Hemotherapy Service Research Articles

The Metabolic syndrome and metabolic characteristics in blood donors

Metabolic syndrome (MS) is associated with increased cardiovascular risk. Blood donors are an apparently healthy population in which certain cardiometabolic characteristics are not evaluated in their selection, and there is limited information on their presence. To determine the frequency of metabolic syndrome and its metabolic characteristics in blood donors. Materials and methods: Cross-sectional study was carried in a population of 244 blood donors between 18 and 55 years of age who attended the Hemotherapy and Blood Bank Service of the Cayetano Heredia Hospital in Lima, Perú during the month of May 2023. The diagnosis of MS was made according to the Adult Treatment Panel III (ATP III) criteria. A bivariate analysis was performed between MS and metabolic characteristics with sex and a significance level of 5% was considered. 63.9% of blood donors were male. 43.6% of the population had MS. The most frequent characteristics found were hypertriglyceridemia (54.5%), abdominal obesity (51.2%) and high-density lipoprotein (HDL) low (48.8%). The age range of 40 to 49 years presented the highest frequency of MS (14.3%). Hypertriglyceridemia and high blood pressure were associated with male sex (p=0.003 and p=0.019 respectively), while low HDL was associated with female sex (p<0.001). Blood donors present an elevated frequency of MS. The detection of MS in apparently healthy populations as part of primary care could allow the formulation of strategies for early detection of cardiovascular risk factors.

Use of educational manuals on blood components in hemotherapy and hematology services in Brazil: a scoping review

Hemotherapy has as its principle the rational use of blood, consisting of the appropriate use of blood components such as red blood cells, platelets, plasma and cryoprecipitate, obtained from the donation of whole blood. The use of educational manuals stands out as support in this process, which helps in the organization and safety of transfusion practice. The objective of the study was to map educational manuals on blood components in hemotherapy and hematology services in Brazil. This is a scoping review based on the recommendations of the Joanna Briggs Institute (JBI) and structured based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoing Reviews (PRISMA-ScR) checklist and was registered in the Open Science Framework, under DOI: 10.17605/OSF.IO/642JZ. The publications had a predominance of articles in Portuguese language 100%. There was a prevalence of studies with a descriptive approach 80%, action research 10% and randomized studies 10%, as well as publications carried out in Brazil 100%. The study showed us the importance of manuals and the difference caused by their use in terms of standardization in Brazilian health units.

NURSING CARE FOR USERS WITH SICKLE CELL ANEMIA: AN INTEGRATIVE REVIEW

Objective: To present the evidence available in the literature on nursing care for users with sickle cell anemia. Methodology: Integrative, qualitative review, with database research. 15 articles published between 2015-2022 were considered. The descriptors were used: “Sickle cell anemia”, “Nursing Care”, “Nursing” and “Hemotherapy Services”. Results: Two thematic categories were found: Nursing care for students with sickle cell anemia; Nursing care for users with sickle cell anemia in the Health Care Network services. Final considerations: Care for this population stands out, with actions that begin from the newborn stage and are also aimed at the black population, as well such as using approaches beyond conventional ones, such as pain relief strategies and helping people deal with a health problem that will accompany them throughout their lives.

Limits and potentialities for health control actions in Hemotherapy services

Resumo Objetivou-se discutir os limites e as potencialidades, sob a perspectiva de gestores de serviços de Hemoterapia/Hemocentro, para a execução das ações e as relações entre os agentes/equipes da VISA estadual e municipal com os Hemocentros. A partir de abordagem qualitativa, utilizaram-se, para análise de conteúdo, oito entrevistas de representantes gestores de hemocentros de diferentes estados, distribuídos nas cinco regiões brasileiras. Os achados evidenciaram limitação no diálogo entre as instituições; mudança de pessoal e rotatividade de gestores; tempo burocrático; notificação descentralizada; difícil estruturação ou ausência do Núcleo de Segurança do Paciente, como limitações. E como potencialidades: atuação da VISA como colaboradora para os processos de qualificação; processos de planejamento construídos de modo articulado e colaborativo; colaboração para a realização de treinamentos e capacitações das equipes; experiência profissional dos trabalhadores de ambas as instituições para o entendimento da rotina dos serviços e melhora do diálogo. Portanto, os limites e as potencialidades evidenciadas a partir deste estudo refletem sobre o desenvolvimento das ações, responsabilidades e diálogo entre os serviços, os quais devem ser considerados para a elaboração de estratégias e desenvolvimento do trabalho articulado e integrado.

