ABSTRACT
【Objective】 To investigate the incidence of clinical massive blood transfusion in hospitals, the proportion of departments conducted massive blood transfusion and the current situation of component transfusion, so as to provide a theoretical basis for medical decision-making and further research on massive blood transfusion. 【Methods】 The basic clinical data and transfusion of blood components were retrospectively collected from 489 patients (514 occasions) who received massive blood transfusion at Sun Yat-sen Memorial Hospital of Sun Yat-sen University from Jan. 1 2014 to Dec. 31 2018. 【Results】 The incidence of massive blood transfusion during the 5-year period was 1.2/1 000 inpatients (95%CI: 1.1-1.3), and the 30-day all-cause mortality was 21.88%; in the departments where massive blood transfusion occurred, the mortality rate was the highest in the trauma emergency department (60%), followed by intensive care unit (56.25%) and other surgery department (46.67%), while there was no death in the obstetric department. All patients received red blood cells [median 14 U (11.5-19.13)] and plasma [median 1 600 mL (1 200-2 200)], of which 47% received platelet [median 0 U (0-10)] and 32.68% received cryoprecipitate [0 U (0-10)]. The results of logistics regression analysis of all-cause mortality risk showed that compared with the youth group, the risk of all-cause death at 30 days of elderly patients over 65 years old (65 80 years old: OR=7.563, 95%CI=[1.587, 36.049], P<0.05) and 24-hour RBC infusion volume greater than 18 U (18≤RBC<27: OR=2.948 95%CI=[1.592, 5.462], P<0.05; RBC≥28: OR=3.992, 95%CI=[1.178, 13.536], P<0.05) was higher. 【Conclusion】 A dynamic definition should be included in massive transfusion studies. If only a 24-hour RBC infusion volume ≥18 U was used as the mass transfusion definition, about 68% of cases would be lost. The mortality rate of patients with massive blood transfusion was higher, and the incidence of massive blood transfusion was higher in the departments of cardiac surgery, general surgery and orthopedics surgery. More attention should be paid to the increasing number of female patients with massive blood transfusion. In addition, the risk of 30-day all-cause death was highest in elderly patients over 65 years of age and those with a 24-hour erythrocyte transfusion level of ≥18 U.
ABSTRACT
Objective To develop a measurement method for determination of optical parameters of a red blood cell ( RBC) suspension based on the measurement of spatial scattered light signals without using an integrating sphere.Methods Multiple independent photoelectric sensors and light intensity modulation were used to obtain the measured values of diffuse reflectance,diffuse transmittance and collimated transmittance.The measured data results were imported into a Monte Carlo simulation based RTE to inversely determine the absorption coefficient, scattering coefficient and anisotropy factor of the measured sample using a new perturbation method.Results The described measurement method was applied to determine the optical parameters of a polystyrene microsphere suspension with a mean diameter of 2.6μm,and the results were essen-tially consistent with the calculated optical parameters by Mie code.Then, the RBC suspension was used for testing optical parameters,and the results were basically consistent with the parameters in the literature.Conclusion The system based on the measurement of spatial scattered light signals without using an integrating sphere will provide a quick and accurate approach for quantitative analysis of free hemoglobins and RBC suspensions.
ABSTRACT
Objective: To investigate the temperature control methods for long-distance transportation of red blood cell suspensions in military affairs or emergence.Methods: We loaded blood transport cars with red blood cell suspensions to full capacity and kept the temperature by combined cooling methods.Results: The temperature in the container was kept between 2-6.2℃ during the 72 h transportation,even when the refrigeration system of the car was out of work.Conclusion: The required temperature for long-distance transportation of red blood cell suspensions could be attained by combined cooling methods in case of insecurity of transportation time and the effect of single cooling method.