0
selected
-
1.
Effect of Early Equal-Proportional Infusion of Plasma and Red Blood Cells on the Prognosis of Emergency Patients with Traumatic Hemorrhage
Fan, Y., Ye, Z., Tang, Y.
Clinical laboratory. 2023;69(7)
Abstract
BACKGROUND The goal was to study the effect of early equal-proportion transfusion on the prognosis of trauma patients with bleeding. METHODS Emergency hospital trauma patients were randomly divided into two groups, a group based on assessment of blood consumption (ABC) to assess whether need to start the massive blood transfusion patients, such as proportion of blood transfusion (fresh frozen plasma: suspended red blood cells = 1:1), and the other group using traditional methods of blood transfusion, namely according to routine blood and clotting function and hemodynamic parameters, to decide when and what blood constituents should be transfused. RESULTS The coagulation got better in the early equal-proportion transfusion group, there were significant differences of PT and APTT (p < 0.05). The amount of 24 hours RBC and plasma transfusion was decreased in the early equal-proportion transfusion group, compared to the control group (p < 0.05), the length of ICU stay was shortened, the 24-hours SOFA score was improved, and there was no significant difference in 24-hours mortality, in-hospital mortality and total length of in-hospital stay (p > 0.05). CONCLUSIONS Early transfusion can reduce the total amount of blood transfusion and shorten ICU time, but has no significant effect on mortality.
-
2.
The Impact of a Humanized Nursing Model on the Nursing Outcomes of Emergency Transfusion Patients
Chen, J., Ding, D.
Alternative therapies in health and medicine. 2023
Abstract
BACKGROUND Emergency transfusion is a frequently performed invasive medical procedure. Patients often experience negative emotions and exhibit poor compliance during transfusion. Therefore, it is imperative to proactively implement effective nursing interventions. OBJECTIVE This study aims to investigate the impact of a humanized nursing model on the nursing outcomes of emergency transfusion patients. DESIGN This research was conducted as a randomized controlled experiment. SETTING The study was conducted in the emergency department of Suzhou Hospital of Integrated Chinese and Western Medicine. PARTICIPANTS A total of 120 patients who underwent emergency transfusion treatment in our hospital from February 2021 to October 2022 were selected. They were divided into two groups, the control group, and the observation group, using a random number table method, with 60 patients in each group. INTERVENTIONS The control group received standard nursing care, while the observation group received humanized nursing. PRIMARY OUTCOME MEASURES The primary outcome measures included (1) assessment of psychological states, (2) evaluation of physical and mental comfort, (3) assessment of transfusion compliance, (4) incidence of adverse transfusion events, and (5) assessment of nursing satisfaction. RESULTS Prior to nursing interventions, anxiety and depression scores were not significantly different between the two groups (P > .05). After nursing interventions, both groups exhibited a decrease in scores, with the observation group showing a more significant reduction compared to the control group (P < .05). In all aspects of physical and mental comfort, the observation group scored significantly higher than the control group (P < .05). Transfusion compliance and nursing satisfaction were significantly higher in the observation group compared to the control group (P < .01). The incidence of adverse transfusion events in the observation group was significantly lower than in the control group (P < .01). CONCLUSIONS Humanized nursing significantly improves anxiety and depression in emergency transfusion patients, enhances their physical and mental comfort, and increases transfusion compliance while reducing adverse transfusion events. It leads to high patient satisfaction with nursing services.
-
3.
Trial-related blood sampling and red-blood-cell transfusions in preterm infants
Lewis, A. E., Kappel, S. S., Hussain, S., Sangild, P. T., Zachariassen, G., Aunsholt, L.
Acta paediatrica (Oslo, Norway : 1992). 2023
Abstract
AIM: To determine if trial-related blood sampling increases the risk of later red-blood-cell (RBC) transfusion in very preterm infants, we compared the volume of clinical- and trial-related blood samples, in a specific trial and correlated to subsequent RBC transfusion. METHODS For 193 very preterm infants, participating in the FortiColos trial (NCT03537365), trial-related blood volume drawn was in accordance to ethical considerations established by the European Commission. Medical records were reviewed to assess the number and cumulated volume (mL/kg) of blood samples (both clinical- and trial-related). Data were compared with need of RBC transfusions during the first 28days of life. RESULTS Mean (SD) gestational age and bith weight was 28 ± 1 weeks and 1168 ± 301 g. In total, 11% of total blood volume was drawn for sampling (8.1 ± 5.1 mL/kg) and trial-related sampling accounted for 1.6 ± 0.6 mL/kg. Trial-related blood sampling had no impact on RBC transfusion (p=0.9). CONCLUSION Clinical blood sampling in very preterm infants is associated with blood loss and subsequent need for RBC transfusions. In a specific trial requiring blood samples, we found no additional burden of trial-related blood sampling. The study suggest that trial-related sampling is safe if European criteria are followed.
-
4.