The impact of COVID-19 of blood donations and blood components usage in Ceará, Brazil

Abstract With increase cases of Coronavirus disease in Brazil and the virus propagation around the world, several health sectors were negatively affected, including hemotherapy services and generating a decrease in blood donation. In this study, we gathered information about total blood donations and usage during COVID-19 pandemic in the state of Ceará, located in the northeast side of Brazil. More specifically data from donations between April 2020 and September 2021 and compared with data gathered from donations of pre-pandemic period. During the period, the state of Ceará received 181.362 candidates for blood donation. Of these, 80.16% were eligible for donation and 19.84% unfit. The number of candidates decreased by 16.72% in 2020 and 5.10% in 2021 in comparison to the same periods in 2018. The main causes of inability for candidates during the pandemic period were low hematocrit/hemoglobin, occasional sexual intercourse in the last 12 months and suspicion or confirmation of COVID in the last 10 days. However, the increasing number of critically ill hospitalized COVID patients increased the blood supply, as transfusions increased by 1.03% in 2020 and 7.96% in 2021, showing a higher demand in RBC, platelets, FFP and CRYO. The pandemic had a significant impact on national blood stocks, causing a change in donation behavior and causing a concern to maintain an adequate blood supply during this crisis. Despite the situation, the stock of blood components in HEMOCE met the Ceará blood demand in the hospitals.

Quality control in blood irradiation

Irradiation is a technique used in hemotherapy to functionally inactivateviable lymphocytes, in cellular blood components, to reduce the risk of Transfusion-associated Graft-versus-Host Disease (AT-GVHD), is rare but letal. One way to avoid it is to irradiate blood componentes in situations such as: intrauterine transfusion, newborns, patients receiving immunosuppressive therapy in bone marrow transplantation. Thus, it is extremely important that blood component is irradiated and, above all, ensure that the minimum dose is 25 Gy.The blood policy in Brazil is implemented through laws and normative decrees, giving rise to a legal system that underpins the actions of hemotherapy services. In order to correct verify absorbed doses and the quality assurance process as well as the safety for the irradiator operators we describe in this paper a several of physical measurements that is mandatory to support a physicist to evaluate the quality assurance during and after the irradiation process. The results obtained from this physical measurements provided a guarantee of proper radiation dose used in hemotherapy as well as methods and procedures applied to protect the patient, employees and general public due to procedure of blood irradiation accordling the Technical Regulation of Hemotherapy Procedures of the National Health Surveillance Agency (ANVISA) and safety regulations by National Nuclear Energy Commission (CNEN).

Management of hemotherapy services in the context of the COVID-19 pandemic.

This study aimed to analyze the management of hemotherapy services (HS) in the context of the COVID-19 pandemic from the perspective of municipal managers in different regions of Brazil. A qualitative approach with semi-structured interviews was applied to HS managers in the three Brazilian capitals, from different regions of Brazil, during the period between September 2021 and April 2022. The textual content of the interviews was submitted to lexicographic textual analysis using the free access software, Iramuteq. The managers' perceptions resulted from the descending hierarchical classification (DHC) analysis, which generated six classes: availability of resources for the development of work; installed capacity of services; strategies and challenges for attracting blood donors; risks and worker protection; measures for crisis management; and communication strategies for the adhesion of candidates for donation. The analysis highlighted several strategies used by the management, as well as pointed out limits and challenges for HS organization and management, exacerbated in the context of the pandemic.

