Packed Red Blood Cells Research Articles

Is Serum Ferritin a Predictor of Blood Transfusions Outcome and Survival in Childhood Lymphomas and Solid Tumors?

Packed red blood cell (PRBC) transfusions are an important part of supportive treatment in oncology; however, when used frequently, they can be a result of transfusion-related iron overload. The aim of the study was to evaluate the role of ferritin as a non-specific marker of neoplastic growth and transfusion-related iron overload in children with lymphomas and solid tumors. We performed a longitudinal analysis of PRBC transfusions and changes in ferritin concentrations during oncological treatment of 88 children with lymphomas and solid tumors. A ferritin concentration above 500 ng/mL was diagnosed in 14.77% of patients at the moment of admission and 18.18% at the end of treatment. No differences were shown in serum ferritin in the context of tumor type-, sex-, and transfusion-related parameters. Those above the age of 10 demonstrated higher ferritin concentrations compared to subjects younger than 5 years of age. In addition, those over than 10 years old or above 30 kg in weight showed a tendency for better survival. All tested patients demonstrated highly significant correlations between ferritin at the 15th month of treatment or after therapy discontinuation and transfusion-related parameters. Interestingly, ferritin levels were found to lower back to the values before therapy shortly after its discontinuation. Transfusion parameters and ferritin levels had no influence on the survival of the studied cancer patients.

Risk of transfusion-associated malaria in sub-Saharan Africa: The case of Mali.

Malaria is a health threat in sub-Saharan Africa, where Plasmodium is not tested in blood bags. Our objective was to determine the prevalence of plasmodial carriage in blood bags and the associated factors, and the involvement of these bags in the occurrence of malaria in recipients. From 1st April to 30th November, 2020, we conducted a prospective cross-sectional study of 348 blood bags stored at 4°C in Bamako. Using SPSS 21.0 software, statistical analyses were performed using a binary logistic regression model with a significance threshold of p < 0.05 and the odds ratio (OR) framed by its 95% confidence interval (CI). During this period, 348 blood bags were transfused into 108/152 hospitalised patients, generating a transfusion frequency of 71.1%, with a prevalence of plasmodial carriage of 22%. Among the 54 initially malaria-negative recipients, all 20 (37%) who received malaria-positive blood bags and slept under long-acting insecticide-treated nets (LLINs) developed malaria. We recorded 33.3% deaths. Donor age ≤ 34 years (p = 0.011; OR = 2.55[CI.95% = 1.25-5.23]), replacement donation (p = 0.000; OR = 0.04[CI.95% = 0.0-0.19]) and not regular use of LLINs by donors (p = 0.048; OR = 0.53[CI.95% = 0.29-1]) were factors associated with plasmodial carriage of blood bags. CD4 count<200 cells/mm3 (p = 0.002; OR = 0.2[CI.95% = 0.10-0.52]), severe anaemia (p = 0.034; OR = 0.26[CI.95% = 0.10-0.90]) and decompensated anaemia (p = 0.034; OR = 3.88[CI.95% = 1.11-13.56]) were factors independently associated with recipient death. The prevalence of plasmodial carriage among blood donors is increasing in Mali. Transfusion malaria is a reality to be feared, with the risk increasing with the level of malaria endemicity of the blood donor.

In- vitro evaluation of blood bags based on poly(vinyl chloride)/ selenium nanocomposites and exposed to electron beam irradiation

In- vitro evaluation of blood bags based on poly(vinyl chloride)/ selenium nanocomposites and exposed to electron beam irradiation

Using Quality Improvement to Optimize Blood Product Utilization in a Pediatric Cardiac Catheterization Laboratory.

