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[PMID]:27774614
[Au] Autor:Dunbar NM; Olson NJ; Szczepiorkowski ZM; Martin ED; Tysarcyk RM; Triulzi DJ; Alarcon LH; Yazer MH
[Ad] Endereço:Department of Pathology and Laboratory Medicine, the Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
[Ti] Título:Blood component transfusion and wastage rates in the setting of massive transfusion in three regional trauma centers.
[So] Source:Transfusion;57(1):45-52, 2017 01.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The purpose of massive transfusion protocols (MTPs) is to provide large quantities of blood products rapidly to exsanguinating patients. The expected rates of blood product transfusion and wastage in this setting have not been defined. This study was undertaken to assess the transfusion and wastage rates for bleeding patients requiring emergency issue of blood components at three American Level I trauma centers. STUDY DESIGN AND METHODS: Three hospitals participated, all of which are Level I trauma centers that have MTPs in place where uncrossmatched red blood cells (RBCs) can be ordered with or without platelets (PLTs), plasma, and cryoprecipitate. Data on the transfusion, return to blood bank, and wastage rates were recorded on all products issued within 3 hours after MTP activation. RESULTS: The majority of products were issued to the emergency department and/or operating room at all three institutions (84%-95%). The percentage of RBCs, plasma, and PLTs transfused during MTPs were 39% to 65%, 43% to 66%, and 75% to 100%, respectively. Wastage rates were comparable for RBCs (0%-9%), plasma (0%-7%), and PLTs (0%-7%). Cryoprecipitate had the highest wastage rates at all three sites (7%-33%). CONCLUSION: A large portion of blood products issued during MTPs are not transfused. Some are wasted due to stringent storage requirements and/or limited shelf lives. The optimum ratio of transfused to returned products in these patients is likely to be determined more by clinical need than by transfusion service policy.
[Mh] Termos MeSH primário: Bancos de Sangue
Transfusão de Componentes Sanguíneos
Centros de Traumatologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13880


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[PMID]:27774608
[Au] Autor:Cumming M; Osinski A; O'Hearn L; Waksmonski P; Herman M; Gordon D; Griffiths E; Knox K; McHale E; Quillen K; Rios J; Pisciotto P; Uhl L; DeMaria A; Andrzejewski C
[Ad] Endereço:Bureau of Infectious Disease and Laboratory Sciences, Division of Epidemiology and Immunization, Massachusetts Department of Public Health, Jamaica Plain, Massachusetts.
[Ti] Título:Hemovigilance in Massachusetts and the adoption of statewide hospital blood bank reporting using the National Healthcare Safety Network.
[So] Source:Transfusion;57(2):478-483, 2017 02.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A collaboration that grew over time between local hemovigilance stakeholders and the Massachusetts Department of Public Health (MDPH) resulted in the change from a paper-based method of reporting adverse reactions and monthly transfusion activity for regulatory compliance purposes to statewide adoption of electronic reporting via the National Healthcare Safety Network (NHSN). The NHSN is a web-based surveillance system that offers the capacity to capture transfusion-related adverse events, incidents, and monthly transfusion statistics from participating facilities. Massachusetts' hospital blood banks share the data they enter into NHSN with the MDPH to satisfy reporting requirements. Users of the NHSN Hemovigilance Module adhere to specified data entry guidelines, resulting in data that are comparable and standardized. Keys to successful statewide adoption of this reporting method include the fostering of strong partnerships with local hemovigilance champions and experts, engagement of regulatory and epidemiology divisions at the state health department, the leveraging of existing relationships with hospital NHSN administrators, and the existence of a regulatory deadline for implementation. Although limitations exist, successful implementation of statewide use of the NHSN Hemovigilance Module for hospital blood bank reporting is possible. The result is standardized, actionable data at both the hospital and state level that can facilitate interfacility comparisons, benchmarking, and opportunities for practice improvement.
[Mh] Termos MeSH primário: Bancos de Sangue
Segurança do Sangue
Transfusão de Sangue/normas
Gestão de Riscos
[Mh] Termos MeSH secundário: Bancos de Sangue/métodos
Bancos de Sangue/normas
Segurança do Sangue/métodos
Segurança do Sangue/normas
Feminino
Seres Humanos
Masculino
Massachusetts
Gestão de Riscos/métodos
Gestão de Riscos/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13872


