Transfusion
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Obstetric services depend on the transfusion service (TS) to provide diagnostic testing and blood component therapy for clinical care pathways. ⋯ QI initiatives for RhIG prophylaxis, diagnostic blood test ordering, and MTP improve TS support of obstetric services.
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Multicenter Study Comparative Study
Reliability of capillary hemoglobin screening under routine conditions.
Capillary hemoglobin (Hb) measurement before admission for whole blood donation is performed in many blood donation services, in spite of several studies reporting many donors with low Hb values being missed by capillary Hb screening. ⋯ The currently available methods for capillary Hb screening allow reliable determination of predonation Hb values under routine conditions. Additional venous Hb measurements in donors with too low capillary Hb values might reduce the rate of deferred donors by approximately one-third.
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Randomized Controlled Trial Multicenter Study Comparative Study
Postoperative complications associated with transfusion of platelets and plasma in cardiac surgery.
Studies in cardiac surgery have reported increased postoperative morbidity and mortality after allogeneic red blood cell (RBC) transfusions. Whether platelet (PLT) and/or plasma transfusions are a marker for more concomitant RBC transfusions or are independently associated with complications after cardiac surgery is unknown. ⋯ Although it is difficult to separate the effects of blood components, we found that in cardiac surgery, perioperative plasma transfusions are independently associated with all-cause mortality. WBC-containing RBC transfusions and PLT transfusions are independently associated with mortality in the presence of infections in the postoperative period. Future transfusion studies in cardiac surgery should concomitantly consider the possible adverse effects of all the various transfused blood components.
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Multicenter Study Clinical Trial
Hemoglobin and iron indices in nonanemic premenopausal blood donors predict future deferral from whole blood donation.
Iron deficiency anemia is an important reason for blood donor deferral. We prospectively determined whether screening donors with hemoglobin (Hb) and iron indices before donation can predict subsequent deferral due to anemia. ⋯ Screening with Hb and iron indices enables prediction of donors at risk of subsequent anemia and who would most benefit from prevention strategies.
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Lipids accumulate during the storage of red blood cells (RBCs), prime neutrophils (PMNs), and have been implicated in transfusion-related acute lung injury (TRALI). These lipids are composed of two classes: nonpolar lipids and lysophosphatidylcholines based on their retention time on separation by high-pressure liquid chromatography. Prestorage leukoreduction significantly decreases white blood cell and platelet contamination of RBCs; therefore, it is hypothesized that prestorage leukoreduction changes the classes of lipids that accumulate during storage, and these lipids prime PMNs and induce acute lung injury (ALI) as the second event in a two-event in vivo model. ⋯ We conclude that the nonpolar lipids that accumulate during LR-RBC storage may represent the agents responsible for antibody-negative TRALI.