• Title/Summary/Keyword: Transfusion

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Viscoelastic Coagulation Test Guided Therapy for a Strategy to Reduce Transfusions (수혈 감소 전략을 위한 점탄성 응고 검사법의 유용성)

  • Park, Sun Young
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.240-252
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    • 2018
  • Viscoelastic coagulation tests provide simultaneous measurements of multiple aspects of whole-blood coagulation, including interactions between the plasma components and cellular components of the coagulation cascade. This can be carried out immediately using a point of care technique. Viscoelastic tests could predict the patient's outcome, including mortality, and detect coagulopathy more sensitively, resulted in reduced blood loss. The transfusion strategy based on the viscoelastic parameters rather than a conventional coagulation test has been shown to reduce the transfusion requirements. Although there are concerns about the reliability and accuracy of this method, viscoelastic tests, including ROTEM, would be a useful method to guide patient blood management strategies.

Development of the Nursing Process Based Performance Measurement Tool for Medication Management and Blood Transfusion (투약과 수혈간호의 간호과정 적용 평가도구 개발)

  • Kim, Keum Soon;Kim, Jin A;Kwon, So Hi;Song, Mal Soon
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.177-196
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    • 2010
  • Purpose: This study was conducted to develop the nursing process based performance measurement tool and the evidence based care standards for nursing care in medication management and blood transfusion. Methods: The care standards and performance measurement tool were drafted through comprehensive review of relevant literature, national guidelines, hospital protocols, and standards of recognized international accrediting bodies. The proposed care standards and performance measurement tool were reviewed by the panel of experts and refined based on the panel's suggestions. Final care standards and performance measurement tool were validated by surveying the hospital nurses. Results: All items of the performance measurement tool for medication management and blood transfusion were evaluated appropriate. All contents of care standards and the measurable elements except the evaluation of discharge education were appropriate. The performance measurement tool developed in this study was found to be acceptable as a tool to evaluate quality of nursing care in medication management and blood transfusion. Conclusion: The outcomes of this study including the performance measurement tool and evidence based care standards would be the important indicators to monitor whether necessary nursing care is implemented and be the useful primary resources to improve quality of nursing care services.

Alterations in $O_2$ Uptake Following Hemorrhage and Transfusion in Rats (실혈 후 및 혈압상승 후의 소화기 조직 혈액량 및 산소 섭취량 -제 2 편 동맥 혈압하강과 산소 섭취량 감소-)

  • Yoon, Byong-Hak;Nam, Kee-Yong
    • The Korean Journal of Physiology
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    • v.2 no.1
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    • pp.17-21
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    • 1968
  • Total body oxygen uptake was measured in rats following hemorrhage (16 rats) and blood transfusion (7 rats) under light Nembutal anesthesia. Arterial blood Pressure measured on the tail artery decreased or increased following hemorrhage or transfusion. No direct relationship was observed between arterial blood pressure alteration and oxygen intake variation. Hematocrit ratio which changed after hemorrhage or transfusion showed a direct relationship with oxygen intake. Decrease in hematocrit ratio resulted in a decrease in oxygen intake of rats. The correlation coefficient between decrement of hematocrit ratio and decrement of oxygen intake was r=.56. The correlation coefficient between increment of hematocrit ratio and increment of oxygen intake was r=.86. Thus it was concluded that alteration in oxygen intake was limited by the systemic oxygen transport capacity of blood.

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A Study on The Relationship Between Intraoperative Neuromonitoring and Hemoglobin Changes

  • Lee, Kyuhyun;Kim, Jaekyung
    • International journal of advanced smart convergence
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    • v.9 no.4
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    • pp.8-15
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    • 2020
  • This study was conducted in order to determine the effect of intraoperative hemoglobin changes on intraoperative neuromonitoring (IONM). This was a retrospective study that included 339 participants who underwent cerebrovascular surgery. We compared anesthetic agents, intraoperative hemoglobin, hematocrit, blood transfusion, and blood loss. We examined motor evoked potential and sensory evoked potential to patients. There were significant differences in hemoglobin changes, bleeding levels, transfusion, anesthesia time, and postoperative mobility disorders. Moreover, compared with patients who received transfusions, those who did not receive transfusion had a lower average hemoglobin level, as well as a higher bleeding amount, and a need of higher anesthesia time and anesthetic dose. Also, we found vasospasm occurred while surgery can bring adverse results after operation. This study showed that an intraoperative decrease in hemoglobin levels affects the function of cerebral perfusion, which could result in abnormal nerve monitoring results. However, as this study could not find a relation of anesthetics to IONM, there is a need for further research regarding the association between anesthetics and hemoglobin changes and IONM.

Twin anemia polycythemia sequence in a dichorionic diamniotic pregnancy: a case report

  • Lee, Soo-Young;Bae, Jin Young;Hong, Seong Yeon
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.150-152
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    • 2022
  • Complications related to the vascular anastomosis of the placental vessels in monochorionic twins are fatal. The clinical syndromes of feto-fetal transfusion include twin anemia polycythemia sequence (TAPS), twin-twin transfusion syndrome, and twin reversed arterial perfusion sequence. We present an extremely rare case of TAPS in a dichorionic diamniotic pregnancy. A 36-year-old woman, gravida 0, para 0, was referred to our hospital with suspected preterm premature membrane rupture. Although her pelvic examination did not reveal specific findings, the non-stress test result showed minimal variability in the first fetus and late deceleration in the second one. An emergency cesarean section was performed. The placenta was fused, and one portion of the placenta was pale, while the other portion was dark red. The hemoglobin level of the first fetus was 7.8 g/dL and that of the second one was 22.2 g/dL.

