Blood Requests Research Articles

An update on red blood cell transfusion in non-cardiac thoracic surgery.

The aim of this study was to evaluate risk factors for red blood cell (RBC) transfusion in non-cardiac thoracic surgery. All patients undergoing non-cardiac thoracic surgery in a single tertiary referral center between January and December 2021 were eligible for this study. Data on blood requests and perioperative RBC transfusion were retrospectively analyzed. A total of 379 patients were included, of whom 275 (72.6%) underwent elective surgery. The overall RBC transfusion rate was 7.4% (elective cases: 2.5%, non-elective cases: 20.2%). Patients with lung resections required transfusion in 2.4% of the cases versus 44.7% in patients undergoing surgery for empyema. In multivariable analysis, empyema (P=0.001), open surgery (P<0.001), low preoperative hemoglobin (P=0.001), and old age (P=0.013) were independent risk factors for RBC transfusion. The best predictor of blood transfusion was preoperative hemoglobin with a cut-off value <10.4 g/dL (sensitivity 82.1%, specificity 86.3%, area under the curve 0.882). The rate of RBC transfusion in current non-cardiac thoracic surgery is low, especially in elective lung resections. In urgent cases and open surgery, transfusion rates remain high, particularly in empyema cases. Preoperative requesting of RBC units should be tailored to patient-specific risk factors.

A Research Paper on Blood Donation Management System (Donor Dreams)

bstract: Blood donation is a critical aspect of healthcare that saves millions of lives every year. However, findingthe right blood donor or blood bank in times of emergencies can be a challenging task, leading to severe consequences, including death. Traditional methods of finding blood donors and blood banks are time-consuming and fragmented, making it difficult for patients to access the required blood units. To address this issue, we propose a web application called "Donor Dreams," which connects blood banks and patients on a single platform. The system maintains a record of every blood bank to keep track of theblood stock and simplifies the search for available blood donors or blood banks. The proposed system consists of three modules: Admin, Blood Bank, and Patient. The Admin module provides realtime data on available blood units and blood banks, updates the blood bank and patient details, and approves or rejects requests made by blood banks and patients. The Blood Bank module allows blood banks to createan account, view their donation history and request for blood from the blood stock. The Patient module enables patients to create an account, request for specific blood groups, and view their blood request history. Our research aims to provide a user-friendly and centralized platform that can connect blood banks and patients in real-time, ultimately saving more lives and making a positive impact on society.

Digital Healthcare Application

The population of the world is multiplying with each coming year and so are the diseases and health issues. There is a rise in the need for blood as the population grows. There are many potential blood donors thanks to the world's expanding population. Blood banks play an important role in the process of collecting blood and managing blood stocks, approving blood requests, updating donations, and updating available blood types. The use of digital healthcare software makes it easier for patients and healthcare professionals to communicate with one another. With the help of this function, medical professionals such as doctors and therapists can interact intimately with their patients and provide them with very individualized health information. The software system is an online healthcare management system that helps in managing various blood banks and healthcare operations effectively. The project comprises a central repository with a variety of blood deposits and related information. These particulars include blood type, storage location, and storage date. These specifics aid in preserving and keeping an eye on the blood deposits. The project is an online system that enables users to determine whether the blood bank has the required blood deposits for a specific group. Moreover, the system also has added features such as patient name and contacts, blood booking, and even use for certain blood groups provided in case of emergency. Also, the project has various other health care facilities like providing contact of hospitals with dialysis services, booking blood test schedules online scheduling of appointments, ambulance services, and ventilator services. Key Word: Flutter, SQL, Languages, Database