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[PMID]:27777340
[Au] Autor:Weisenhorn EM; van T Erve TJ; Riley NM; Hess JR; Raife TJ; Coon JJ
[Ad] Endereço:From the ‡Integrated Program in Biochemistry.
[Ti] Título:Multi-omics Evidence for Inheritance of Energy Pathways in Red Blood Cells.
[So] Source:Mol Cell Proteomics;15(12):3614-3623, 2016 Dec.
[Is] ISSN:1535-9484
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Each year over 90 million units of blood are transfused worldwide. Our dependence on this blood supply mandates optimized blood management and storage. During storage, red blood cells undergo degenerative processes resulting in altered metabolic characteristics which may make blood less viable for transfusion. However, not all stored blood spoils at the same rate, a difference that has been attributed to variable rates of energy usage and metabolism in red blood cells. Specific metabolite abundances are heritable traits; however, the link between heritability of energy metabolism and red blood cell storage profiles is unclear. Herein we performed a comprehensive metabolomics and proteomics study of red blood cells from 18 mono- and di-zygotic twin pairs to measure heritability and identify correlations with ATP and other molecular indices of energy metabolism. Without using affinity-based hemoglobin depletion, our work afforded the deepest multi-omic characterization of red blood cell membranes to date (1280 membrane proteins and 330 metabolites), with 119 membrane protein and 148 metabolite concentrations found to be over 30% heritable. We demonstrate a high degree of heritability in the concentration of energy metabolism metabolites, especially glycolytic metabolites. In addition to being heritable, proteins and metabolites involved in glycolysis and redox metabolism are highly correlated, suggesting that crucial energy metabolism pathways are inherited en bloc at distinct levels. We conclude that individuals can inherit a phenotype composed of higher or lower concentrations of these proteins together. This can result in vastly different red blood cells storage profiles which may need to be considered to develop precise and individualized storage options. Beyond guiding proper blood storage, this intimate link in heritability between energy and redox metabolism pathways may someday prove useful in determining the predisposition of an individual toward metabolic diseases.
[Mh] Termos MeSH primário: Eritrócitos/metabolismo
Proteínas de Membrana/metabolismo
Metabolômica/métodos
Proteômica/métodos
Característica Quantitativa Herdável
[Mh] Termos MeSH secundário: Adolescente
Adulto
Bancos de Sangue
Preservação de Sangue
Metabolismo Energético
Feminino
Seres Humanos
Masculino
Gêmeos Dizigóticos
Gêmeos Monozigóticos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Membrane Proteins)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171201
[Lr] Data última revisão:
171201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29084832
[Au] Autor:Shearer WT; Lubin BH; Cairo MS; Notarangelo LD; SECTION ON HEMATOLOGY/ONCOLOGY; SECTION ON ALLERGY AND IMMUNOLOGY
[Ti] Título:Cord Blood Banking for Potential Future Transplantation.
[So] Source:Pediatrics;140(5), 2017 Nov.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This policy statement is intended to provide information to guide pediatricians, obstetricians, and other medical specialists and health care providers in responding to parents' questions about cord blood donation and banking as well as the types (public versus private) and quality of cord blood banks. Cord blood is an excellent source of stem cells for hematopoietic stem cell transplantation in children with some fatal diseases. Cord blood transplantation offers another method of definitive therapy for infants, children, and adults with certain hematologic malignancies, hemoglobinopathies, severe forms of T-lymphocyte and other immunodeficiencies, and metabolic diseases. The development of universal screening for severe immunodeficiency assay in a growing number of states is likely to increase the number of cord blood transplants. Both public and private cord blood banks worldwide hold hundreds of thousands of cord blood units designated for the treatment of fatal or debilitating illnesses. The procurement, characterization, and cryopreservation of cord blood is free for families who choose public banking. However, the family cost for private banking is significant and not covered by insurance, and the unit may never be used. Quality-assessment reviews by several national and international accrediting bodies show private cord blood banks to be underused for treatment, less regulated for quality control, and more expensive for the family than public cord blood banks. There is an unquestionable need to study the use of cord blood banking to make new and important alternative means of reconstituting the hematopoietic blood system in patients with malignancies and blood disorders and possibly regenerating tissue systems in the future. Recommendations regarding appropriate ethical and operational standards (including informed consent policies, financial disclosures, and conflict-of-interest policies) are provided for physicians, institutions, and organizations that operate or have a relationship with cord blood banking programs. The information on all aspects of cord blood banking gathered in this policy statement will facilitate parental choice for public or private cord blood banking.
[Mh] Termos MeSH primário: Academias e Institutos/normas
Bancos de Sangue/normas
Transplante de Células-Tronco de Sangue do Cordão Umbilical/normas
Sangue Fetal/transplante
Pediatria/normas
[Mh] Termos MeSH secundário: Academias e Institutos/economia
Bancos de Sangue/economia
Bancos de Sangue/tendências
Criança
Transplante de Células-Tronco de Sangue do Cordão Umbilical/economia
Transplante de Células-Tronco de Sangue do Cordão Umbilical/tendências
Política de Saúde/tendências
Doenças Hematológicas/economia
Doenças Hematológicas/epidemiologia
Doenças Hematológicas/terapia
Seres Humanos
Pediatria/economia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171101
[St] Status:MEDLINE


