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PubMed1984

Blood component transfusion in the intensive care nursery. Indications and special problems.

Increasingly, transfusions of component blood products are used in the setting of the neonatal intensive care unit. There is a need to analyze the indications and potential complications of this therapy critically. We review here the problems primarily unique to the neonatal population and suggest an approach to the transfusion requirements of this group. Specifically, we discuss the rationale, indications and complications of red cell, granulocyte, and platelet transfusions in these patients. Discussion of exchange transfusion and the particular blood banking requirements of these patients will be reviewed in subsequent articles.

Blood Transfusion↗
PubMed1983

[Experiences with blood component transfusion and plasmapheresis during the last 6 months].

Our experiences with blood component transfusion and plasma exchange therapy during the last 6 months were reported. Total amounts used were 1,100 units with thrombocytes and 15 times (1 X 10(10) cells each time) with granulocytes obtained by centrifugation. Plasmapheresis was done 11 times with 7 patients and results obtained were compared with those of filtration leucapheresis which was done 100 times. Advantages and disadvantages of these methods are discussed.

Adolescent↗
PubMedDate not supplied

[Blood component transfusion in full-term and premature new born infants].

BACKGROUND: Blood transfusion requirements for preterm infants are greater than for newborn ones. We compare blood transfusion requirements for newborn and premature infants and their pathology: clinical or surgical; hemorrhagic accidents and survival. METHODS: 48 newborns classified in 2 groups: 26 newborn and 22 preterm infants received 251 units of blood components: 177 units of red cell concentrates, 36 of platelet concentrates, 30 of fresh frozen plasma and 8 of total blood in a 186 days period. We analyzed total requirements of components in each group and daily, under a live-infant/day rate until 120 days. RESULTS: The all-components median requirements were 7.31 units for premature and 3.46 for newborn infants. Daily requirements analyzes reveal that requirements were greater before 60th day of life (d.l.) on clinical patients and after 86th d.l. may be caused by surgical acts. Hemorrhagic accidents happen on premature with less than 60,000 platelets/mm3. The survival wave by number of transfusions, until 186 d.l., show an inversely proportional trend between the number of transfusions done and the hope of life. CONCLUSIONS: Blood requirements for preterm infants are greater than for term ones. Those requirements are related to their pathology. Prophylatic platelet transfusions may reduce hemorrhagic accidents then red blood cell transfusions in preterm infants group. The number of transfusions over 10 is a surrogate marker of bad prognosis for both groups up to 120 d.l.

Blood Component Transfusion↗
PubMed1995

[Validation of a computer-assisted procedure for producing blood and blood component transfusions].

BACKGROUND: The validation of computer-aided methods in the production of stored blood and blood components represents for a pharmaceutical institution a basic condition for the carrying out of the decrees of pharmaceutical companies. When validating computer-aided methods in medicine or pharmacy, the fields of informatics and technology have to be linked to applications in medicine and pharmacy. METHOD: In many cases the methods for the documented proof that a system achieves the expected capacity are too complex, so that a validation is only practicable in module groups. This is shown with an example of the blood typing on microtiter plates. RESULTS: After the selection of the hard- and software according to the safety criteria of information technology taking into consideration functional classes and degrees of quality, a complete documentation of the validation of blood typing on the microtiter plate was carried out.

Blood Banks↗
PubMed2006

Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting.

OBJECTIVE: Our objective was to quantify incremental risk associated with transfusion of packed red blood cells and other blood components on morbidity after coronary artery bypass grafting. DESIGN: The study design was an observational cohort study. SETTING: This investigation took place at a large tertiary care referral center. PATIENTS: A total of 11,963 patients who underwent isolated coronary artery bypass from January 1, 1995, through July 1, 2002. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 11,963 patients who underwent isolated coronary artery bypass grafting, 5,814 (48.6%) were transfused. Risk-adjusted probability of developing in-hospital mortality and morbidity as a function of red blood cell and blood-component transfusion was modeled using logistic regression. Transfusion of red blood cells was associated with a risk-adjusted increased risk for every postoperative morbid event: mortality (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.67-1.87; p<.0001), renal failure (OR, 2.06; 95% CI, 1.87-2.27; p<.0001), prolonged ventilatory support (OR, 1.79; 95% CI, 1.72-1.86; p<.0001), serious infection (OR, 1.76; 95% CI, 1.68-1.84; p<.0001), cardiac complications (OR, 1.55; 95% CI, 1.47-1.63; p<.0001), and neurologic events (OR, 1.37; 95% CI, 1.30-1.44; p<.0001). CONCLUSIONS: Perioperative red blood cell transfusion is the single factor most reliably associated with increased risk of postoperative morbid events after isolated coronary artery bypass grafting. Each unit of red cells transfused is associated with incrementally increased risk for adverse outcome.

Aged↗
PubMedDate not supplied

Blood component transfusion in primary coronary artery bypass surgery in Kuwait.