Packed red blood cells (PRBC) are frequently ordered for cardiac catheterization procedures, which increases resource utilization and patient charges. We applied the Plan-Do-Study-Act (PDSA) principle in order to optimize the ordering of PRBC for pediatric cardiac procedures and reducing charges. Our primary aim was to increase adherence to ordering guidelines to greater than 97%, with a global aim to reduce resource utilization. The existing PRBC ordering guidelines were revised and procedure reports were updated to include administration of PRBC. The rate of pre-procedure PRBC orders, adherence to the new protocol guidelines, presence of documentation and rate of blood transfusion within 24h post-procedure, frequency of emergency release blood during a procedure were monitored. During our study period, there was an increased adherence from 86 to 100% adherence following implementation of the updated guidelines. With improved adherence, we decreased PRBC ordering and hospital charges to the patient in low-risk cardiac catheterization procedures, without an increase in blood transfusions.

Improving the performance of polyvinyl chloride with added natural extracts for medical storage

Abstract Polyvinyl chloride (PVC) is a candidate biopolymer for medical packaging due to its inertness to biological fluids, high &amp;#xD;mechanical and chemical resistance, and wide range of processing possibilities. Blood bags were fabricated to obtain a &amp;#xD;flexible blood bag with high durability, antibacterial resistance, and good bio-properties. Recently, most of the problems &amp;#xD;related to blood bags available in hospitals are related to the synthetic plasticizer added to the base material to provide the &amp;#xD;required flexibility for application, but these synthetic materials harm human blood as they lead to blood dissolution and thus &amp;#xD;blood corruption quickly. So the present work focuses on modifying the properties of PVC by incorporating extracted natural &amp;#xD;materials including basil seeds at different concentrations (1%, 2%, and 3%) using solvent cast method. Then, extracted &amp;#xD;wheat gel at concentrations (0.5 and 1%) was added to composite samples containing basil seed gel (3%). The resulting &amp;#xD;samples were characterized by tensile, water absorption, FTIR, wettability, transparency, antibacterial, and hemolytic tests. It &amp;#xD;was found that the ultimate tensile strength decreased with increasing concentration of two additives. While the elastic &amp;#xD;modulus value decreased when basil seed gel was added, but tended to increase when wheat gel was added. The elongation &amp;#xD;ratio results showed improvement with the addition of gel. The results showed that the water absorption and wettability of the &amp;#xD;composites increased with the increase of the additive concentration. The results also showed that these materials had better&amp;#xD;resistance to S. aureus and C. albicans bacteria. The transparency and hemolysis results decreased with the addition of a gel &amp;#xD;enhancer. According to the obtained results the resultant composite has better properties than commercial blood bags and is &amp;#xD;more suitable for blood bags.

Validating a Pneumatic Tube System for Blood Product Delivery

Abstract Introduction/Objective Timely delivery of blood products can be of utmost importance to providing quality care. We aimed to validate the use of a high-speed pneumatic tube system (PTS) that was already installed at our hospital. By reducing delivery times, patient resuscitation and survivability can be increased. Methods/Case Report We followed the Association for the Advancement of Blood &amp; Biotherapies (AABB) guidelines to validate a PTS in a large tertiary academic medical center. The requirements include: verifying product suitability, ensuring product integrity, temperature monitoring, transportation time measurements, and proper packaging and tracking of product receipt. We validated the transfer of packed red blood cells (PRBC), plasma, platelets, and cryoprecipitate from the central blood transfusion services lab (BTS) to nursing stations in a separate building up to 1500 feet (&amp;gt;1/4 mile) away using a Swisslog Translogic® PTS Inclusion with foam inside the PTS carriers helped reduce bumps during transit and insulated products from heat. Results (if a Case Study enter NA) The mean temperature of the PRBC was 6.6 degrees Celsius and none exceeded the AABB maximum of 10 degrees Celsius. The mean time for blood products transit to the nursing stations was 3 minutes (m) and 33 seconds (s). The median time was 3m 31s, and it ranged from 2m 18s to 5m 38s. The PTS reduced delivery times of blood products by up to 10-12 minutes compared to manual porters. Conclusion Transporting blood products via PTS is an efficient method that reduces the required manpower and leads to better utilization of resources. However, it is essential to validate the PTS system before implementing it operationally.