Alarming rise in professional Blood donors and its repercussions

The department of transfusion medicine, also known as blood bank, is one of the most important parts of a healthcare facility. It provides whole blood as well as different blood components like packed red blood cells (RBCs), thrombocytes, plasma, and coagulation factors to all necessary patient populations. Almost all major surgeries require it and only 2.5 billion of the 5 billion blood units required by our country each year are available. Because human blood cannot be replaced; the gift of life is given through the optimum use of blood and its components. According to the study, the demand for screened blood is very high, and the world requires blood every two seconds. When a patient is admitted to a hospital’s emergency ward, a blood test is almost always performed first and is usually followed by a blood request. Gunshot wounds and unintentional injuries necessitate immediate medical attention, including blood transfusions to compensate for low blood pressure and significant blood loss. A hospital would be considered incomplete without a state-of-the-art blood bank, which significantly facilitates cardiac procedures. Cross-matching and organizing at least five units of packed RBCs is a scheduled step in cardiac surgery. Simultaneously, one donor is cross-matched and tested for all parameters, including infectious markers, and its blood is drawn first when needed during cardiac surgery. After that, the arranged blood units are supplied for transfusion. This happens because freshly drawn blood contains all of the essential components for coagulation. Burns, hemorrhagic disorders, anemia, leukemia, thalassemia, and hemolytic disorders, as well as accidents, all necessitate the use of blood. Patients are transfused with blood on an exchange basis. During an emergency, blood units are released from the blood bank, and replacement blood is drawn from the patient’s relatives. Because of this system of blood unit replacement, many patients’ relatives are hesitant to donate blood or do not have donors for replacement. This gave rise to one of blood banks’ most unethical practices: bringing in paid donors or professional donors to donate blood for patients in exchange for money. This became a major issue for the entire medical community, resulting in the spreading of diseases such as HIV, HBsAg, HCV, SYPHILIS, and blood with low hemoglobin levels being transfused to patients with no clinical benefits.

K-NEAREST NEIGHBOR MENGGUNAKAN FEATURE SELECTION BACKWARD ELIMINATION UNTUK PREDIKSI JUMLAH PERMINTAAN DARAH PADA PMMI KOTA GORONTALO

The importance of the availability of blood at PMI, it is expected that PMI always maintains the amount of blood supply to meet the need for blood transfusions. Prediction of blood supply is needed to overcome problems related to bloodstock supply at PMI Gorontalo. The application of predicting the number of blood requests with the K-Nearest Neighbor Algorithm can be done to overcome the existing problems. K-NN is a non-parametric algorithm that can be used for classification and regression. The last few decades have been used in prediction cases, but the K-NN algorithm is better if feature selection is applied in selecting features that are not relevant to the model, the feature selection used in this study is Backward Selection. This study aims to determine the error value in predicting the number of requests for blood at the PMI in Gorontalo City. Meanwhile, the purpose of this research is to find the error value of the K-Nearest Neighbor Algorithm and Feature Selection which can be used as a reference for PMI in making policies to make various efforts to maintainbloodstockk in the future.

Enhancing Blood Products Sharing Among Established Blood Banks and Health Facilities through the use of ICT

The gap between blood supply and blood demand is a widening everyday as the population increases and it needs to be bridged. Since the amount blood donated in Kenya is below the world Health Organization’s recommendation (WHO 2015), inter-facility sharing of information relating to blood availability should be enhanced to improve sharing of available donated blood between health facilities. The objective of the research study was to determine the current processes used when sharing blood between health facilities and there challenges and to propose coordination between blood supply and demand among health facilities and blood banks through the use of ICT .The study used descriptive research design and 22 participants (lab technicians and doctors) in different health facilities in Nairobi County participated in the study. Results from the study indicate that in most health facilities (72%) blood demand exceeds blood supply. During emergencies when blood stocks are inadequate, most health facilities (63.6%) source the blood by requesting it from other health facilities and blood banks and mostly making these blood requests through telephone calls. The main challenge faced when using the current mechanisms is the delay in blood supply (40.9%) followed by a challenge of getting the response/feedback on time Based on the findings it was evident that the proposed intervention will be of a great use to bridge the gap of between blood supply and demand and solving the challenges faced when sharing blood during emergencies. Rapid Application Development (RAD) system design AND Service Oriented Architecture (SOA) were applied in developing the ICT intervention. To evaluate the success of the ICT intervention, a survey was conducted in five health facilities (two level 4 and three level 3 health facilities) to evaluate the satisfaction of the health facilities when using the system.

Red cell requisition and utilization pattern in a tertiary care hospital of South India.

