS: The prospective physician self-audit system implemented at the study hospital did not reverse physician transfusion decisions, and the process of issuing to physicians a memo with transfusion guidelines at the control hospital failed to reduce blood usage. However, a transient reduction in blood utilization was observed at the study hospital. CONCLUSION: The reduction was hypothesized to be due to a Hawthorne effect, in which observed behavior is affected by the subject's awareness of the research study.

Blood Grouping and Crossmatching↗
PubMed1996

Are retrospective peer-review transfusion monitoring systems effective in reducing red blood cell utilization?

OBJECTIVE: This research used a study-control group design and examined data collected from five hospitals to evaluate the effectiveness of retrospective peer-review systems on reducing utilization of red blood cells (RBCs). DESIGN: The effects of retrospective peer-review systems were studied in three parts: (1) trends of RBC utilization were compared by the slopes of linear regression lines that assessed the effect of time on RBC utilization among four study hospitals and one control hospital, (2) diagnosis-specific RBC utilization was compared between the control hospital and one matched study hospital, and (3) the effect of the retrospective review system of one study hospital was assessed by linear regression using data accumulated 1 year before and 2 years after implementation of the program. RESULTS: Three study hospitals showed no significant changes in RBC utilization during the 10-month study period. One study hospital and the control hospital demonstrated trends of reduced RBC use with negative slopes of regression lines; however, there was no difference in the degree of the two slopes, and the diagnosis-specific RBC utilization was not lower at the study hospital than at the control hospital. Furthermore, implementation of the retrospective peer-review system at one study hospital demonstrated no effect on RBC utilization. CONCLUSIONS: We conclude that the retrospective peer-review systems implemented at these four hospitals had no effect on reducing red blood cell utilization.

Erythrocyte Transfusion↗
PubMed1993

Nursing station order entry for hospital computers.

Tired of illegible labels, unlabeled specimens, and frantic phone calls asking what happened to specimens? This lab was and devised a system to allow test ordering and label printing from nurse stations.

California↗
PubMed1992

The extension of 4 degrees C storage time of frozen-thawed red cells.

Blood was drawn from volunteer donors and frozen using the high glycerin, mechanical freezing procedure accepted by the United States Navy. Subsequently, the units of blood were thawed and washed. Various anticoagulants were added, and the red cells were stored in a refrigerator at 4 degrees C for periods of up to 28 days. Chemical analyses were performed periodically. These showed that the addition of the anticoagulants ACD, CPD and CPDA-1 caused the red cells to be preserved better than the currently accepted 0.9-percent NaCl, 0.2-percent glucose solution. In vivo 51Cr viability studies performed on blood stored with CPDA-1 for 14 days showed a 24-hour viability of 78.8 +/- 8.4 percent. In a subsequent study, the blood was stored for 21 days prior to freezing and then was rejuvenated and frozen. The cells were thawed, washed, and stored at 4 degrees C with CPDA-1 for an additional 14 days. The 24-hour viability of these cells was determined to be 74.0 +/- 5.1 percent. These findings show that the postthaw storage time of red cells can be increased greatly over the now-accepted 24 hours, if bacterial sterility can be assured.

Blood Preservation↗
PubMed1990

The first recorded blood transfusions: 1656 to 1668.

The transfusion of blood was only one of many scientific competitions in which the citizens of France and England engaged in the 1600s. This particular competition laid the foundations for transfusion therapy that were built on 100 years later when more was known about blood. At the time of the studies discussed here, the most important goal seemed to be the establishment of the primacy of the discovery by one or the other nation. In this, most scholars give Lower and the English the first animal-to-animal transfusion and Denys and the French the first animal-to-man transfusion. However, even though this national primacy might not seem so important now, we must realize that the international competition created knowledge that still benefits us today, and those results might not have been produced so swiftly if the competition had not taken place.

Blood Transfusion↗
PubMed1989

The probability of finding suitable directed donors.

A series of tables based on mathematical calculations is given as guidelines for the number of directed donors needed by members of various ethnic/racial groups to provide a desired number of units of blood with a selected probability of achieving this result. From these tables, certain conclusions can be drawn. Unrelated donors who do not know their blood type are an inefficient source of directed donors. Rh-negative patients are unlikely to obtain enough directed-donor units from either related or unrelated donors with confidence unless these donors known their blood type. In general, siblings, parents, and offspring are the most efficient directed donors from the standpoint of compatibility. Cousins, uncles, aunts, nieces, and nephews are not much more likely to be compatible than unrelated donors are. It is easier to obtain suitable directed-donor units among Hispanics than among whites, blacks, or Asians, due to their skewed blood group frequencies. In general, using O-negative directed donors for Rh-positive recipients does not significantly increase the likelihood of finding suitable donors.

Blood Donors↗
PubMed1987

Survival of red cells stored for 21 and 35 days in a non-di-(2-ethylhexyl)phthalate plastic container.

Whole blood and red cells were stored using citrate-phosphate-dextrose (CPD) and citrate-phosphate-dextrose-adenine (CPDA-1) anticoagulants in polyvinylchloride bags made flexible with di-(2-ethylhexyl)phthalate (DEHP) or tri-(2-ethylhexyl)trimellitate (TOTM) plasticizers. After storage the posttransfusion viability of these cells was tested in autologous donors. Cells stored in TOTM-plasticized film had a survival rate less than 75% when stored for 35 days, while other systems had a survival greater than this. When compared with the red cells stored in CPD-DEHP-plasticized film, the viability of whole blood and red cells stored in CPDA-TOTM showed a statistically significant decrease (p = less than 0.01). Therefore, red cell storage in TOTM-plasticized PVC with current anticoagulant should be limited to 21 days.

Benzoates↗