High-energy blunt pelvic ring injuries and pre-hospital pelvic binder applications – A retrospective assessment based on a prospective registry

IntroductionApplication of a pelvic binder in the pre-hospital settings is a crucial step of high-energy blunt pelvic ring injury (PRI) management protocols. The aim of this retrospective cohort study was to evaluate the percentage of pre-hospital pelvic binder's applications in high-energy blunt type B or C PRI patients managed at a single level I trauma center, and to assess its impact on the medical resource requirements and patients' outcomes. MethodsThe institutional Severely Injured Patients’ Registry was screened for patients meeting the following inclusion criteria: (1) high-energy blunt PRI; (2) admission between 2014.01.01 and 2022.12.31; (3) age ≥16 years; and (4) available computed tomography of the pelvis. Exclusion criteria were: (1) death before admission; (2) low-energy injury; (3) penetrating, blast and electrical injuries; and (4) secondary transfers. Study variables, including pre-hospital application of a pelvic binder and demographic, clinical, management and outcome data were extracted from the registry. Additionally, AO/OTA classifications were determined. ResultsA consecutive series of 262 patients was included into the final analysis. Of these, 58.8 % received a pre-hospital pelvic binder (PPB), increasing from type A (45.1 %) to type B (57.8 %) and type C (73.7 %). Pre-hospital hemodynamic instability was a major factor triggering the use of PPB in high-energy blunt type B PRI patients with PPB in 76.9 % of the cases with hemodynamic instability vs. 51.3 % of the cases without hemodynamic instability (p = 0.009). This difference was not statistically significant for high-energy blunt type C PRI patients (82.8 % vs. 64.3 %, p = 0.200). The presence of a physician on the trauma site contributed to the increased percentage of PRI managed with PPB from 43.5 % to 67.3 % in type B PRI (p = 0.011), and from 50 % to 77.1 % in type C PRI (p = 0.257).This study showed an increased need for packed red blood cells (PRBC) transfusions in subgroups treated with PPB and no statistically significant differences in term of intensive care unit (ICU) and total hospital length of stay and complications between high-energy blunt type B or C PRI patients with or without PPB.Comparison of mortality rates in patients with and without PPB showed a trend towards lower mortality rates with PPB in patients with AIS extremity participating in at least 50 % of the total ISS. ConclusionIn the ideal pre-hospital scenario, every high-energy blunt type B or C PRI patient should be managed with a PPB. Continuous pre-hospital team training and information is crucial to achieve this goal. The preparation of Emergency Department and ICU who admit a patient with PPB should include a sufficient number of PRBC ready for transfusion. Mortality rates did not seem to be affected by PPB, except for a trend towards lower mortality rates in patients in whom their PRI was the major component of the global severity of their injury. This might point out the critical and positive effect of PPB in high-energy blunt PRI patients.

Application of Fuzzy Mamdani Method to Predict the Number of Blood Bags Based on Demand and Supply Data Using Matlab

Fuzzy logic is a control system technique in solving problems and is applied to systems, from basic systems to difficult or complex systems. Fuzzy logic is the proper method to plan an input space into an output space using MATLAB's mathematical theory of fuzzy sets. The reason for using fuzzy logic is because it is related to uncertainty. The unstable demand for blood bags in hospitals makes the supply of blood bags excessive or lacking from demand. The lack of blood supply results in the unfulfilled demand for blood needed by the hospital, while the excess blood supply worsens the quality of blood. In this study, we will predict the number of bags produced using the Mamdani Fuzzy Inference System (FIS) method based on the minimum demand and maximum demand values and the minimum supply and maximum supply that produce output from the defuzzification process. Applying the Mamdani Fuzzy Inference System (FIS) method based on demand and supply data obtains optimal output with MATLAB in predicting the number of blood bags produced. The results of the study showed that the Mean Absolute Percentage Error (MAPE) fuzzy logic Mamdani error value was 24%, the accuracy value of the Fuzzy Inference System (FIS) Mamdani in determining the number of blood bag production was 76%, and the production output generated through the Fuzzy Inference System (FIS) Mamdani was 4,774 blood bags. The number of blood requests at the hospital is 4,443 blood bags, so the amount of blood that must be produced to meet the hospital's demand is 4,774 bags.