Gestão dos serviços hemoterápicos no contexto da pandemia de COVID-19

Abstract This study aimed to analyze the management of hemotherapy services (HS) in the context of the COVID-19 pandemic from the perspective of municipal managers in different regions of Brazil. A qualitative approach with semi-structured interviews was applied to HS managers in the three Brazilian capitals, from different regions of Brazil, during the period between September 2021 and April 2022. The textual content of the interviews was submitted to lexicographic textual analysis using the free access software, Iramuteq. The managers’ perceptions resulted from the descending hierarchical classification (DHC) analysis, which generated six classes: availability of resources for the development of work; installed capacity of services; strategies and challenges for attracting blood donors; risks and worker protection; measures for crisis management; and communication strategies for the adhesion of candidates for donation. The analysis highlighted several strategies used by the management, as well as pointed out limits and challenges for HS organization and management, exacerbated in the context of the pandemic.

Streptococcus gallolyticus Bacteremia Detected in Apheresis Platelets and Its Link to Colonic Neoplasms

Abstract Introduction Streptococcus gallolyticus belongs to the Streptococcus bovis complex, and it is a common bacterium colonizing the gastrointestinal tract. Its presence in the blood may suggest an underlying pathology such as a colonic neoplasm. We report herein a case of S. bovis bacteremia in an apheresis platelet donor, review similar cases in the literature, and suggest a flowchart for the management of similar cases in other blood donation centers. Case Presentation A 61-year-old subject presented to a Hemotherapy Service to make an apheresis platelet donation. On quality control testing, S. gallolyticus was identified in hemoculture, and the donor was called back for follow-up. At first, a new hemoculture was requested, and the patient was referred to the outpatient department of infectious diseases to further investigate pathologies associated with S. gallolyticus. A subsequent colonoscopy investigation evidenced a polypoid structure in the ascending colon. Pathology reported the resected specimen as a low-grade tubular adenoma. Conclusion Isolation of S. bovis in blood products requires further investigation and should be managed with precision by Hemotherapy Services. A standard protocol for the management of asymptomatic patients with S. bovis positive hemoculture, with the requests of a new blood culture, a colonoscopy, and an echocardiogram is crucial, as it may ensure early diagnosis and reduce morbidity and mortality.

Impact of COVID-19 on the efficacy of meeting the transfusion demand by a Brazilian blood banks network

One of the effects of the pandemic in the hemotherapy services was the reduction in the attendance of blood donors and production of blood components. It is relevant to investigate how the capacity to meet the demand for blood components was affected, especially in blood centers located in the regions most affected by the pandemic, such as Brazil. This study aimed to describe the impact of the pandemic on the capacity to meet the demand for different types of blood components by a Brazilian blood center in 2020, compared to the historical series of 2016–2019 and to discuss the measures adopted to mitigate the effects of the pandemic. Retrospective cross-sectional study was carried out with comparative analysis of the blood components requested and attended in the period from 2016 to 2020. Data analysis was performed by Graphpad Prism 5. The spread of COVID-19 cases since March 2020 had impact on the blood components production and transfusions. The reduction in the production of blood components was observed prior to the restriction measures, in March 2020. In comparison to 2016–2019, there was a reduction in the number of transfusions performed in all months of 2020. The results suggest that the measures adopted in a Brazilian blood center to face the COVID-19 pandemic resulted in reasonable regularity in the supply of blood components. The sharing of experiences between blood banks in different regions, social and epidemiological contexts can contribute to the improvement of strategies to reduce the impact of COVID-19 in transfusion medicine.

Nursing in hemotherapy services: considerations on public policies associated with blood and blood components.

Reflect on how the evolution of legislation related to blood and blood-based products has shaped the role of nurses in hemotherapy services. A reflective study, carried out employing surveys in databases, about the evolution of the nurse's role in hemotherapy services. Several legislations, published since 1950, have encouraged blood donation and shaped the work of nurses in hemotherapy services, being the most relevant Law #10.205/2001 (Lei nº 10.205/2001), about blood collection, processing, storage, distribution, and blood transfusion; and COFEN's resolution # 629/2020 (COFEN nº 629/2020), which addresses in detail the practice of these services. The evolution of legislation related to blood and blood-based products contributed to the consolidation of nurses' attributions in hemotherapy services since it guaranteed legal support and defined the practices in these services.