The equilibrium between supply and demand for red blood cells is increasing unpredictably in many countries. An understanding of trends in blood usage profile and current usage can help predict future trends in demand and to put efforts to reduce use in particular areas. This study helps in analyzing the pattern of red blood cell utilization in a tertiary care hospital. This retrospective study was conducted in a blood bank, tertiary care hospital over a period of 6 months. All the requests coming to blood bank with information regarding patient's demographic details, diagnosis and indication for transfusion, type of request, blood transfused or returned were collected and reviewed. Crossmatch transfusion (CT) ratio, transfusion index (TI), and transfusion probability were also calculated. A total of 10,364 patients (20,399 requests) utilized total 32,608 units of blood and its components, out of those 14,195 units of packed red cells units were utilized. March month had maximum number of requests and utilization. Most of the requests for blood were from the inpatients (wards) and were requested and utilized in the age group of 21-30 years with male predominance. Patients in the division of medicine utilized most blood. Although the division of surgery requested most of the blood, on an average, they utilized only one-third of the requested product. Overall, anemia was the most common indication for red cell utilization. In surgical group, spine surgery had a maximum CT ratio. Neurosurgery and hand surgery had the lowest TI in all specialties. Hand surgery and spine surgery had a lowest transfusion probability. Overall, utilization rate in our study was 59.8%. A regular review of blood unit's usage is very important to estimate the blood utilization pattern in any hospital. Profile of blood utilization will act as indicator for quality management of blood bank.

Forecasting blood demand for different blood groups in Shiraz using auto regressive integrated moving average (ARIMA) and artificial neural network (ANN) and a hybrid approaches

Providing fresh blood to keep people in need of blood alive, has always been a main issues of health systems. Right policy-making in this area requires accurate forecasting of blood demand. The current study aimed at predicting demand for different blood groups in Shiraz using Auto Regressive Integrated Moving Average (ARIMA), Artificial Neural Network (ANN) and a hybrid approaches. In the current time series analysis, monthly data of the Shiraz hospitals and medical centers demand for 8 blood groups during 2012–2019 were gathered from Shiraz branch of Iranian Blood Transfusion Organization. ARIMA, ANN and a hybrid model of them was used for prediction. To validate and comprise ARIMA and ANN models, Mean Square Error (MSE) and Mean Absolute Error (MAE) criteria were used. Finally, ARIMA, ANN and hybrid model estimates were compared to actual data for the last 12 months. R3.6.3 were used for statistical analysis. Based on the MSE and MAE of models, ARIMA had the best prediction for demand of all blood groups except O+ and O−. Moreover, for most blood groups, ARIMA had closer prediction to actual data. The demand for four blood groups (mostly negative groups) was increasing and the demand for other four blood groups (mostly positive ones) was decreasing. All three approaches including ARIMA, ANN and the hybrid of them predicted an almost downward trend for the total blood demand. Differences in the performance of various models could be due to the reasons such as different forecast horizons, daily/month/annual data, different sample sizes, types of demand variables and the transformation applied on them, and finally different blood demand behaviors in communities. Advances in surgical techniques, fetal screening, reduction of accidents leading to heavy bleeding, and the modified pattern of blood request for surgeries appeared to have been effective in reducing the demand trend in the current study. However, a longer time period would certainly provide more accurate estimates.

Sistem Peramalan Permintaan Darah dengan Metode Simple Moving Average

Simple Moving Average (SMA) is a method used to forecast a state of affairs in the next period. This method is applied to determine the number of blood requests in PMI in the Asahan Regency area. Blood stock is an important factor to support activities in this PMI organization by paying attention to the condition of this month /period and predicting the next period. The purpose of this study is to build a blood demand forecasting system with the SMA method. The model used to build this system is a waterfall with stages of analysis, design, implementation and testing. The data we use for this forecasting is the demand for blood from July 2021 to June 2022. Data analysis used the SMA method to determine the rate of prediction errors in this system, while testing this system used a black box. The results of our products are in the form of a web consisting of the login menu, the main menu, the calculation results. The calculation results using the SMA method in our system are appropriate, and can display the number of blood demand stocks in each period. The results of testing the system using black box show that this system is running properly without any errors, and it is working properly. Therefore, the existence of this system can help pmi to determine the number of requests based on blood type.

Lessons learned from the COVID-19 pandemic: Improving initial investigations with the implementation of a COVID-19 blood request panel.

