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ABSTRACT Introduction: The knowledge of clinicians regarding blood transfusion services may impact patient care and transfusion outcome. The wide variation in transfusion practices among clinicians leads to inappropriate blood product usage and jeopardizes patient safety. Hence, this survey study aimed to assess knowledge, attitude and practice among the residents and interns of safe blood transfusion. Methods: The online survey was based on self-administered questionnaires of three sections: 1. Demography; 2. Knowledge, and; 3. Attitude and Practice. One point was assigned for the correct response of each question in every section. The knowledge score was further categorized into three categories, depending on the points obtained. The participants were also divided into four groups, depending on their experience. The Kruskal-Wallis test was applied to determine the difference of knowledge and practice scores in three designated groups of residents and interns. A p-value of less than 0.05 was considered to be significant. Result: A total of 247 residents and interns participated in this study. Thirteen participants had an incomplete response. Out of 234 participants, Senior Residents (SR), Junior Residents (JR), and interns were 70, 96 and 68 participants, respectively. The knowledge scores of interns were significantly low, as compared to SRs and JRs. Practice scores of interns were also significantly low, compared to the JRs. However, most of the residents and interns (85%) were aware of the pre-transfusion testing. Conclusion: Therefore, the mandatory incorporation of the transfusion medicine subject in the undergraduate curriculum can help the young budding doctors to better implement the patient blood management.
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Anemia often occurs in patients undergoing cardiac surgery, which increases the incidence and related risks of blood transfusion together with surgical bleeding.Both anemia and transfusion were associated with poor prognosis and increased mortality.Current practice guidelines generally recommend the implementation of patient blood management (PBM), which relies on anemia management and restrictive transfusion to reduce perioperative blood loss and transfusion rate, and improve the prognosis of patients.This article reviews recent research progress of anemia management and blood transfusion in adult patients undergoing cardiac surgery, in order to provide basis for the practice of PBM in cardiac surgery patients in the future.
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Platelet transfusion is an irreplaceable method to treat patients with platelet reduction in Hematology Department and Oncology Department. However, immunogenic platelet transfusion refractoriness is a huge challenge to patients who require repeatedly platelet transfusion. Therefore, mechanisms and reasonable transfusion strategies should be formulated to improve immunogenic platelet transfusion outcomes. This article aims to review the research progress and prospects concerning mechanisms and solutions of immunogenic platelet transfusion refractoriness, and provide rational transfusion strategies for platelet transfusion refractoriness patients, thus improving platelet transfusion outcomes.
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【Objective】 To investigate the impact of ABO blood group compatibility and incompatibility(major /minor/bidirectional incompatibility) on the outcomes of patients underwent allogeneic hematopoietic stem cell transplantation(allo-HSCT), and to provide evidences for optimizing the transplantation program. 【Methods】 From January 2014 to June 2018, we retrospectively reviewed the clinical courses of 18 recipients of allo-HSCT from ABO-compatible donors and 52 from ABO-incompatible donors at our hospital. The implantation time of granulocyte/erythrocyte/megakaryoblast, RBC/platelet transfusions within 3 months posttransplantation, the initiating and completion time of ABO blood group conversion(for ABO-compatible donors only) were analyzed and compared among the ABO-incompatible and ABO-compatible donors as such variables including demographic data, donor and patient relationship, diagnosis of disease, bone marrow hematopoietic function prior to transplantation, HLA matching were not significant different. 【Results】 For 18 recipients of allo-HSCT from ABO-compatible donors, the implantation time of granulocyte, erythrocyte, megakaryoblast was 12.0(11.0~16.3), 41.5 (35.0~49.0) and 19.0(16.0~22.5)days, respectively. For 52 recipients of allo-HSCT from ABO-incompatible donors, the ABO blood group conversion was initiated at 28.0(22.5~44.0)days posttransplantation and completed at 105.5(85.0~141.8)days. In the ABO-compatible group, the time of erythrocyte implantation was shortened(P0.05), no significant difference was observed between these two variables. The blood group conversion time, implantation time of granulocyte/erythrocyte/megakaryoblast, and RBC /platelet transfusions among ABO major, minor and bidirectional incompatible groups were not significant different (P>0.05). 【Conclusion】 ABO-compatiblity enjoys priority in allo-HSCT. ABO-incompatiblity can be chosen in the order of minor, major and bidirectional incompatibility in the absence of ABO-compatiblity.
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Gastrointestinal bleeding is a common acute and critical illness that may result in hemorrhagic shock.In conventional concept, sufficient blood transfusion to ensure volume resuscitation was necessary for this emergency condition.With the propose and application of restrictive transfusion strategy in clinical practice, the new concept has been applied in patients with gastrointestinal bleeding.Restrictive transfusion strategy could maintain the perfusion of vital organs with a minimized blood transfusion, and avoiding the coagulopathy and acidosis caused by massive transfusion.This article reviewed the advances in study on gastrointestinal bleeding and restrictive transfusion strategy.