Shared surgery blood reserve reduces surgery suspension rate due to blood unavailability

The hemotherapy service in health units with high surgical demand has been pointed out as a challenge, especially concerning storage management simultaneously with transfusion demand attendance. The objective of this study is to analyze service efficacy after the implementation of a new strategy to meet storage and transfusion demands. The present study analyzed the records of the hemotherapy service related to blood components management in surgeries where blood reserve was necessary for RhD positive patients at the National Institute of Traumatology and Orthopedics. A shared compatibility test and surgery reserve from the first semester of 2018 was compared to an equivalent period in 2017, prior to its implementation, under an individualized protocol to each patient scheduled on the surgery map. After the implementation of the shared protocol, the transfusion demand was higher, due to an increase in the percentage of surgeries that required transfusion, as well as to the augmented number of blood components used in the surgeries. Even in the presence of a slight decrease in storage, the hemotherapy assistance was considered efficient, since the percentage of surgery suspension reduced from 2 % to 0.2 % after the implementation of the shared protocol. This improvement resulted in an adjustment in the classification of reasons for surgical procedure cancellations, so that the reason “blood shortage” was repositioned from the first to the seventeenth position. This is the first record of a shared compatibility protocol and surgery reserve and we hope to contribute to the development of the hemotherapy service and surgical patient healthcare.

Profile of apheresis donors at Professor Alberto Antunes University Hospital of the Federal University of Alagoas

Hemotherapy services play a key role in attracting donors and providing safe blood to the population. The apheresis platelet collection procedure is a relatively simple, safe and important procedure for increasing the stocks of these services. However, the recruitment and retention of these donors still represent a major challenge. Objective: Evaluating the profile of donors of blood components by apheresis in the Transfusion Unit of Professor Alberto Antunes University Hospital - UFAL, as well as knowing the hematological parameters pre- and post-donation, the occurrence of the main adverse events related to the procedure and the difficulties faced by the donor. Method: This was a cross-sectional observational study. We analyzed a total of 160 forms of apheresis donors from March 2017 to June 2018. The data were tabulated using the Excel program, and then analyzed in order to determinethe objectives. Results: Most donors were male (93.13%), aged between 25 and 40 years (48.75%) and brown (25.62%). There was a slight prevalence of singles (49.37%) and 73.75% were from Maceió. The most prevalent ABO and Rh phenotyping was O+ (39.3%). Most of the procedures were simple platelet collection (75.60%) and the occurrence of adverse events during donations was 30.63%. Conclusion: Evaluation of apheresis donor profile and the knowledge of the possible side effects related to the procedure provided a better understanding of this type of donation and may improve the capture and retention processes of these individuals, minimizing the effects of lack of blood for Alagoana population.

Frequency of allogenic blood transfusion in patients with gastrointestinal cancer: a cross-sectional study in Peru.

BackgroundGastrointestinal cancer demands a high frequency of transfusions, and the high availability of blood products. We aimed to determine the frequency of blood transfusions and the most used blood products according to the type of gastrointestinal cancer.MethodsA cross-sectional study was conducted in a Peruvian Type I Hemotherapy and Blood Bank Service of a Private Oncological Clinic during 2016–2018. We included patients with gastrointestinal cancer using the International Code of Diseases. The donations were made in compliance with the requirements of the Programa Nacional de Hemoterapía y Banco de Sangre and in accordance with the Standardised Operational Procedure of the clinic.ResultsWe analysed 3,022 patients, of which 163 (5.4%) had gastrointestinal cancer (67.1 ± 12 years). The 80 (49.1%) men did not show significant differences with the 83 (50.9%) women (p = 0.178). The most frequent neoplasia was the colon (41.7%) and pancreas (37.4%). Three hundred and four blood products were transfused (average 1.8 ± 2.5 units (range: 1–30 units/patient)), of which 81.3% (247 units) were red blood cells concentrated, 8.6% (26 units) were fresh-frozen-plasma (FFP) and 6.6% (20 units) were cryoprecipitate. The type of cancer that most blood products demanded was colon neoplasia (41.8%), followed by pancreatic cancer (26.3%) and liver cancer (10.9%). We determined that ~55% of patients were O Rh(D)+ and in five patients we were poly-transfused.ConclusionOur findings suggested that patients with gastrointestinal cancer require large numbers of transfusions of blood cell concentrate and FFP. Also, we showed that cancer of the colon, pancreas and liver demanded more than 75% of blood products.

