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Plateletpheresis in a disposable system.
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The procurement of blood and plasma for the production of components and derivatives within the frame on an integrated National Blood Program.
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Current problems and results in testing microaggregate filters.
Most in vitro studies on microaggregate filters focus on the mechanical retention of microparticles. Data are based on bulk techniques such as differential dry weight and screen filtration pressure measurements or single-particle counting using resistance measurement (Coulter principle). Errors in measurements may result from various steps in sample handling, interaction of the sample with the environment and inborn errors of different techniques. High-speed laser cytometry has been applied and was found to diminish the number of possible errors. The results of these measurements are compared with conventional techniques.
Evaluation of three procedures for the preparation of leukocyte-poor and leukocyte-free red blood cells for transfusion.
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Simulation analysis of platelet production and inventory management.
To maximize the availability of platelet concentrates (PC) and minimize their outdate, competing criteria, a computer simulation model of platelet production and distribution was developed. Based on 2 years of actual platelet orders placed with a regional blood center, the simulation program generated daily platelet orders, and also calculated mean demand and standard deviation of demand for each day of the week. The number of PC to be produced on a given day was calculated from: PC to be produced = (mean demand for that day of the week) + Tx (standard deviation of demand for that day of the week)-(PC in inventory on the given day), where T is a selected multiple of the standard deviation. As T increases, availability is maximized, but outdating is expected to increase. Conversely, lower T is associated with less availability, but lower outdate. At the simulated platelet demand level (about 735 PC per week), with 3-day platelet storage life, 99% availability is associated with 1% outdate and distribution of PC of less than 1 day average age. 100% availability, with no outdate is predicted for a 5-day storage life, with no further improvement in logistics with 7-day storage life, at this level of demand. Although logistics of platelet production and distribution vary from center to center, the simulation analysis is generally applicable, and a formal plan has the great advantage of predictive, rather than reactive, platelet production.
Invention and development of the blood bag.
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What is the 'optimum' optimal additive solution?
Spontaneous formation of clotted material occurs occasionally in all stored red cell units, but larger amounts have been noted in SAG-M optimal additive suspensions. These can be substantially reduced by substitution of the SAG-M solution by a SAG-M/CPDA-1 mixture suggesting that there is insufficient citrate in SAG-M red cell suspensions to completely inhibit coagulation of the residual plasma.
Health outcomes research using large donor-recipient databases: a new frontier for assessing transfusion safety and contributing to public health.
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Initial experience of intra-operative red cell salvage.
The use of red cell saving machines is described in 16 cases of aortic reconstruction. There were 3 deaths in the series, all unrelated to use of the technique. Salvaged autologous blood accounted for 45% of red cell requirements. Biochemical and haematologic parameters were monitored before, during and after operation. When large volumes of blood are salvaged, the system becomes cost effective and the risks of homologous transfusion are reduced.
Autologous blood donation for elective gynaecological surgery.
The utilization and effectiveness of a hospital autologous blood donation programme for elective gynaecological surgery at Ramathibodi Hospital during April 1, 1988-March 31, 1991 were analyzed. A total of 438 patients or 98% of eligible patients were enrolled into the programme. Each patient gave 1 unit of blood within 14 days of undergoing gynaecological surgery. The untoward effects observed in the programme were higher than those found in the regular donors. However, these were very mild. Nearly 90% of the participants used no homologous blood during their hospitalization, 8% used only their autologous blood, while 2% used additional homologous transfusion. The released autologous components were subsequently administered to other recipients. The patients' acceptance was excellent. Autologous blood donation is a safe, inexpensive and feasible procedure for transfusion treatment in elective gynaecological surgery especially in developing countries.
Fast three-dimensional numerical hemolysis approximation.
The in vivo implantation of a mechanical device contributes to hemodynamic disturbances, which are responsible for damage to the membranes of red blood cells that in turn can lead to their rupture (hemolysis). It is important to ascertain at the design stage of such mechanical devices that they are innocuous to blood. Because there is no in vivo hemolysis index, we concentrated our efforts on the in vitro hemolysis index of the American Society for Testing and Material (ASTM) standard. We present in this work a framework for minimizing medical device-induced hemolysis by the development of a numerical method for predicting hemolysis similar to that used in in vitro experiments. The method is based on a novel interpretation of the Giersiepen-Wurzinger blood damage correlation that replaces the computation of blood damage along the streamline by a volume integration of a damage function over the computational domain. We assess the behavior and accuracy of this methodology with 3D examples.
Human cadaver blood for transfusion.
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Studies on stored whole blood. II. Use of packed red blood cells.
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Plateletpheresis in a disposable system.
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Hydroxyethyl starch and dexamethasone as an adjunct to leukocyte separation with the IBM blood cell separator.
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White particulate matter: this time too much precaution.
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Percutaneous umbilical blood sampling.
Percutaneous umbilical blood sampling (PUBS) provides a new and exciting method for assessment and management of certain fetal disorders. This procedure offers direct access to the fetal circulation for obtaining blood samples or for transfusing the fetus in utero. Although investigational, PUBS offers treatment approaches that were not previously available. This ability to treat the fetus in utero can prolong pregnancy, resulting in decreased prematurity and mortality rates for infants with erythroblastosis fetalis. This article describes the PUBS procedure and the indications for PUBS and discusses the nursing implications associated with the care of women undergoing PUBS.