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[PMID]:29020590
[Au] Autor:Klein HG; Hrouda JC; Epstein JS
[Ad] Endereço:From the Department of Transfusion Medicine, National Institutes of Health, Bethesda, MD (H.G.K.); and the American National Red Cross Biomedical Services (J.C.H.) and the Office of Blood Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration (J.S.E.) - both in Washington, DC.
[Ti] Título:Crisis in the Sustainability of the U.S. Blood System.
[So] Source:N Engl J Med;377(15):1485-1488, 2017 10 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Bancos de Sangue/organização & administração
Transfusão de Sangue/economia
[Mh] Termos MeSH secundário: Bancos de Sangue/economia
Transfusão de Sangue/tendências
Transfusão de Sangue/utilização
Regulamentação Governamental
Seres Humanos
Obtenção de Tecidos e Órgãos/organização & administração
Estados Unidos
United States Dept. of Health and Human Services
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMsb1706496


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[PMID]:28885446
[Au] Autor:Frank SM; Thakkar RN; Podlasek SJ; Ken Lee KH; Wintermeyer TL; Yang WW; Liu J; Rotello LC; Fleury TA; Wachter PA; Ishii LE; Demski R; Pronovost PJ; Ness PM
[Ad] Endereço:From the Department of Anesthesiology and Critical Care Medicine (S.M.F., W.W.Y., P.J.P.), Department of Medicine (R.N.T., L.C.R.), Department of Pathology, Transfusion Medicine (S.J.P., J.L., T.A.F., P.M.N.), Armstrong Institute for Patient Safety and Quality (K.H.K.L., T.L.W., P.A.W., R.D., P.J.P.), and Department of Otolaryngology Head and Neck Surgery (L.E.I.), The Johns Hopkins Medical Institutions, Baltimore, Maryland.
[Ti] Título:Implementing a Health System-wide Patient Blood Management Program with a Clinical Community Approach.
[So] Source:Anesthesiology;127(5):754-764, 2017 Nov.
[Is] ISSN:1528-1175
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patient blood management programs are gaining popularity as quality improvement and patient safety initiatives, but methods for implementing such programs across multihospital health systems are not well understood. Having recently incorporated a patient blood management program across our health system using a clinical community approach, we describe our methods and results. METHODS: We formed the Johns Hopkins Health System blood management clinical community to reduce transfusion overuse across five hospitals. This physician-led, multidisciplinary, collaborative, quality-improvement team (the clinical community) worked to implement best practices for patient blood management, which we describe in detail. Changes in blood utilization and blood acquisition costs were compared for the pre- and post-patient blood management time periods. RESULTS: Across the health system, multiunit erythrocyte transfusion orders decreased from 39.7 to 20.2% (by 49%; P < 0.0001). The percentage of patients transfused decreased for erythrocytes from 11.3 to 10.4%, for plasma from 2.9 to 2.2%, and for platelets from 3.1 to 2.7%, (P < 0.0001 for all three). The number of units transfused per 1,000 patients decreased for erythrocytes from 455 to 365 (by 19.8%; P < 0.0001), for plasma from 175 to 107 (by 38.9%; P = 0.0002), and for platelets from 167 to 141 (by 15.6%; P = 0.04). Blood acquisition cost savings were $2,120,273/yr, an approximate 400% return on investment for our patient blood management efforts. CONCLUSIONS: Implementing a health system-wide patient blood management program by using a clinical community approach substantially reduced blood utilization and blood acquisition costs.
[Mh] Termos MeSH primário: Bancos de Sangue/normas
Transfusão de Sangue/normas
Serviços de Saúde Comunitária/normas
Assistência à Saúde/normas
Hospitais/normas
[Mh] Termos MeSH secundário: Bancos de Sangue/métodos
Transfusão de Sangue/métodos
Tomada de Decisão Clínica/métodos
Serviços de Saúde Comunitária/métodos
Assistência à Saúde/métodos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/ALN.0000000000001851