Epidemiological and molecular profile of blood donors infected with HTLV-1/2 in the state of Pará, northern Brazil.

The Human T-lymphotropic virus (HTLV) is a retrovirus of the genus Deltaretrovirus, which belongs to the family Retroviridae. The most important types are HTLV-1 and HTLV-2. It is estimated that between five and 10 million individuals are infected with HTLV-1, worldwide. Studies in the state of Pará indicate that it has the third highest prevalence of HTLV infections of any Brazilian state. The present study describes the epidemiological, serological, and molecular profile of blood donors from the state of Pará that were classified as unfit due to infection by HTLV-1 and 2. The present study is based on a descriptive, retrospective, and cross-sectional review of the epidemiological, serological, and molecular data on blood donations, between January 2015 and December 2019. The data were obtained from the blood bank system and were digitalized to form a database in the Statistical Package for Social Sciences program, version 20. Descriptive statistics were used to determine the absolute and relative frequencies of the qualitative variables. For the quantitative variables, the mean, standard deviation, and minimum and maximum values were calculated. A p < 0.05 significance level was adopted for all analyses. A total of 632 samples were analyzed, of which 496 (78%) had no detectable proviral DNA and 136 (22%) had detectable HTLV. The HTLV-1 was detected in most (78%; 106/136) of these samples, while only 30 (22%) were detected for HTLV-2. The HTLV proviral DNA was detected primarily in females (69.1%), with a mean age of 40years, with the highest frequencies of detection being recorded in single individuals (66.2%), first-time donors (74.3%), and individuals that had graduated high school (44.1%). The molecular confirmation of HTLV showed that three-quarters (78%) of the serologically reactive individuals were negative for either types 1 or 2, so the epidemiological profile of these individuals was significantly different from their detectable profile. The HTLV is neglected in Brazil; there is thus a clear need for further research in the area of regional hemotherapy and hematology services, in order to contribute to the definition of regional infection profiles, that will be fundamental to the development of effective prophylactic practices for the prevention of the infection and the dissemination of knowledge on the dangers of HTLV in the community.

Difficulties and strategies related to blood donation in a hemotherapy service

Objective: to analyze the aspects that hinder blood donation and strategies to attract donors. Methods: qualitative study conducted with 12 donors. The data was collected through semi-structured interviews and analyzed using Content Analysis. Results: regarding the complicating aspects, the lack of time and little flexibility in service hours, the displacement in accessing the service and the fear of the donation process were scored. As strategies for attraction, the interviewees talked about the dissemination and internal campaigns in companies, education in schools and universities, loyalty of donors, flexibility in the hours of the blood center and mobile units for blood donation at strategic points in the city. Conclusion: donors pointed out difficulties and suggestions for strategies, constituting relevant information for innovative proposals that help in the process of attracting new blood donors.

Methods of preserving platelets: cryopreservation as a reasonable option for its implementation in Argentina

Platelets are one of the most widely used blood components in transfusion medicine, given their importance in the prevention of bleeding disorders in patients with multifactorial thrombocytopenia and Asian non-immunological etiology, as well as in the management of traumatic or blood-related surgical treatments. Given its extensive use and the constant demand for it to be used within the different procedures associated with medicine, it is the objective of both hemotherapy services and blood banks to ensure that blood product components are constantly available to meet such requirements. The main challenge with this resource is its short useful life (5–7 days) which limits its availability, especially in the Latin American context where the production of blood components as well as the resources allocated for this purpose by state entities to blood banks, are generally limited. Cryopreservation at –80°C using dimethylsulfoxide as a preservative solution is a technique used since the 1950s to prolong platelet survival, the improvement of which has been remarkable in recent years, thereby constituting an alternative solution to this problem.

Social distancing measures and demands for the reorganization of hemotherapy services in the context of Covid-19.