During the COVID-19 pandemic, the Hillingdon Hospitals NHS Foundation Trust produced trust guidelines for the initial blood investigation of COVID-19 inpatients. However, insufficient education meant inconsistent adherence to this guidance. To examine whether the implementation of a COVID-19 blood request panel improves adherence to local trust guidelines. Between March and April 2020, initial blood investigations performed for positive COVID-19 cases were compared to guidelines. Results were presented locally and a COVID-19 panel was added to the electronic system that provided prompts for appropriate investigations. A re-audit between May and June 2020 was conducted to assess adherence post-intervention. 383 patients were identified in the initial audit cohort and a sample of 20 patients were re-audited. Adherence to Full Blood Count, Urea and Electrolytes, C-reactive Protein and Liver Function Tests increased to 100% from 99.7% (p =0.8), 99.2% (p =0.69), 98.7% (p =0.61), and 96.6% (p =0.4) respectively. Coagulation screen adherence increased to 90% from 72.8% (p =0.09). Appropriate requesting of D dimers increased to 50% from 19.9% (p =0.001). Inappropriate troponin requesting decreased to 26.3% from 38.9% (p =0.23). A user-friendly COVID-19 panel of investigations resulted in improved adherence to guidelines. Clear communication and education are essential to help alleviate uncertainty during a pandemic.

A combined continuous-time Markov chain and queueing-inventory model for a blood transfusion network considering ABO/Rh substitution priority and unreliable screening laboratory

The uncertain nature of blood supply and demand in a blood supply chain network (BSCN) makes it impossible completely meet the blood demands on time. That’s why there is a vital need to develop a comprehensive model for optimally managing blood networks considering all challenges they face with. Although many researches have studied blood inventory management (BIM) in BSCNs, there is still a lack of models simultaneously considering blood inventory levels in hospital blood banks (HBBs) and blood centers (BCs) as a stochastic process. Also, most models have not evaluated the impact of false positive (FP) and false negative (FN) errors in the screening laboratories (SLs) of BCs. Moreover, no study has modeled the HBB demands as a queueing-inventory model with multiple blood types according to ABO/Rh substitution priority. To fill these gaps, this paper develops a two-echelon blood bank network considering ABO/Rh factors and substitution priority in which inventory levels of all red blood cell (RBC) types in an HBB and BC are simultaneously modeled as eight dependent continuous-time Markov chains (CTMCs). An unobservable M/M/m queueing-inventory system with infected RBCs and (r,Q) policy in the HBB is proposed. The blood requests arrive at the requests queueing system in the HBB, and after processing and departing from the queue, they leave the HBB with exactly-one RBC unit with the same ABO and Rh (Rhesus) groups or compatible with other types of RBC. Lost sales occur if all possible types of RBC for transfusion are unavailable. HBB continuously checks each RBC type's inventory level and places an order to the BC once the inventory level of each one of them reaches a predetermined reorder point. Due to transfusion-transmissible infections (TTIs), an SL conducts a 100 % quality-assured screening in the BC modeled as an M/M/m queueing system. Due to unreliable inspectors, FP and FN errors are considered in the SL. The stationary distribution of the number of requests at the HBB, the number of RBCs in the SL, and joint stationary distributions of inventory level of all RBC types in the HBB and BC are derived. Afterward, each RBC type's waiting-time distribution in the HBB is obtained. Some performance measures and the long-run total cost are extended, and a mixed integer nonlinear programming model (MINLP) is presented. Then, we propose the grasshopper optimization algorithm (GOA) to solve the complicated model. Also, this model is implemented in a case study in Tehran. Results show RBCs types O+ and A+ have the most lost sales, and the management should absorb more donors with these blood groups. Afterward, an approximation method to deal with multiple HBBs is suggested. Finally, several remarkable managerial and practical implications are presented.

Probabilistic mathematical modelling to predict the red cell phenotyped donor panel size.