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[PMID]:28833250
[Au] Autor:Jhang JS; Francis RO; Winkler A; Tormey C
[Ad] Endereço:Department of Pathology, Icahn School of Medicine at Mount Sinai; and.
[Ti] Título:How do we perform and bill for blood bank physician consultative services?
[So] Source:Transfusion;57(10):2311-2318, 2017 Oct.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Transfusion medicine (TM) physicians provide medical services that benefit all patients such as providing 24-hour laboratory coverage, advising health care providers on test interpretation and selection, validating new methods, and supervising technical personnel. These services ensure delivery of accurate, reliable, and timely laboratory test results and blood products. TM physicians also provide consultations to individual patients by 1) interpreting and determining the clinical significance of test results (e.g., alloantibodies, direct antiglobulin tests), 2) recommending appropriate component therapy and approving deviations from laboratory policy, and 3) evaluating and recommending treatment of suspected transfusion reactions. The potential benefits of consultations are improved quality and cost of health care, enhanced provider education, and decreased inappropriate testing and product utilization. When physician services are delivered to individual patients, are appropriately requested, provide a diagnosis or recommendation, and are properly documented, TM physicians can receive professional reimbursement. While many TM physicians provide medical direction and oversight of apheresis procedures, billing in this area is sufficiently complex to be reviewed elsewhere. The objective of this article is for educational purposes to describe the 1) benefits of a consultative TM service, 2) development of reimbursement systems in the United States for professional component services and the current regulatory requirements, 3) current procedural terminology codes commonly used for TM physician services, and 4) examples of consultation documentation and daily workflow at tertiary care teaching hospitals. The information provided should help guide physicians to deliver and bill for these services.
[Mh] Termos MeSH primário: Bancos de Sangue/recursos humanos
Médicos
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Bancos de Sangue/economia
Honorários e Preços
Seres Humanos
Médicos/economia
Encaminhamento e Consulta/economia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1111/trf.14264


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[PMID]:28703889
[Au] Autor:Fadeyi EA; Emery W; Simmons JH; Jones MR; Pomper GJ
[Ad] Endereço:Department of Pathology and Laboratory Medicine, Wake Forest University School of Medicine.
[Ti] Título:Implementation of a new blood cooler insert and tracking technology with educational initiatives and its effect on reducing red blood cell wastage.
[So] Source:Transfusion;57(10):2477-2482, 2017 Oct.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The objective was to report a successful implementation of a blood cooler insert and tracking technology with educational initiatives and its effect on reducing red blood cell (RBC) wastage. STUDY DESIGN AND METHODS: The blood bank database was used to quantify and categorize total RBC units issued in blood coolers from January 2010 to December 2015 with and without the new inserts throughout the hospital. Radiofrequency identification tags were used with special software to monitor blood cooler tracking. An educational policy on how to handle the coolers was initiated. Data were gathered from the software that provided a real-time location monitoring of the blood coolers with inserts throughout the institution. RESULTS: The implementation of the blood cooler with inserts and tracking device reduced mean yearly RBC wastage by fourfold from 0.64% to 0.17% between 2010 and 2015. The conserved RBCs corresponded to a total cost savings of $167,844 during the 3-year postimplementation period. CONCLUSIONS: The implementation of new blood cooler inserts, tracking system, and educational initiatives substantially reduced the mean annual total RBC wastage. The cost to implement this initiative may be small if there is an existing institutional infrastructure to monitor and track hospital equipment into which the blood bank intervention can be adapted when compared to the cost of blood wastage.
[Mh] Termos MeSH primário: Preservação de Sangue/métodos
Temperatura Baixa
Eritrócitos/citologia
Resíduos de Serviços de Saúde/prevenção & controle
[Mh] Termos MeSH secundário: Bancos de Sangue/métodos
Preservação de Sangue/instrumentação
Hospitais
Seres Humanos
Melhoria de Qualidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Medical Waste)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1111/trf.14234