The Frequency and Distribution of Unexpected Antibodies at a Tertiary Hospital in Daejeon (대전지역 대학병원에서 동정된 비예기항체의 분포와 빈도)

  • Kang, Hee-Jung;Ihm, Chun-Hwa;Lee, Moon-Hee;Hyun, Sung-Hee;Kim, In-Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.42 no.2
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    • pp.63-70
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    • 2010
  • Antibody screening and identification tests before blood transfusion are important because unexpected red antibodies can cause acute or delayed hemolytic transfusion reactions. Although a tube method was used for detecting unexpected antibodies, a column agglutination method has recently been used because of its simple procedure and a high detection of warm antibodies. This study investigated the frequency and distribution of unexpected antibodies in transfusion candidates during the recent 5 years, and transfusion characteristics in the identified cases. From January 2005 to December 2009, 46,923 sera of the cases from E hospital were screened and 98 sera were identified by the DiaMed-ID System. 272 cases (0.58%) showed positive results out of all 46,923 cases that underwent unexpected antibodies screening. Among them, unexpected antibodies were identified in 98 cases. The anti-Rh antibodies included in warm antibodies were the most frequently detected in 47 cases (47.96%). Anti-Lewis and anti-MNSs antibodies were detected in 11 cases (11.22%) and 6 cases (6.12%), respectively. Unidentified antibodies were detected in 6 cases (6.12%). Among the patients with unexpected antibodies, 43 cases (43.88%) had a history of previous transfusion. Anti-E was the most frequently detected antibody (4/14 cases, 30.77%) in the cases who had a previous history of transfusion and showed different screening results from negative to positive, This study may provide the basic data for the frequency and characteristics of red cell antibodies.

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Successful treatment by exchange transfusion of a young infant with sodium nitroprusside poisoning

  • Baek, Jong-Geun;Jeong, Hoar-Lim;Park, Ji-Sook;Seo, Ji-Hyun;Park, Eun-Sil;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Yeom, Jung-Sook
    • Clinical and Experimental Pediatrics
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    • v.53 no.8
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    • pp.805-808
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    • 2010
  • Although sodium nitroprusside (SNP) is often used in pediatric intensive care units, cyanide toxicity can occur after SNP treatment. To treat SNP-induced cyanide poisoning, antidotes such as amyl nitrite, sodium nitrite, sodium thiosulfate, and hydroxycobalamin should be administered immediately after diagnosis. Here, we report the first case of a very young infant whose SNP-induced cyanide poisoning was successfully treated by exchange transfusion. The success of this alternative method may be related to the fact that exchange transfusion not only removes the cyanide from the blood but also activates detoxification systems by supplying sulfur-rich plasma. Moreover, exchange transfusion replaces cyanide-contaminated erythrocytes with fresh erythrocytes, thereby improving the blood's oxygen carrying capacity more rapidly than antidote therapy. Therefore, we believe that exchange transfusion might be an effective therapeutic modality for critical cases of cyanide poisoning.

Acute Respiratory Distress Syndrome Related with Blood Transfusion in a Dog with Chronic Kidney Disease (만성신장질환 개에서 수혈과 관련된 급성호흡곤란증후군)

  • Jung, Joohyun;Choi, Mincheol
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.94-97
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    • 2015
  • An 11-year-old intact male Yorkshire terrier had intermittent vomiting, anorexia and depression for a month. Clinical laboratory works showed azotemia and anemia. Chronic kidney disease with developing anemia was diagnosed clinically. Clinical signs were resolved but anemia was deteriorated and blood transfusion was performed. On 10 hours after transfusion, the dog showed acute respiratory distress. Transfusion related acute respiratory distress syndrome (ARDS) was diagnosed based on acute clinical signs, risk factors of transfusion, bilateral alveolar infiltration on thoracic radiographs, and $PO_2:FiO_2$ ratio less than 200 on arterial blood analysis. The dog died within 2 hours after ARDS diagnosis.

Autotransfusion Using Ccell Saver in Cardiac Surgery (개심술에서의 자가수혈기(Cell Saver)를 이용한 자가수혈)

  • 육을수
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.125-130
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    • 1995
  • Autotransfusion system is a common method of reducing the need of intraoperative and postoperative homologous blood transfusion in cardiac operation. Between August 1991 and August 1993, a series of 51 adults undergoing open heart surgery was selected. Autotransfusion using Cell Saver [COBE Baylor Rapid Autologous Transfusion System was done with homologous blood transfusion in 15 cases [Group II or without homologous blood transfusion in 17 cases [Group III . The other 19 cases were taken without Cell Saver for control [Group I . The shed blood in the operative field, remained blood in the oxygenator after cardiopulmonary bypass, and blood drained from chest tubes in postoperative care were aspirated by means of a locally heparinized collection system. After the salvaged blood was washed and centrifuged, the processed blood subsequently reinfused. Composition of processed blood by Cell Saver was hemoglobin 16.9gm%, hematocrit 49%, RBC 5,140,000/ml, WBC 670/ml, and platelet 30,000/ml. In three group, hemoglobin, hematocrit, and platelet counts were decreased postoperatively, but no significant differences between three group. Postoperatively, the amounts of drainage from chest tubes was 543$\pm$121ml in Group I, 809$\pm$201ml in Group II, and 631$\pm$147ml in Group III. In Group II, there was large amount of drainage compared with Group I [p<0.05 . The amount of homologous blood transfused was 1116$\pm$219 ml in Group I, 791$\pm$183 ml in Group II [p<0.05 . The homologous blood was not transfused in 17 cases [53% with Cell Saver.Preoperative and postoperative, coagulation parameters showed no significant differences between three group. And there was no complication related to Cell Saver. We conclude that the autotransfusion using Cell Saver is effective for reducing the homologous blood transfusion in cardiac surgery.

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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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