In the last decade, Australia has experienced an overall decline in red cell demand, but there has been an increased need for phenotyped matched red cells. Lifeblood and mathematicians from Queensland universities have developed a probabilistic model to determine the percentage of the donor panel that would need extended antigen typing to meet this increasing demand, and an estimated timeline to achieve the optimum required phenotyped (genotyped) panel. Mathematical modelling, based on Multinomial distributions, was used to provide guidance on the percentage of typed donor panel needed, based on recent historical blood request data and the current donor panel size. Only antigen combinations determined to be uncommon, but not rare, were considered. Simulations were run to attain at least 95% success percentage. Modelling predicted a target of 38% of the donor panel, or 205,000 donors, would need to be genotyped to meet the current demand. If 5% of weekly returning donors were genotyped, this target would be reached within 12 years. For phenotyping, 35% or 188,000 donors would need to be phenotyped to meet Lifeblood's demand. With the current level of testing, this would take eight years but could be performed within three years if testing was increased to 9% of weekly returning donors. An additional 26,140 returning donors need to be phenotyped annually to maintain this panel. This mathematical model will inform business decisions and assist Lifeblood in determining the level of investment required to meet the desired timeline to achieve the optimum donor panel size.

Evaluation of Blood Requisition Forms Submitted to Transfusion Medicine Department of a Tertiary Care Hospital in Dhaka, Bangladesh

Introduction: Blood requisition form (BRF) analysis is one of the most efficient and effective approaches to assess and monitor rational use of blood and its product. BRF is the first line of communication between the clinicians and transfusion medicine specialists which helps to recognize and evaluate inappropriate use of blood. This issue is frequently underrated by the clinicians which results in increased risk of inappropriate transfusion. The current study is aimed to examine the pattern of completion of blood requisition forms and to ensure safe blood transfusion. Materials and methods: This cross sectional prospective study was conducted from January 2020 to December 2021, at the Department of Transfusion Medicine, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh. A total of 32,133 blood requisition forms that were submitted during the study period were compiled and reviewed anonymously. The data were analyzed using Microsoft Excel. Results: During the study period, a total of 32,133 Blood requisition forms were analyzed. Only 15.2% of these forms were duly completed. Rest of the forms had one or more important parameters left blank. The most common incomplete BRF items were the clinical history or differential diagnosis of the patient (52.66%), presumed date and time of transfusion (95.19%), previous transfusion history (95.9%), and referring doctor’s name and designation (88%). Blood requests were more for females (52.02%) than males (47.98%) during the period. Requisitions were more for adults (90%) than pediatric patients. Conclusion: The current study provides evidence that the rate of completion of BRFs is not satisfactory. The request forms evaluated were not covering acceptable demographic and clinical data of the patients. Both the Hospital Transfusion Committee (HTC) and the Department of Transfusion Medicine can help to improve and standardize transfusion practice by working together. Sir Salimullah Med Coll J 2022; 30: 142-147

Pengendalian Persediaan Darah untuk Pasien dengan Hemoglobin Rendah Menggunakan Metode Backpropagation

The Blood Transfusion Unit (UTD) of the Rokan Hulu Regional General Hospital (RSUD) has an important role to fulfill the demand for blood from patients. Patients who need blood donation are patients with low hemoglobin levels. The problem faced by the UTD-RS is that they have not been able to meet the needs of each patient's blood request optimally. The reason is because it is not able to predict the need for blood that will come. To see the pattern of blood demand and then determine the appropriate inventory control method to assist the planning process for the fulfillment of blood supply at UTD in the next period. Materials (data) and Methods: The data processed in this study were patient data and blood demand data from January 2020 to January 2021. The data were sourced from the Laboratory Installation and UTD at the Rokan Hulu Hospital. The data is divided into training data and testing data. Then the blood demand data is processed by normalizing it first and then the prediction process is carried out using the Backpropagation method. Then analyzed and tested with the help of Matlab software. This study uses the best network architecture pattern produced is 5-5-1 with an accuracy rate of 68% and a Mean Squared Error value of 0.198. The backpropagation method used is able to help UTD Rokan Hulu Hospital to find out the blood needs that must be met so that the blood supply can be controlled. So that every blood request from patients with low hemoglobin can be met quickly.