Effect of chitosan and natural materials on properties of polyvinylchloride for blood bags applications

Abstract Polyvinyl chloride is the most common material used in the manufacture of blood bags, and chitosan and wheat extract were used to improve the biological, physical, mechanical and optical properties of the manufactured blood bag. Chitosan was added at three concentrations (1, 2, and 3%) to the PVC matrix sample, and the wheat extract was supplemented to the sample having the highest properties to study its effect. It was found that the addition of chitosan led to an increase in tensile strength, as well as a significant increase in inhibition against the bacterial activity of two types of bacteria (S. aureus and C. albicans), and the ability to absorb water, but the addition of wheat extract led to a very small decrease in absorbency. Also, the supplement of chitosan and wheat extract reduced the transparency of the manufactured blood bag. All samples were characterized as not having the ability to non-hemolytic in the hemolysis test. All the results of polymer blends and polymer composite were compared with the pure PVC and commercial blood bags as reference samples.

A study to reveal the rationales of overnight transfusion in a training and research hospital

BackgroundMonitoring of overnight transfusions would be beneficial to improve blood transfusion safety. The objective of this study was to prospectively evaluate the practice and need for overnight transfusions (OT) in a teaching and research hospital. MethodsThe study was conducted on data from patients who received packed red blood cells (PRBCs) transfusions between 11 September and 13 October 2023 at a Training and Research Hospital in Ankara, Turkey. Clinical data of patients were obtained from the Hospital Database Management System (HDBS) and blood transfusion order forms. The critical time point of the transfusion process was recorded using HDBS. ResultsA total of 1502 PRBCs transfusions were noted during the study period, of which 400 (26.6%) were OT. OT was most frequently administered to patients with symptomatic anemia (34.6%; 138/400) and patients with an Hb level <7 (27.7%; 111/400). The time interval in which OT was most frequently ordered was between 15:00 and 17:00 [20.2% (81/400)], while the most frequent time to start transfusion was between 17:00 and 19:00 [22% (88/400)]. The average time taken from ordering OT to starting OT was 3 hours 41 minutes. The most of patients (36.8%; 91/248) were discharged after 48 hours of transfusion or were still in the hospital for more than 48 hours (20.3%; 50/248). ConclusionTo ensure transfusion safety by reducing OT to a minimum, OT should be used only in emergencies, policies should be put in place to make sure that transfusions can be done during the day easily, and healthcare professionals should be made aware of this issue.

Where Do We Stand in Blood Transfusion Practices: Insights From the First Clinical Audit From Khyber Pakhtunkhwa, Pakistan.

Objective To evaluate the appropriateness of packed red blood cell (PRBC) transfusions across different departments of a tertiary care hospital. Methods This audit included 632 patients admitted to the major departments of Hayatabad Medical Complex, Peshawar, Pakistan, who received one or more PRBC transfusions from November 2023 till July 2024. Six categories were defined who had different characteristics and thresholds for PRBC transfusion according to the Association for the Advancement of Blood & Biotherapies Red Blood Cell Transfusion International Guidelines. The appropriateness of PRBC transfusions was evaluated by checking if the pre-transfusion hemoglobin (Hb) met the threshold as specified in the guidelines. The chi-square test was used to test the association between the appropriateness of PRBC transfusions and the gender, department, and category of the patient. The significance of the difference in the mean pre-transfusion Hb was determined using an independent samples t-test. Results The median age was 30 years (IQR: 23-48.75). The majority of the patients were female (n=430, 68%). Patients from the Department of Gynecology and Obstetrics (n=267, 42.2%) outnumbered those from other departments. The majority of PRBC transfusions were inappropriate (n=465, 73.6%). Most transfusions in female patients (83.3%), in the patients of the Department of Gynecology and Obstetrics (95.5%), and in patients in the general category (86.9%) were found inappropriate. In the case of inappropriate transfusion, the mean pre-transfusion Hb was significantly different among departments, with the highest (14.1 gm/dL) value documented in the Department of Gynecology and Obstetrics. Conclusion Female patients, patients in the Department of Gynecology and Obstetrics, and patients in the general category had the highest frequency of inappropriate PRBC transfusions.

