Transfusion medicine
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Transfusion medicine · Feb 2006
A multistate cluster of red blood cell transfusion reactions associated with use of a leucocyte reduction filter.
In 2000, the American Red Cross (ARC) received reports of unusual transfusion reactions of unknown aetiology among patients receiving leucocyte-reduced (LR) red blood cell (RBC) units in multiple distribution regions. We evaluated potential risk factors of reactions among patients who received LR-RBC transfusions. A case-patient was defined as any patient with onset of back pain while receiving an LR-RBC transfusion from 1 January to 25 May 2000. ⋯ The reactions also were independently associated with premedication and transfusion as an outpatient; these may be surrogates for an increased risk of reaction or for greater likelihood of detection. The mechanism for these reactions has not been elucidated. This cluster of reactions underscores the importance of surveillance efforts to detect adverse events after transfusion, particularly when new methods to modify blood products are introduced.
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Transfusion medicine · Feb 2006
The emergency room transfusion score (ETS): prediction of blood transfusion requirement in initial resuscitation after severe trauma.
The presented study was initiated to develop a scoring system for the prediction of red blood cell transfusion requirement in the early care of trauma patients. All trauma patients admitted to our institution who needed trauma team activation were evaluated during a 4-year period. A set of nine parameters with possible predictive value for the need of blood transfusion was recorded. ⋯ The score identifies patients in need for immediate red blood cell substitution. Cost effectiveness appears to be a further advantage of the score. For patients not in need of urgent transfusion (low-risk group), the costs for transportation, cross-matching and loss by maltreatment of blood products may be avoided.
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Transfusion medicine · Feb 2006
An audit of red cell and blood product use after the institution of thromboelastometry in a cardiac intensive care unit.
Cardiac surgery is estimated to use 20% of the UK blood supply. However, there has been much interest recently in decreasing red cell and blood product use not only to ease strain on blood stocks or avoid potential transmission of infection but also to decrease post-operative transfusion-related complications. Coagulopathies are not uncommon in cardiac surgical patients, but the time lapse for reporting conventional laboratory results has been highlighted as an obstacle to the appropriate use of blood products. ⋯ In the 6 months prior to its introduction, red cells were used in 60% of patients and fresh frozen plasma (FFP) and platelets used in 17 and 16% of patients, respectively. In the following 6 months, red cell use had fallen to 53% and FFP and platelets to 12 and 11%, respectively (P < 0.05). Introduction of thromboelastometry has significantly decreased our use of red cells and blood products.