• Title/Summary/Keyword: Preparation for blood transfusion

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Risk factors for blood transfusion after Cesarean section in patients with partial placenta previa

  • Hyun Jung Kim;Woo Hee Lim;Young Sun Kim
    • Journal of Medicine and Life Science
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    • v.20 no.4
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    • pp.172-177
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    • 2023
  • This study assessed risk factors for blood transfusion after Cesarean section in patients with partial placenta previa. We retrospectively reviewed the medical records of 149 patients who underwent Cesarean sections for partial placenta previa between January 2010 and October 2021. Clinical characteristics were compared between the two groups: the blood transfusion group (n=22), defined as patients who received a blood transfusion during surgery or within 24 hours after surgery, and the non-blood transfusion group (n=127), which included other patients. Multivariable logistic regression analysis identified two risk factors independently associated with blood transfusion: antenatal hemorrhage (adjusted odds ratio [aOR], 16.283; 95% confidence interval [CI], 4.405-60.190; P<0.001) and preoperative hemoglobin (g/dL) (aOR, 0.427; 95% CI, 0.246-0.739; P=0.002). Thus, patients who are at risk for these two factors should be carefully managed with sufficient preparation for blood transfusion and anesthetic management.

Evaluation of Appropriateness of Blood Order Based on Crossmatching to Transfusion Ratio in Elective Surgery (선택적 수술에서 교차시험/수혈비를 활용한 혈액요청의 적정성 평가에 관한 연구)

  • Chang, Young Do;Kim, Jae Soo;Kim, Min Jung;Rho, Tae Jun;Lee, Sang Il
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.2
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    • pp.158-162
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    • 2004
  • The over-preparation of blood for elective surgery causes some problems such as returning of blood, inefficient task and loss of reagents. In recent blood transfusion practice, there has been changing patterns of blood use in elective surgery as various side effects of transfusion have become known and operation techniques are developed. This study was performed to evaluate the optimal utilization of blood for various elective and/or emergency surgery. We surveyed the quantity of blood transmitted to wards, returned to blood bank, and the number of crossmatching test done for the elective surgery of the patients at the D. University Hospital, the tertiary teaching hospital from August 1, 2001 to October 31, 2001. Crossmatched to transfusion ratio (C/T ratio) was calculated, in which C means the unit of accomplished crossmatching test and T means the unit of transfused blood component. The unit of transfused blood was analysed in terms of issuing time, sex, age, clinical department, and blood component type. The usage of bloods for the emergency surgery was also analyzed. In our study, C/T ratio was highest on Monday (1.54) and Tuesday (1.53), and higher in female patients(1.54) than in male patients (1.32). No significant relationship was observed between age groups. Among clinical departments, thoracic and cardiovascular surgery showed the highest C/T ratio (1.54). From above results, we could be sure that the management of transfusion practice was relatively appropriate in recent years, although the entire introduction of type and screen (T&S) method was desirable. If the T&S method is performed, the C/T ratio would be almost 1.00 and it would also relieve the duty of blood bank.

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Status of Blood Products Release at a General Hospital in Gyeonggi-Do (경기도 일개 종합병원에서 혈액제제 출고 현황)

  • Choi, Ho-Keun;Choi, Kyung-Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.73-77
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    • 2022
  • Blood products (BPs) can only be obtained through blood donation and hence represent a finite resource. BPs should therefore be used conservatively. However, BPs are being used indiscriminately without evidence. The purpose of this study was to evaluate the reasons for the use of BPs and their appropriateness. The investigation was carried out based on hemoglobin levels. Data were obtained from Nov 1, 2020, to Oct 31, 2021, from a hospital's OCS/EMR systems. The BPs were dispensed in 21,303 cases, and the number of hemoglobin levels >7.0 g/dL or higher among red blood cell drugs used by each treatment department was 1,173 (>7.0 g/dL). The misuse of blood transfusions is increasing social costs, with the adequacy of transfusion becoming increasingly important. Hence, each medical institution should review the transfusion guideline evaluation index, check the status of the release of BPs, and institute educational programs covering transfusion guidelines and continually evaluate their adequacy.

Three Year Old Male with Multiple Dieulafoy Lesions Treated with Epinephrine Injections via Therapeutic Endoscopy

  • Baldwin, Christina L.;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.4
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    • pp.276-280
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    • 2016
  • Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion. Endoscopy revealed four isolated Dieulafoy lesions along the lesser curvature of the stomach, which were treated with an epinephrine injection. The Dieulafoy lesion, although thought to be rare, should be considered when investigating an acute gastrointestinal bleed. These lesions have been successfully treated endoscopically. Appropriate anticipation and preparation for diagnosis and therapy can lead to optimal outcomes for the pediatric patient.

A Case of Paroxysmal Nocturnal Hemoglobinuria (발작성야간혈색소뇨증 1례)

  • Kim, Chung-Sook;Kim, Kyung-Dong;Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.185-195
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    • 1989
  • Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon hematologic disease characterized by an abnormal sensitivity of blood cells to the lytic action of serum complement. We experienced one case of PNH in Yeungnam University Hospital from May 1983 to May 1989. The patients was followed up without severe complications for 4 years since diagnosis with the only consevating treatments such as washed blood transfusion, adrenal corticosteroids, androgens, folate and iron preparation, intermittently.