Estimation the Properties of Polymer Matrix Reinforced with Plants Extract Used for Medical Fluid Bags

Abstract The utilize of polyvinyl chloride in the manufacturing of blood bags responsible for preserving blood. It attains an extensive range of performance and processing requirements such as flexibility, transparency, physical, antibacterial and non-hemolysis properties. So, in the present flax-seed gel was incorporated in PVC matrix at various concentration (1, 2 and 3) %. Then wheat extract was added to samples has better properties in two percentage (0.5 and 1) %. The obtained results show, a significant change in the properties of the composite produce, where the tensile strength increased with increasing concentration of extract from flax seed gel, but it decreased when wheat extract was added, and when both extracts were added, the inhibition zone increased against bacterial activity for two types of bacteria (S. aureus and C. albicans). Also, the ability to absorb water and wettability increased with increasing concentration of plant extracts. On the other hand, the transparency decreased with increasing concentration of flaxseed gel, but when wheat gel was added to it increase of transparency. All samples were non-hemolytic in hemolysis test.

Evaluation of IgG and Complement Component C4 Levels in Low-Income Countries, Yemen Republic in Light of Their Proposed Role in the Hemolysis of Stored CPDA-1 Whole Blood.

Hemolysis is the most severe change that occurs in stored blood and can cause severe consequences in patients after transfusion. This study examines the potential role of IgG and complement, exampled by C4, in the hemolysis of stored CPDA-1 blood under poor storage conditions in low-income countries. The study was performed on 30 whole blood units (250 mL) drawn from convenience healthy volunteer donors with CPDA-1 anticoagulant and stored at 2-6 °C for 35 days. Each well-mixed blood bag was sampled at 0, 7, 21 and 35 days and examined for CBC, plasma hemoglobin, hemolysis percent and determination of IgG and C4. The plasma hemoglobin level and hemolysis percent increased continuously to reach 1.56 g/dl and 7.05% at the end of storage time. Hemolysis increased alongside the mean IgG concentration that was increased significantly from day 0 of storage (7.68±1.75 g/L) and peaked on day 7 (11.55±1.57 g/L), then declined to reach 8.33±2.09 g/L on day 35. Also, the mean concentration of C4 increased from day 0 of storage (0.15±0.06 g/L) to a peaked on day 21 (0.18±0.04) then declined on day 35 (0.17±0.06 g/L). The coordinated action of IgG and C4 is reflected by the positive correlation of their delta changes (r=0.616, p<0.0001). Elevated hemolysis percent in whole CPDA-1 stored blood in Yemen was accompanied by initial increase of IgG and C4 followed by final decline, which indicate their activation and consumption during hemolysis. Further studies for other hemolysis markers and analyses will give a full idea about that.

Problems/Issues in Blood Transfusion Process: A Focus Group Discussion (FGD) with Nursing Personnel in a Tertiary Care Center of North India