The article aims to discuss the consequences of social distancing measures on the availability of blood and organization of blood therapy services at the beginning of the Covid-19 pandemic in Brazil. News published in April 2020 on the websites of the country's state Blood Service Networks were consulted and organized in an Excel spreadsheet, presented in summary charts, and descriptions of results were prepared. A critical situation of blood supply, especially of some blood types, has been observed in many states. This situation is influenced by the circulation of the new coronavirus. The adoption of social distancing measures associated with unchanged transfusion demands for outpatient, urgency and emergency care required the implementation of strategies and actions for the reorganization of the services. Protection measures were incorporated, flows were changed and new routines were established. This study shows the extent to which the epidemiological situation of Covid-19 and the necessary measures for its control influenced the stocks and availability of blood. Changes in the organization of blood therapy services were fundamental in order to ensure protection, mitigate the risks of spreading the virus, and ensure the blood supply to meet the needs of the health system.

Quality management in hemotherapy services in the interior of Rio Grande do Norte: analysis of the effects of an improvement cycle

Introdução: A gestão da qualidade em serviços de hemoterapia é um elemento crucial para a segurança transfusional. A implementação das atividades de gerenciamento da qualidade é um desafio no contexto brasileiro. Objetivo: Avaliar o efeito de um ciclo de melhoria nos serviços de hemoterapia do interior do Rio Grande do Norte, na conformidade com os critérios de gestão da qualidade, elaborados com base no Método de Avaliação de Risco Potencial em Serviços de Hemoterapia (MARPSH). Método: Estudo quase-experimental,antes e depois, que avaliou 13 critérios de qualidade, elaborados com base no MARPSH da Agência Nacional de Vigilância Sanitária. Participaram do estudo oito serviços de hemoterapia do interior do estado do Rio Grande do Norte, sendo quatro Agências Transfusionais, duas Unidades de Coleta e Transfusão e dois Hemocentros Regionais. Estatísticas descritivas e gráficos de Pareto foram utilizados. Resultados: Observou-se redução de 36,4% dos problemas de qualidade após a realização do ciclo de melhoria. Na análise por serviço, houve um aumento no cumprimento dos critérios variando entre 7,0% e 50,0%. A implementação de protocolos, os procedimentos de auditoria interna e o monitoramento da qualidade foram os critérios que registraram relativamente uma maior adesão após a intervenção, todavia permaneceram como as principais causas de não conformidades, tanto antes quanto após a intervenção. Conclusões: O ciclo de melhoria demonstrou ser uma intervenção válida no aumento da adesão dos serviços às atividades de gestão da qualidade preconizadas pela legislação sanitária, tendo a Vigilância Sanitária um importante papel para alcance dos padrões estabelecidos.

Prevenção e controle de pragas e vetores no serviço de hemoterapia sob a visão da gestão do Hemocentro de Arapiraca/AL

RESUMO: A presença de insetos e outros animais em ambientes de saúde caracteriza-se como um risco para a saúde, uma vez que pode trazer problemas ao ambiente, aos profissionais e aos usuários. Assim, idealizou-se o presente estudo tendo como objetivo analisar o controle e as medidas de prevenção de pragas e vetores no serviço de hemoterapia do hemocentro Regional de Arapiraca/AL (HEMOAL); discorrer sobre o entendimento da gestão/supervisão acerca da problemática, das legislações sanitárias e as medidas de enfrentamento de caráter preventivo adotadas pelo serviço. Realizamos uma pesquisa bibliográfica e de campo. A pesquisa de campo utilizando um questionário junto à gestão de qualidade e supervisão do Hemocentro de Arapiraca. Com o estudo foi possível verificar que na instituição pesquisada existe uma preocupação e conhecimentos sobre pragas e vetores, que a gestão/supervisão do hemocentro procura seguir as legislações sanitárias, bem como, que são desenvolvidas estratégias de enfrentamento e prevenção, na rotina do hemocentro, com o objetivo de manter a instituição livre de possíveis infestações.&#x0D; PALAVRAS-CHAVE: Entomologia, Vigilância Sanitária, Dedetização.