Transfusion medicine
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Transfusion medicine · Aug 2005
Comparative StudyCosts associated with blood transfusions in Sweden--the societal cost of autologous, allogeneic and perioperative RBC transfusion.
Anaemia is characterised by an insufficient number of red blood cells (RBCs) and might occur for different reasons, e.g. surgical procedures are often with associated blood loss. Patients who suffer from anaemia have the option of treatment with blood transfusion or medical treatment. In this study, the societal cost, for the case of Sweden, of RBC transfusion using three different techniques, i.e. allogeneic, autologous and intraoperative transfusion, was estimated. ⋯ Transfusion reactions accounted for almost 35 per cent of the costs of allogeneic RBC transfusions. The administration cost was found to be much higher for autologous transfusions compared with allogeneic transfusions. The cost of intraoperative erythrocyte salvage was calculated to be SEK 2567 (285 Euro) per transfusion (>4 units).
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Transfusion medicine · Aug 2005
A retrospective study evaluating single-unit red blood cell transfusions in reducing allogeneic blood exposure.
Although guidelines recommend the use of single-unit red blood cell (RBC) transfusions to minimize allogeneic blood exposure, clinical practice remains dominated by two-unit transfusions. This study assesses the potential impact of a single-unit transfusion policy on reducing RBC utilization. We performed a retrospective analysis of adult patients admitted to a tertiary care hospital who received one or two RBC units. ⋯ This corresponds to 0.21, 0.57 and 0.82 mean RBC units saved per patient. In the orthopaedic subpopulation, the mean RBC units saved are 0.53, 0.88 and 1.00 for the same haemoglobin targets. Adopting a policy of transfusing RBC in single-unit aliquots could significantly improve RBC utilization and decrease patient exposure to allogeneic blood.
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Transfusion medicine · Feb 2005
Comparative StudyPre-storage leucocyte depletion and transfusion reaction rates in cancer patients.
Passenger leucocytes transfused with allogenic blood are responsible for potential adverse effects. The impact of pre-storage leucodepletion (in-line filtration) of all whole blood units on transfusion reaction rate among patients suffering from cancer was retrospectively studied, comparing all reactions following red blood cell (RBC) transfusions during 2 years of pre-storage vs. 2 years of selective (bedside) leucodepletion. During selective leucodepletion, 5165 RBC units - of which 2745 were bedside filtered units- were transfused to 866 patients. ⋯ The percentage of reactions for transfused RBC units was 0.26 (0.09 for FNHTR). Comparison between pre-storage filtration and bedside filtration with regard to FNHTR showed an odds ratio of 2.80 (95% confidence interval = 0.83-14.87) for bedside filtration. The study suggests that, for transfused patients affected by cancer, pre-storage leucodepletion is more effective than selective (bedside) filtration in reducing the incidence of transfusion reactions (FNHTR).
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Transfusion medicine · Feb 2005
Compliance with prophylactic platelet transfusion trigger in haematological patients.
The aim of prophylactic platelet transfusions in haemato-oncologic patients with thrombocytopenia is to prevent bleeding. Currently, a platelet transfusion trigger of 10 x 10(9) L(- 1) is considered to be safe. Transfusion compliance with this trigger can save costs. ⋯ About three-quarters of all platelet transfusions were given at platelet counts < or =20 x 10(9) L(- 1). Transfusions at levels >20 x 10(9) L(- 1) were usually performed because of bleeding, scheduled interventions or concurrent anticoagulant therapy. We conclude that compliance with the prophylactic platelet transfusion trigger of 10 x 10(9) L(- 1) was about 50%; however, deviation from the trigger was partly explained by risk factors that justify a higher transfusion trigger.
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Transfusion medicine · Aug 2004
A simple automatized audit system for following and managing practices of platelet and plasma transfusions in a neonatal intensive care unit.
During neonatal intensive care, blood components are often used in clinical situations where both their efficacy and safety lack solid justification. A practical system to continuously analyse actual transfusion practices is a prerequisite for improvements of quality in transfusion therapy. We hypothesized that such a system would reveal inappropriate variations in clinical decision making and offer a means for staff education and quality improvement and assurance. ⋯ Inappropriate transfusions of both platelets and plasma remain a significant challenge for quality assurance of neonatal intensive care. Automated recording of pretransfusion platelet count and prothrombin time reliably identified the poorly justified transfusions and thus offered a practical resource-saving tool for quality assurance of transfusion in the NICU. A significant shift towards more appropriate use of plasma was demonstrated after implementation of the audit system.