Background Blood and blood product transfusion is an essential component of the health care system. Nursing personnel constitute a significant aspect of the transfusion process as they are the last in the chain of the transfusion process to ultimately transfuse the blood and blood products to the recipient. Nurses face many problems/issues in this process. The present study highlights the problems/issues faced by them in the transfusion of blood and blood products. Objective To explore the problems/issues faced by nursing personnel related to blood and blood products transfusion process in a tertiary care hospital in North India. Methods A qualitative design was used. Three focused group discussions were conducted with 8–10 nurses in each group working in the Emergency Neurosurgery Ward of a tertiary care hospital in North India. Tools used were the sociodemographic and job profile of nurses and a focus group discussion (FGD) guide about blood and blood products transfusion. Each FGD session lasted for 15–20 minutes and data saturation was achieved after three FGDs. Colaizzi’s procedural steps were used to analyse the data. Themes and subthemes were generated. Results and Conclusion The problems/issues identified in the FGD were related to a lack of awareness regarding awareness, transportation, storage in the ward, thawing of fresh frozen plasma, problems in a blood bag, wastage of blood in case of children, inadequate nurse patients ratio, taking consent, Judicial request, proper prescription/orders, related to transfusion responsibilities, monitoring and documentation of blood, and blood products transfusion. The above problem/issues should be addressed and overcome to promote safe transfusion. It is recommended that regular In-service education programs should be planned for nursing personnel to update guidelines awareness, and the developed transfusion monitoring sheet should be implemented, to improve documentation and reduce transfusion errors.

Evaluation of leukocyte depletion of packed red blood cells for the prevention of clinically observed transfusion reactions at a medical center in Eastern Taiwan

ABSTRACT Objectives: The incidence of febrile nonhemolytic transfusion reactions (FNHTRs) is correlated with the level of cytokines released by donor leukocytes in blood bags during storage, which is the most common transfusion reaction. The study aimed to reveal whether the use of leukocyte-poor red blood cells (LPRBCs) can reduce the incidence of transfusion reactions to promote patient safety. Materials and Methods: From January 2014 to June 2022, 158,122 blood transfusion reports were collected from a medical center in Eastern Taiwan. Data were categorized into three groups according to usage prepromotion use of LPRBCs (January 2014–April 2016), promotion use of LPRBCs (May 2016 to February 2018), and full utilization of LPRBCs (March 2018 to June 2022). According to the American Association of Blood Bank Common Transfusion Reaction Reporting Form version 2.0 reporting system, FNHTRs were classified as moderate transfusion reactions. We used these data to analyze the association between LPRBC use and transfusion reaction rate. Results: At our hospital, the LPRBC usage rate from January 2014 to April 2016, May 2016 to February 2018, and March 2018 to June 2022 was 5.37%, 34.82%, and 56.45%, respectively. The total transfusion reaction rate from January 2014 to April 2016 was 1.66%, whereas the moderate reaction rate was 1.29%. The total transfusion and moderate reaction rates from May 2016 to February 2018 were 1.41% and 1.00%, whereas those from March 2018 to June 2022 were 0.95% and 0.63%, respectively. The total transfusion and moderate reaction rates from March 2018 to June 2022 decreased by 42.8% and 51.2%, respectively, compared with those from January 2014 to April 2016. We further compared the incidence of transfusion reactions caused by packed red blood cells (PRBC) and LPRBC products in different years. The results showed that between 2014 and 2022, the types of blood transfusion reaction caused using PRBC and LPRBC products are the mild transfusion reaction rate of 0.20%/0.20%, the moderate transfusion reaction rate of 1.61%/0.69%, the severe transfusion reaction rates 0.38%/0.16%, and the total transfusion reaction rates 2.19%/1.05%. Conclusion: Our study results indicate that both total transfusion and moderate reaction rates significantly decreased with increasing LPRBC usage rate. Based on our data analysis, LPRBC is more effective in reducing moderate and severe transfusion reactions than PRBC.

