ABSTRACT
La pérdida de sangre quirúrgica es uno de los mayores retos que enfrentan los cirujanos actualmente. La demanda de cirugías de alta complejidad se ha incrementado por múltiples causas. Se realizó una revisión acerca de los principales factores que inciden en la pérdida de sangre en cada etapa de las intervenciones quirúrgicas, con énfasis en los procedimientos quirúrgicos ortopédicos. Se examinaron y evaluaron los fármacos hemostáticos existentes que contribuyen a prevenir dicha pérdida y evitan el riesgo de transfusión. Diversos factores como la anemia, edad avanzada, la existencia de comorbilidades, el tiempo quirúrgico prolongado, el empleo en el posoperatorio de medicamentos con la finalidad de lograr anticoagulación, favorecen la pérdida sanguínea quirúrgica y elevan los índices de transfusión sanguínea. El empleo de agentes hemostáticos debe estar basado en el sentido clínico de la eficacia terapéutica que se espera, la seguridad frente a posibles complicaciones y los costos económicos de su administración(AU)
Surgical blood loss is one of the biggest challenges facing surgeons today. The demand for highly complex surgeries has increased for multiple reasons. A review was made of the main factors that influence blood loss at each stage of surgery, with emphasis on orthopedic surgical procedures. Existing hemostatic drugs that help prevent such loss and avoid the risk of transfusion were examined and evaluated. Various factors such as anemia, advanced age, the existence of comorbidities, prolonged surgical time, the use in the postoperative of medicines in order to achieve anticoagulation, favor surgical blood loss and elevate blood transfusion rates. The use of hemostatic agents should be based on the clinical sense of the expected therapeutic efficacy, safety against possible complications and the economic costs of its administration(AU)
La perte de sang chirurgicale est l'un des plus grands défis actuels auxquels sont confrontés les chirurgiens. La demande pour les chirurgies très complexes a augmenté de multiples causes. Un examen sur les principaux facteurs qui influent sur la perte de sang à chaque étape de la chirurgie, en mettant l'accent sur les interventions chirurgicales orthopédiques effectuées. Ils ont été examinés et évalués médicaments hémostatiques existants qui aident à prévenir la perte et de prévenir le risque de transfusion. Divers facteurs tels que l'anémie, la vieillesse, la présence de comorbidités, le temps opératoire prolongé, l'utilisation post-opératoire des médicaments afin d'atteindre anticoagulation, promouvoir et élever les taux de transfusion sanguine de chirurgie de perte de sang. L'utilisation d'agents hémostatiques doit être fondée sur le sens clinique de l'efficacité thérapeutique attendu, la sécurité contre les complications potentielles et les coûts économiques de l'administration(AU)
Subject(s)
Humans , Surgical Procedures, Operative , Blood Loss, Surgical , Blood Loss, Surgical/prevention & control , Transfusion Reaction , Anemia/surgeryABSTRACT
Objective@#To evaluate the reduction of the residual risk of blood transfusion- transmitted hepatitis B virus (HBV), using nucleic acid detection(NAT)test for enzyme linked immunosorbent assay (ELISA) qualified volunteer-donor bloods in Quzhou area after NAT was developed.@*Methods@#Specimens were collected from March 2016 to March 2017, detected by ELISA twice with two different reagents and NAT only once. The residual risks of blood transfusion-transmitted HBV infection were calculated by mathematical model of risk evaluation.@*Results@#Totally 27 646 specimens were collected from March 2016 to March 2017, which included 76 specimens that were both ELISA and NAT positive, 31 specimens were ELISA negative but NAT positive.The total number of NAT positive specimens was 107.The residual risk of HBV by ELISA test was 28.2×10 -5and NAT test was 13.0×10-5.@*Conclusions@#NAT detection can greatly reduce the residual risk of blood transfusion-transmitted HBV infection, and provide effective value for bloods safety in practice.
ABSTRACT
BACKGROUND: Screening of donor blood for malaria has not been activated in Korea yet in spite of the recent resurgence of tertian malaria among Korean army soldiers in Delimited Militarized Zone areas. Prospective donors (travelers, immigrants, refugees, citizens or residents) following a visit to or coming from an endemic area who have had malaria or taken antimalarial prophylaxis should be deferred for 3 years after cessation of therapy or after departure from malarial area. We studied the risk of the transmission of malaria, especially through army blood donation which comprised up to 57.8% of whole blood donation in Korea. METHODS: The data were collected by personal interview and review of donation records of Korea Red Cross Center and medical records from 174 army soldiers with malaria who admitted to Army Hospital from May 1995 to October 1996. We analyzed the time interval between onset of illness and blood donation, and geographic distribution of the patients. RESULTS: About 70.7% (123/174) of the patients donated blood before the onset of illness, and the interval between blood donation and onset of illness ranged from 2 days to 2,750 days (mean 377, standard deviation 488). Patients who donated blood within 3 years before onset of illness were 87.8%(n=108) of the total blood donation. All donation (n=18) after treatment were within 3 years from 46 days to 342 days (mean 138, standard deviation 80.7). The frequent of blood donations were from the prevalent areas of malaria such as Pajoo City (40%), Younchon Kun (29%), Cholwon Kun (15.5%) and others(15.5%). CONCLUSION: We showed that donated army blood a risk of malaria transmission. Therefore the blood bank needs to set strict guidelines for blood donation especially from Korean army soldiers to control malaria transmission.
Subject(s)
Humans , Blood Banks , Blood Donors , Emigrants and Immigrants , Hospitals, Military , Korea , Malaria , Mass Screening , Medical Records , Military Personnel , Red Cross , Refugees , Tissue DonorsABSTRACT
OBJECTIVE To investigate the degree of risk of viral prevalence of HBV,HCV and HIV through blood transfusion in Beijing Hospital in China,and to assess the need of a national Haemovigilance System. METHODS Retrospectively,7883 blood bank specimens (collected from 2004 to 2007) were re-examined using 8 indicators (including 5-item Hepatitis B,anti-HCV,anti-HIV and Syphilis) for the prevalence of most common viral infection. RESULTS From the blood bank specimens,the prevalence of HBsAg was 0.88% (69),the anti-HBc positive blood,only the anti-HBc was found in 2.65% of the specimens,while both the anti-HBc and the anti-HBe were found in 2.09% of the specimens. The prevalence of anti-HCV was 0.09% (7). CONCLUSIONS We need to establish the national Haemovigilance System to strengthen the monitoring of the above HbsAg,HBcAb and HCV indicators to prevent the transfusion-transmitted infection. Only in this way can the public confidence in blood safety be improved.