OBJECTIVE: The aims of this study were to determine the rate of blood product transfusion, associated perioperative factors and cost of such blood product transfusion in primary coronary artery bypass surgery (CABG). SUBJECTS AND METHODS: The medical records of 159 consecutive primary CABG patients (142 male, 17 female) from January 1, 2003 to June 30, 2003 at Chest Diseases Hospital, Kuwait, were reviewed. Urgent and emergency cases were included. RESULTS: The mean age of the patients was 57.2 (range 36-77 years). Overall, 128 (80.5%) patients received blood product transfusion during primary CABG: 113 (70.5%) packed red blood cells (RBC), 54 (33.9%) fresh frozen plasma, and 13 (8%) platelets. Overall, 23 patients (12.6%) received more than two RBC transfusions intraoperatively. Significant factors for intraoperative RBC transfusion were: age >60 years, female gender, preoperative hemoglobin <12 g/dl, and 3 or more coronary bypass grafts constructed. One hundred and fifty-nine patients consumed 342 units of RBC at an average of 2.1 RBC units per patient. The cost per patient was 80 Kuwaiti dinar (KD; USD 240). CONCLUSION: The findings indicate a high rate of blood component transfusion in primary CABG patients in Kuwait that could expose the patients to the possible adverse effects, and such transfusions have high economic impact.

Adult↗
PubMed1989

Computer-assisted audits of blood component transfusion.

Comprehensive review of clinical blood transfusion practice at a tertiary-care medical center is complicated by the extraordinary number of patients that receive such therapy. Computer-assisted review of the key objective data used in making the decisions about transfusion is necessary to evaluate the process. Use of 15,873 units of red blood cells, 3,641 units of plasma, 2,619 pools of platelets or pheresis units, and 259 pools of cryoprecipitate was screened by comparing pre-transfusion and post-transfusion blood counts with the medical staff's evaluation criteria. On this basis, 81.4% of transfusion episodes (TEs) were considered fully justified. Medical records were selected for audit from the cases in which the transfusion decisions could not be justified by on-line information. Abstracted data subsequently justified 82 of 139 audited cases; 68.4% of the comments pertaining to the remaining 57 cases adequately explained the transfusion decision. Thus, nearly 96% of the TEs were justifiable as determined by peer review.

Blood Preservation↗
PubMed2003

Computerized quality assurance of decisions to transfuse blood components to critically ill patients.

BACKGROUND: In critically ill patients optimal transfusion therapy for most clinical settings has not been determined. The objective of this study was to evaluate the impact of a computerized audit on transfusion decisions of red blood cells (RBC), fresh frozen plasma (FFP), and platelets among critically ill patients. METHODS: Two hundred and ninety consecutive patients admitted to nine-bed medical-surgical intensive care unit at a university hospital were included in this prospective study. Prior to the study, the criteria for transfusions of RBCs, FFP and platelets were established. Phase I, the first 3-month period served as a control period. During phase II the fulfilment of these criteria was prospectively monitored by an audit software belonging to the computerized blood request program. If the predefined transfusion criteria were not met the audit software was automatically activated. The last 3-month period, phase III, was to assess if possible effects on transfusion decisions were permanent. RESULTS: The proportion of RBC transfusions administered according to predefined trigger during the study phases I, II, and III were 55.9%, 75.1% and 67.9%, respectively (P < 0.001). The proportion of FFP and platelet transfusions according to a predefined trigger did not differ statistically significantly between the study phases. Logistic multiple regression analysis revealed an independent effect of the audit phase on the decision to transfuse RBCs and FFP. CONCLUSIONS: The data suggests that a computerized prospective transfusion audit has impact on the realisation of predefined transfusion decisions.

Adult↗
PubMed1996

Experimental haemorrhage and blood component transfusion in humans: no change in plasma concentration of thrombin-antithrombin complex and plasmin-antiplasmin complex.

The influence of haemorrhage and blood transfusion on primary haemostasis, coagulation and fibrinolysis was investigated in ten healthy male volunteers. Acute loss of 10% of the blood volume did not give any significant alteration in thrombin- antithrombin III (TAT) complex and plasmin-alpha 2-antiplasmin (PAP) complex levels compared with a control series. The skin bleeding time with the Simplate II device was not altered after the 10% blood loss. Acute loss of 10% of blood volume followed by transfusion of packed red cells or stored plasma did not resulted in any significant change in bleeding time, TAT and PAP complex levels. It could be concluded that a controlled haemorrhage does not give any detectable changes of the platelet dependent primary haemostasis, blood coagulation and fibrinolysis. Transfusion of one unit of packed red cells or stored plasma does not seem to adversely affect the haemostasis.

Adult↗
PubMed1993

[Autologous blood transfusion as whole blood or blood components?].

Modern haemotherapy is equivalent to restrictive use of blood components. Therefore, transfusion of whole blood in homologous transfusion generally cannot be accepted. In autologous blood transfusion blood components also are preferable if they can be separated appropriately. In order to have broad application of preoperative autologous blood deposits, close cooperation to transfusion services should be established guaranteeing optimal production of blood components. If this cooperation is impossible there are no objections against the use of autologous whole blood as long as the expected blood consumption is less than 3 red cell units. Additionally, in this case storage of more than 3 weeks mostly is not necessary. The fact that whole blood is not further part of the 'Monographien' of the Federal Health Administration (BGA) does not forbid the use of autologous whole blood since the 'Monographien' only concern generally available homologous blood components.

Blood Component Transfusion↗