Placental Abruption: Unveiling Persistent Challenges and Management Strategies from the Obstetrical Intensive Care Unit Experience in Fes, Morocco

Introduction: Postpartum haemorrhage (PPH) remains the leading cause of maternal mortality, with placental abruption (PA) being a serious and challenging etiology. Late diagnosis and inadequate management of PA can exacerbate PPH and worsen maternal outcomes. This work aims to analyse the epidemiological, clinical and Para-clinical profile of PA in the Intensive Care Unit (ICU); as well as to determine the profile of coagulopathy in PPH and to discuss various treatment modalities. Materials &amp; Methods: This retrospective, descriptive, non-interventional study reviews cases of PA requiring ICU admission at Hassan II University Hospital in Fez from January 2019 to December 2023. Results: Forty-two patients met the inclusion criteria, with a mean age of 32 years. Primiparae constituted 33.4% of the cohort. 78.6% lacked prenatal care. The average gestational age was 32 weeks. Preeclampsia was the predominant risk factor (57.1%). Symptoms included mostly slow fetal movements, hemorrhage, and abdominal rigidity. At admission, 26% of patients exhibited hemorrhagic shock. General anesthesia was used in 82.5% of cases. In the operating room, 12% of patients received fibrinogen, and 50% received tranexamic acid. Blood transfusions were administered to 67% of patients, with an average of 2.14 packed red blood cells (PRBCs), 5.3 platelets (PLTs), and 3.5 fresh frozen plasma (FFP). Surgical interventions included hysterectomy, B-Lynch procedure, and vascular ligature. The mean duration of mechanical ventilation in the ICU was 3.66 days. The maternal mortality rate was 9.5%, and five newborns survived to discharge. Conclusion: This study emphasizes the need for a multidisciplinary approach and early intervention to manage PPH from PA effectively, and highlights the importance of national programs to address modifiable risk factors. Keywords: Fibrinogen, Placental Abruption, Postpartum Hemorrhage, Tranexamic Acid, Transfusion, Morocco

Categorization of the Inevitable Causes of Blood and Components Wastage Detected in South Indian Urban Blood Centre

Background: Since there is no artificial substitute for human blood, it plays a vital role in the patient management in this era of modern medicine. Therefore the donated blood from a healthy donor is precious and must not be wasted without proper utilization. Blood wastage is a universal phenomenon which needs a careful approach with strict guidelines. The study aims at categorizing the various inevitable causes of wastage with an attempt to determine ways of preventing the loss due to non-utilization. Materials and Methods: A retrospective – cross sectional study was conducted in a newly started Stand-alone Blood Centre in South Indian Urban city between June, 2022 and June 2024.All the components including Whole Blood (WB), Packed Red Blood Cell Concentrate (PRBC), Platelet concentrate (PC) and Fresh Frozen Plasma (FFP) were included in the study. The reasons for blood and component wastage was noted down from the various Registers of the Blood Centre and all the data was analyzed using Microsoft Excel Spread Sheet. Results: A total of 2456 units of blood were collected. 5284 components were prepared from these which includes 42 units of Whole Blood, 2397 Packed Red Blood cells(PRBC), 2393 Fresh frozen Plasma(FFP), 452 Platelet Concentrate(PC).Overall discard rate was found to be 11.90%. PC discard rate was highest (49.34%) followed by WBU (19.04%), PRBC (13.01%) AND FFP (3.59%). The commonest cause for the discarding was expiry of the shelf life of blood bags (74.72%) followed by damaged bags (9.69%) and TTI’s (6.76%). Conclusion: Blood and its components wastage is an inevitable reality which needs to be approached as upmost priority. Zero wastage of blood and components may be targeted by recommendations like appropriate training of the blood bank staff, keeping negative group donors on reserve, strictly following FIFO policy while dispensing blood, whole blood unit collection may be minimized, encouraging Single Donor Platelets (SDP) by apheresis instead of Random Donor Platelets (RDP) preparation, Blood Utilization Committee to be made mandatory and permission for reciprocal sharing of blood components among blood banks.