Analysis of Blood Request Form and Blood Utilization Pattern in a Tertiary Care Specialized Hospital

Background: The growing demands for blood products are vital resources to health care facilities. If requested blood is not transfused, this causes blood wastage. Minimal utilization of requested blood squanders technical time, reagent and imposes extra expenses on patients. This study was conducted to evaluate blood requisition and utilization pattern in a tertiary care hospital. Methods: This retrospective study was conductedin the transfusion medicine dept. of a tertiary care specialized hospital from1 January 2017 to 31 December 2020. Blood request forms were reviewed and blood utilization indices were computed from blood bank registries. Blood utilization was calculated determining cross match to transfusion ratio (C:T), transfusion probability (%T), transfusion index (TI) and non-utilization pattern i.e. wastage. Results: A total of 9,841 recipients were requested to prepare cross match. A total of 13,965 units of blood were cross matched and among these 10316 units were transfused to 9,291 recipients. The overall C:T, %T, and TI were 1.35, 94.41% and 1.05 respectively. The wastage implying in this study was 26.13%. Conclusion: The overallblood utilization was encouraging, but excessive cross matching with minimal transfusion practice was observed implying wastage of blood. Blood transfusion services should adopt blood conserving policies. Bangladesh J Medicine 2022; 33: 259-262

765 Preoperative Coagulation Screening Audit in General Surgery

Abstract Aim Routine preoperative coagulation screening is considered standard practice to predict peri-operative bleeding. However, according to British Society of Haematology, indiscriminate coagulation screening is not recommended as it may to inappropriate delay of surgery, lead to further unnecessary tests and is also associated with significant costs. Instead, they recommend detailed bleeding history, including family history and use of medications. This audit was to evaluate the current practice and improve. Method A retrospective audit of 148 post-operative patients, randomly selected in Northwick Park Hospital admitted under the General Surgery between 01.04.2021 to 14.05.2021 at the initial audit and between 20.09.2021 to 07.10.2021 at the re-audit. Results The initial audit was done over a 6-week period with 98 cases selected. 19% of them had appropriate requests with 81% of the tests done being inappropriate. There was significant improvement by the re-audit with appropriate requests increasing to 56% and inappropriate tests dropping at 44%. The criteria for appropriate were a) Not requested as no significant medical history. b) Requested as clinically indicated. With each coagulation screening costing an average of £29.42, an overall estimate of £2971.42 was expended in inappropriate requests Conclusion All patients had relevant blood requests and PMH were documented but many inappropriate requests were made. It was recommended that instead of indiscriminate coagulation testing, a thorough history was advised to determine appropriate testing. There was a marked improvement at the re-audit with more appropriate requests being made. Recommendations Further meetings with the Anaesthesiologists to ensure a joint effort in achieving the target goal

TH7.7 Pre-operative Coagulation Screening in General Surgery

Abstract Aim Routine preoperative coagulation screening is considered standard practice to predict peri-operative bleeding. However, according to British Society of Haematology, indiscriminate coagulation screening is not recommended as it may to inappropriate delay of surgery, lead to further unnecessary tests and is also associated with significant costs. Instead, they recommend detailed bleeding history, including family history and use of medications. Methodology A retrospective audit of 148 post-operative patients in Northwick Park Hospital admitted under the General Surgical who presented to Surgical Assessment Unit between 01.04.2021 to 14.05.2021 at the initial audit and between 20.09.2021 to 07.10.2021 at the re-audit. Results The initial audit was done over a 6 week period with 98 cases selected. 19% of them had appropriate requests with 81% of the tests done being inappropriate. There was significant improvement by the re-audit with appropriate requests increasing to 56% and inappropriate tests dropping at 44%. The criteria for appropriate were: a) Not requested as no significant medical history. b) Requested as clinically indicated. With each coagulation screening costing an average of £29.42, an overall estimate of £2971.42 was expended in inappropriate requests Conclusion All patients had relevant blood requests and PMH were documented but many inappropriate requests were made. It was recommended that instead of indiscriminate coagulation testing, a thorough history was advised to determine appropriate testing. There was a marked improvement at the re-audit with more appropriate requests being made. Recommendations

Crossmatch to Transfusion Ratio (C/T Ratio) Komponen Darah WB dan PRC di RSUD Kabupaten Brebes