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The Development and Evaluation of an e-Learning Program for Novice Nurses before Beginning to Work in a Hospital Using KMS(Knowledge Management System) (지식경영 시스템을 활용한 신규간호사 e-Learning 프로그램 개발 및 평가)

  • Song, Young-Shin
    • The Journal of Korean Academic Society of Nursing Education
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    • v.13 no.1
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    • pp.82-89
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    • 2007
  • Purpose: The purpose of this study was to develop and evaluate an e-Learning Program designed to enhance novice nurses's performance ability Method: The e-Learning program was designed for novice nurses before beginning to work in a hospital using a KMS(Knowledge Management System). This study was carried out from February 2006 to April 2007. The program had progressive steps including design, pilot test & modification, contents development, program application and evaluation. After the program design and pilot testing, the learner's satisfaction was analyzed. Result: The program site is http://kms.emc.ac.kr titled, 'Cyber Education Center'. The sixteen part course has been developed as follows: blood sugar test, skin test, insulin test 1, insulin test 2, blood culture, blood sampling, heat therapy, cold therapy, glycerin enema, preparation of operation, oxygen therapy, suction technique, transfusion, foley catheterization and aseptic technique. The overall learner's satisfaction score was 4.08 out of 5 points. Conclusion: E-Learning could be useful for education and nursing work. This method may be effective for clinical nurses.

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Frequencies and Distributions of Unexpected Antibodies at a General Hospital in the Daejeon of Korea (대전지역 일개 종합병원에서의 비예기 항체 발생현황과 분포)

  • Kim, Jae-Jung
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.354-358
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    • 2018
  • When preparing for a blood transfusion, the presence and types of unexpected antibodies should be identified through screening tests. Using the DiaMed-ID system, antibody identification among unexpected antibody screening tests performed at a university hospital in Daejeon area for two years from January 2016 to December 2017 were limited to 55 patients and were predominantly women. A total of 36 patients (65.5%) belonged to the Rh group, 7 (12.7%) patients to the Lewis group, 4 (7.3%) patients to the Kidd and Duffy groups, 3 patients (5.5%) to the MNS group, and 1 (1.8%) to the Rh+Kidd combined group. In the Rh group, 19 (34.5%) patients had Anti-E single antibody, 5 (9.1%) patients had Anti-D single antibody, 4 (7.3%) patients had Anti-E/-c, 4 (7.3%) patients had Anti-C/-e, and 1 (1.8%) patient had $Anti-E/-c/-Jk^b$. In the Lewis group, three (5.5%) patients had both $Anti-Le^a$ and $Anti-Le^b$. In the Kidd group, one (1.8%) patient had $Anti-Jk^a$ and three (5.5%) patients had $Anti-Jk^b$. In the Duffy and MNS groups, only single antibody was found: one (1.8%) patient with $Anti-Fy^a$, three (5.5%) patients with $Anti-Fy^b$, two (3.6%) patients with Anti-M, and one (1.8%) patient with Anti-S. This study reflects the recent frequencies and distributions of unexpected antibodies in Daejeon, which would be helpful for the efficient preparation for transfusions.

Development of the Standard Blood Inventory Level Decision Rule in Hospitals (병원의 표준 혈액재고량 산출식 개발)

  • Kim, Byoung-Yik
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.195-206
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    • 1988
  • Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation has gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better.' The shortage itself by no means unnecessitate inventory control. In fact, in spite of shortage, no small amount of blood is outdated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this tudy is to develop formulae forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study informations of $A^+$ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated.48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measures of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of the issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study' were as follows ; 1. The formulae to calculate the standard blood inventory level($S^*$)was $S^*=2.8617X(d)^{0.9342}$ where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performace - outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level - were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First In-First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

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Experiences of Emergency Surgical Treatment for a COVID-19 Patient with Severe Traumatic Brain Injury at a Regional Trauma Center: A Case Report

  • Yun, Jung-Ho
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.212-217
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    • 2021
  • Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

Immunogenicity and Protective Efficacy of Solubilized Merozoite-enriched Theileria sergenti Immunogens. II. Protection against Natural Exposure under Field Conditions (Theileria sergenti merozoite 수용성 항원의 항원성과 면역성 II. 자연 조건하에서의 감염에 대한 면역시험)

  • 백병걸;김병수
    • Parasites, Hosts and Diseases
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    • v.30 no.3
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    • pp.201-208
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    • 1992
  • A Theileria sergenti soluble merozoite preparation containing the 29, 34, 35 and 105 KD as the immunodominant polypeptides, was evaluated for efficacy, safety and protectivity in Holstein calves against virulent field tick challenge. The soluble antigens (100 mg/dose) were fortified with either complete or incomplete Freund's adjuvant. Twenty naive calves, aged one month, were subcutaneously inoculated with the preparation and a booster dose was administered 4 weeks later. Twenty additional calves served as controls. Five weeks after the booster dose, vaccinates and uninoculated controls were moved to a pasture, a heavily tick infested area in Cheju-do, Korea. The vaccinates showed negligible change in hematocrit and total RBC count whereas control animals showed significant (p<0.05) hematological changes and associated anemia. Only 30% of vaccinates required chemotherapy after the experiment was terminated. All control animals required chemotherapy and 25% received blood transfusion. The highest percent parasitized erythrocytes in vaccinated cattle was 0.4% as compared with 3.6% among controls during the month of July. A significant difference (p<0.05) was observed in the rate of body weight increase. Significant difFerences were also noted in serum albumin, aspartate aminotransferase, total protein and bilirubin. Significantly more vaccinated cattle maintained normal ranges of hematological and biochemical values as compared with the control group. It is suggested that soluble merozoite T. sergenti antigens may be potential vaccine candidates for developing a genetic vaccine in Korea.

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