Comparative analysis of four upper gastrointestinal bleeding scoring systems for predicting multiple outcomes: an observational study in the emergency department

Objective: Numerous scoring systems have been developed to assess the risk associated with upper gastrointestinal bleeding (UGIB), and several studies have investigated their comparative accuracy in predicting patient outcomes. This study was undertaken to compare four well-known scoring systems, namely the pre-endoscopy Rockall score, full Rockall score, Glasgow-Blatchford Bleeding score (GBS), and AIMS65, with the aim of predicting five distinct outcomes in cases of non-variceal UGIB. Methods: This prospective observational study was conducted focusing on adult patients with UGIB presenting to the emergency department (ED). The primary endpoints of this study included in-hospital mortality, the need for re-endoscopy, the requirements for packed red blood cell (PRBC) transfusion, massive transfusion, and one-month rebleeding. Results: A total number of 320 patients were enrolled, with 44 (13·75%) in-hospital deaths. Based on the area under the curves (AUC), while certain scores outperformed others in specific outcome prediction, the AIMS65 scoring system demonstrated superior predictive capability for both in-hospital mortality (0.91) and massive transfusion (0.71). Regarding PRBC transfusion requirements, both AIMS65 and GBS exhibited similar predictive capacities (AUC=0.67 and 0.68, respectively). In terms of re-endoscopy and one-month rebleeding, the GBS scoring system displayed slightly better performance compared to the other systems (AUC=0.61 and 0.63, respectively). In the composite outcome, all scores had significant associations, and among them, the AIMS-65 score had the highest AUC (0.76). Conclusion: The AIMS65 scoring system was the most reliable tool for predicting in-hospital mortality and, to a lesser extent, massive transfusion requirements, while GBS and AIMS65 could be moderately and cautiously relied on for preparations regarding the need for PRBC transfusion.

Hemoglobin level, degree of mobilization, and pneumonia are associated with the development of postoperative delirium in cemented hemiarthroplasty after femoral neck fracture.

The aim of this retrospective study was to identify independent prognostic factors for developing a postoperative delirium (POD) in patients suffering from a proximal femoral neck fracture and treated by implantation of a hemiprosthesis. A retrospective study, including patients with hip hemiarthroplasty due to a femoral neck fracture between 2011 and 2020 was performed. Demographic data, preexisting conditions, intra-/postoperative complications, mobilization and laboratory results were extracted from the patients' charts. The different parameters were analyzed comparing patients with and without POD. 412 patients, mean age of 81 ± 9.58 years were included, 66.5% (n = 274) were female, 18.2% (n = 75) of them developed a POD. Significantly higher incidence of POD was associated with older age (p < 0.001), lower level of haemoglobin (p < 0.001), higher post-surgery interleukin 6 (IL 6) level (p = 0.008), higher postoperative level of leukocytes (p = 0.01). Patients with POD received more units of packed red blood cells (PRBC) (p = 0.007). Patients with no mobility limitations pre-operatively developed POD less frequently (p = 0.01), whereas suffering from pneumonia (p = 0.03) or limited mobility postoperatively increased the risk of POD (p < 0.001). This study could help to identify patients with a risk for developing POD after a hemiarthroplasty in femoral neck fractures. As a consequence, frequent controls of Hb, IL 6 and leucocytes levels to avoid anemia and infections, as well as the well surgical treatment to guarantee a good postoperative outcome.

Kegiatan Donor Darah di Lingkungan KPP Pratama Kabanjahe Bekerjsama dengan Unit Donor Darah PMI Kabupaten Karo

Blood donation activities are carried out to maintain the stability of the blood stock of the Karo Regency PMI. Blood donation activities are carried out on Tuesday, July 9, 2024 starting at 09.00 WIB at the Kabanjahe Pratama KPP. The blood donation service activity was attended by a total of 14 participants. From the results of the implementation of the activity, 13 blood bags have been collected. Based on interviews with the participants, their motivation to donate blood is because of a sense of humanity for people in need, to maintain their health, invitations from friends, and some are interested because of the gifts offered at the end of the event. The implementation of this blood donation activity as a form of community service has been carried out well and has received a good response from the participants. Socialization is also needed so that the number of blood donors increases and more people are willing to become blood donors.