A crossmatch test between patient and donor’s blood must be carried out before blood transfusion. However, not all crossmatched blood will be transfused to the patient. This indicates inappropriate distribution of blood products, blood wastage, inaccessibility of blood for emergency patients, increased costs, and increased workload for staff. Crossmatch to Transfusion Ratio (C/T Ratio) is used as an indicator to determine the efficiency of blood use and can serve as a guide to anticipate excessive blood demand. This study aims to determine C/T Ratio score of blood components WB and PRC in the Brebes Regency Hospital 2021. This research is a descriptive study with a retrospective approach. Sampling was done using total sampling technique. Data was obtained from the blood requests recapitulation book in Brebes Regency Hospital’s Blood Bank 2021. The result showed there were 47 units WB crossmatched and 34 units (72%) transfused. There were 4589 units PRC crossmatched and 4369 units (95%) transfused. The C/T Ratio score of WB is 1.38. The C/T Ratio score of PRC is 1.05. The overall C/T Ratio score is 1.05.

A novel approach to monitoring lithium blood levels and renal function in patients receiving lithium during the COVID-19 pandemic

IntroductionLithium is commonly administered to patients in an outpatient department (OPD) setting. Regular monitoring of lithium levels and renal function in accordance with published guidelines is required. In our unit, this is usually performed at OPD review. During the COVID-19 pandemic, reviews were either postponed or done remotely.Objectives1. To devise a system to ensure that patients receiving lithium had appropriate blood test monitoring in the absence of traditional OPD appointments. 2. To assess the efficacy of this intervention by recording blood test dates and comparing with pre-COVID compliance.MethodsAll outpatients receiving lithium, identified from the hospital database, received (1) a letter summarising the monitoring guidelines and (2) prospectively dated blood request forms. Patients at higher risk of contracting COVID-19 were advised to attend their primary care setting. Others were encouraged to attend primary care or our phlebotomy department. Compliance was measured by accessing the hospital’s laboratory enquiry computer based system and compared with pre-COVID-19 figures. Information was anonymised, as per General Data Protection Regulations.Results57 patients receiving lithium were identified. Prior to the first Irish lockdown in March 2020, 16 (28%) were overdue testing. Three months into the pandemic, 15 patients (26%) were overdue testing.ConclusionsIn the absence of routine outpatient appointments during the COVID-19 pandemic, the provision of written guidelines and completed blood request forms for patients receiving lithium was effective in ensuring monitoring of lithium levels and renal function. This system can be utilised as an alternative/adjunct to OPD review benefitting patients and health service delivery.DisclosureNo significant relationships.

Blood Transfusion in Covid-19 Patients: One Year Survey

Abstract Introduction: Due to the COVID-19 outbreak, many chronic patients and elective surgical procedures have been postponed to create spaces for the hospitalization of COVID-19 patients, raising issues related to this change. The objective of this study is to assess the effect of the COVID-19 pandemic on the demand for blood products transfusion. Materials ant methods: The study presents the results of a retrospective study of blood transfusions in COVID-19 patients admitted to the Constanta County Emergency Clinical Hospital. The period of study was January-December 2021. We compared the transfusion requirement for each type of blood component in COVID 19 patients versus patients with non-COVID pathology. Results and discussions: During 2021, we transfused 282 COVID-19 patients; 150 patients had only Covid pneumonia (of which 19 patients with severe forms needed intensive care in ICU-Covid), and 132 patients had various co-morbidities. The maximum blood requests was registered in the period February - April 2021, with a peak of 63 patients in April 2021. The main co-morbidities in patients with Covid 19 were: severe anemia in patients with malignant hemopathies. Anemia at admission in patients with Covid pneumonia is reported in more than 40% of patients . Moderate anemia (Hb &lt;11 g/dL) is considered as an independent risk factor for the severe course of COVID-19 infection and mortality in these patients. The transfusion requirement in these patients was greater than 1.43 RBC (units/patient), 0.81 Plasma units/patient, 0.40 Platelets concentrate units + single donor platelet concentrate units/patient, in accordance with the associated pathology. Conclusions: The most requested product was packed red blood cells, the correction of anaemia being an important factor in preventing the severe course of the disease. The platelet requirement was 0.15 units/patient, thrombocytopenia being present in patients with severe evolution of the infection (hospitalized in ICU-COVID). The most requested blood groups were O+ and A+. COVID-19 transfusion data will help plan and prepare for the use of blood resources during the pandemic.