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[PMID]:28678865
[Au] Autor:Biadgo B; Shiferaw E; Woldu B; Alene KA; Melku M
[Ad] Endereço:Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
[Ti] Título:Transfusion-transmissible viral infections among blood donors at the North Gondar district blood bank, northwest Ethiopia: A three year retrospective study.
[So] Source:PLoS One;12(7):e0180416, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transfusion-transmissible viral infections, such as hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV), remain a major public health problem in developing countries. The prevalence of these viral infections among blood donors may reflect the burden of these diseases among populations. Therefore, the aim of this study was to assess the sero-prevalence of transfusion-transmissible viral infections among blood donors. METHODS: A retrospective study was conducted using data obtained from registration books of blood donors from the Ethiopian North Gondar District Blood Bank from 2010 to 2012. Descriptive statistics, such as percentages, medians and interquartile ranges were computed. A binary logistic regression model was fitted to identify factors associated with each viral infection. The odds ratio with a 99% confidence interval was calculated. A p-value < 0.01 was considered statistically significant. RESULT: A total of 6,471 blood donors were included in the study. Of these, 5,311 (82.1%) were male, and 382 (5.9%) were voluntary blood donors. Overall, 424 (6.55%) of the blood donors were sero-reactive for at least one transfusion-transmissible viral infection. Of all study participants, 233 (3.6%) were sero-reactive for HBV, 145 (2.24%) were sero-reactive for HIV, and 51 (0.8%) were sero-reactive for HCV. Four (0.062%) of the study's participants were co-infected: 3 (75%) with HBV-HCV and 1 (25%) with HIV-HBV-HCV. Being a farmer, unemployed or employed donor was significantly associated with transfusion-transmissible viral infections compared to being a student donor. CONCLUSION: The prevalence of transfusion-transmissible viral infections is substantial and has increased overtime. Hence, it demands more vigilance in routine screening of donated blood prior to transfusion. Further community-based studies to identify societal risk factors are necessary.
[Mh] Termos MeSH primário: Bancos de Sangue
Doadores de Sangue
Infecções por HIV/transmissão
Hepatite B/transmissão
Hepatite C/transmissão
Reação Transfusional
[Mh] Termos MeSH secundário: Adolescente
Adulto
Etiópia/epidemiologia
Feminino
Infecções por HIV/epidemiologia
Hepatite B/epidemiologia
Hepatite C/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Estudos Soroepidemiológicos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180416


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[PMID]:28671296
[Au] Autor:Leahy MF; Trentino KM; May C; Swain SG; Chuah H; Farmer SL
[Ad] Endereço:School of Medicine and Pharmacology.
[Ti] Título:Blood use in patients receiving intensive chemotherapy for acute leukemia or hematopoietic stem cell transplantation: the impact of a health system-wide patient blood management program.
[So] Source:Transfusion;57(9):2189-2196, 2017 Sep.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Little is published on patient blood management (PBM) programs in hematology. In 2008 Western Australia announced a health system-wide PBM program with PBM staff appointments commencing in November 2009. Our aim was to assess the impact this program had on blood utilization and patient outcomes in intensive chemotherapy for acute leukemia or hematopoietic stem cell transplantation. STUDY DESIGN AND METHODS: A retrospective study of 695 admissions at two tertiary hospitals receiving intensive chemotherapy for acute leukemia or undergoing hematopoietic stem cell transplantation between July 2010 and December 2014 was conducted. Main outcomes included pre-red blood cell (RBC) transfusion hemoglobin (Hb) levels, single-unit RBC transfusions, number of RBC and platelet (PLT) units transfused per admission, subsequent day case transfusions, length of stay, serious bleeding, and in-hospital mortality. RESULTS: Over the study period, the mean RBC units transfused per admission decreased 39% from 6.1 to 3.7 (p < 0.001), and the mean PLT units transfused decreased 35% from 6.3 to 4.1 (p < 0.001), with mean RBC and PLT units transfused for follow-up day cases decreasing from 0.6 to 0.4 units (p < 0.001). Mean pre-RBC transfusion Hb level decreased from 8.0 to 6.8 g/dL (p < 0.001), and single-unit RBC transfusions increased 39% to 67% (p < 0.001). This reduction represents blood product cost savings of AU$694,886 (US$654,007). There were no significant changes in unadjusted or adjusted length of stay, serious bleeding events, or in-hospital mortality over the study. CONCLUSION: The health system-wide PBM program had a significant impact, reducing blood product use and costs without increased morbidity or mortality in patients receiving intensive chemotherapy for acute leukemia or hematopoietic stem cell transplantation.
[Mh] Termos MeSH primário: Bancos de Sangue/métodos
Transfusão de Sangue/utilização
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Leucemia/terapia
[Mh] Termos MeSH secundário: Austrália
Transfusão de Sangue/economia
Transfusão de Sangue/mortalidade
Transfusão de Eritrócitos/economia
Transfusão de Eritrócitos/mortalidade
Transfusão de Eritrócitos/utilização
Hemoglobinas/normas
Hemorragia
Mortalidade Hospitalar
Seres Humanos
Leucemia/tratamento farmacológico
Transfusão de Plaquetas/utilização
Estudos Retrospectivos
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Hemoglobins)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1111/trf.14191



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