Effect of Umbilical Cord Blood Sampling versus Admission Blood Sampling on Requirement of Blood Transfusion in Extremely Preterm Infants: A Randomized Controlled Trial
Balasubramanian H, Malpani P, Sindhur M, Kabra NS, Ahmed J, Srinivasan L
The Journal of pediatrics. 2019
Abstract
OBJECTIVE To evaluate the effect of blood sampling from the placental end of the umbilical cord compared with initial blood sampling from neonates, on the need for first packed red blood cell transfusion in extremely preterm infants. We hypothesized that cord blood sampling could delay the time to first blood transfusion. STUDY DESIGN In this single-center, assessor blind, randomized controlled trial, we included extremely low birth weight neonates <28 weeks of gestational age at birth. Five milliliter of blood for initial laboratory investigations was collected either from the placental end of the umbilical cord (study group) or from the neonate upon neonatal intensive care unit admission (control group). Both groups received similar anemia prevention strategies. The primary outcome was the time (in days) to the first packed red blood cell transfusion, and was compared using survival analysis. RESULTS Eighty neonates were enrolled. The time to first transfusion was significantly delayed in the cord sampling group (30 vs 14 days, hazard ratio: 0.44, [95% CI 0.27-0.72], P < .001). Fewer neonates in the cord sampling group were transfused in the first 28 days of life (30% vs 75%, P < .001). Overall transfusion requirements and other clinical outcomes were similar in the groups. CONCLUSIONS Initial blood sampling from placental end of umbilical cord, when combined with anemia prevention strategies, significantly prolonged the time to first transfusion and reduced the need for early transfusions among extremely premature neonates. TRIAL REGISTRATION Ctri.nic.in/ (CTRI/2017/04/008320).
-
5.
Closed system for blood sampling and transfusion in critically ill patients
Rezende E, Ferez MA, Silva Junior JM, Oliveira AM, Viana RA, Mendes CL, Toledo Dde O, Ribeiro Neto MC, Setoyama TA
Revista Brasileira de Terapia Intensiva. 2010;22((1)):5-10.
Abstract
OBJECTIVE Anemia is common in severely ill patients, and blood sampling plays a relevant causative role. Consequently, blood transfusions are frequent an related to several complications. Trying to reduce the transfusion-related risk, minimizing blood loss is mandatory. Thus, this work aimed to evaluate a closed blood sampling system as a strategy to spare unnecessary blood losses and transfusions. METHODS This was a prospective, randomized, controlled, multicenter, 6 months, clinical trial. The patients were assigned to either VAMP (Venous Arterial Blood Management Protection) group, using a closed blood sampling system, or control group. The groups' transfusion rate, as well as hemoglobin (Hb) and Hematocrit (Ht) changes were compared for 14 days. RESULTS Were included 127 patients, 65 assigned to the control group, and 62 to VAMP. During the intensive care unit stay, both groups experienced both hemoglobin and hematocrit drops. However, when the final Ht and Hb were compared between the groups, a difference was identified with higher values in the VAMP group (p=0.03; p=0.006, respectively). No statistical difference was found for both groups transfusion rates, although the VAMP group had an absolute 12% blood transfusion reduction. CONCLUSION The use of a closed blood sampling system was able to minimize blood count values changes, however failed to reduce transfusions rate.
-
6.
The rapid infusion system: a superior method for the resuscitation of hypovolemic trauma patients
Dunham CM, Belzberg H, Lyles R, Weireter L, Skurdal D, Sullivan G, Esposito T, Namini M
Resuscitation. 1991;21((2-3):):207-27.
Abstract
The rapid infusion system (RIS), which can deliver fluids/blood products rapidly at precise rates and normothermic conditions, was compared with conventional fluid administration (CFA) in a randomized study of 36 hypovolemic trauma patients. Admission stratification criteria of the groups were similar relative to age, Glasgow Coma Score (GCS), Injury Severity Score (ISS) and plasma lactate. Despite the lack of difference in blood loss between the 24-h survivors of the two groups, the CFA group required greater total fluids (23.6/20.21), red blood cells (5.5/4.61), fresh frozen plasma (FFP) (2.8/1.91), platelets (523/204 ml), and crystalloids (12.9/10.61). Lactate levels were lower in the RIS group at virtually all times from hours 1 to 24 (4.3/5.3 mM/l, t-value = 3.3, DF = 279, P = 0.001). Post-admission hypothermia was greater in the CFA group at all times during the first 24 h (35.2/36.4 degrees C, t-value = 5.6, DF = 250, P = 0.001). The mean partial thromboplastin time was significantly higher in the CFA group (47.3/35.1 s, t-value = 3.1, DF = 279, P = 0.002). The PTT and PT were related to the degree of lactic acidosis (P = 0.0001) and hypothermia (P = 0.001) but not to the amount of FFP given (P = 0.14). The hospital costs, days in the ICU, and days on the ventilator were greater for the CFA group, as was the incidence of pneumonia (0/11 vs. 6/17; P = 0.03). Hypovolemic trauma patients resuscitated with the RIS needed fewer fluid/blood products and had less coagulopathy; more rapid resolution of hypoperfusion acidosis; better temperature preservation; and fewer hospital complications than those resuscitated with conventional methods of fluid/blood product administration.