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Objetivo: construção de um instrumento, do tipo checklist , como subsídio para segurança transfusional beira-leito. Método: foi empregada a Técnica Delphi, contando com a participação de 18 especialistas em hemoterapia na primeira etapa e 11 na segunda. Para a validação de conteúdo, foi utilizado o cálculo do índice de validade de conteúdo, com concordância ≥ 80% na primeira e ≥ 90% na segunda rodada de julgamento. Resultados: na primeira fase, dos 67 itens iniciais, 15 foram retirados por contabilizar índice de validade de conteúdo < 80%. O instrumento foi reformulado para nova avaliação dos especialistas, contando com 53 itens e 11 observações e intervenções. Destes, 8 itens foram retirados por contabilizarem índice de validade de conteúdo < 90%. O coeficiente alfa de Cronbach calculado para o checklist foi de 0,8940. Conclusão: o checklist poderá auxiliar na segurança da assistência hemoterápica em enfermagem, visto que apresenta boa confiabilidade.

Objective: to build a checklist to support bedside transfusion safety. Method: the Delphi Technique was used, with the participation of 18 specialists in hemotherapy in the first stage and 11 in the second. For content validation, the content validity index was calculated, with agreement ≥ 80% in the first round and ≥ 90% in the second round. Results: in the first phase, of the 67 initial items, 15 were removed for having a content validity index < 80%. The instrument was reformulated for a new expert evaluation, with 53 items and 11 observations and interventions. Of these, 8 items were removed due to content validity index < 90%. The Cronbach's alpha coefficient calculated for the checklist was 0.8940. Conclusion: the checklist could help to ensure the safety of hemotherapy nursing care, as it has good reliability.

Objetivo: elaborar una herramienta de tipo checklist para apoyar la seguridad transfusional a pie de cama. Método: se utilizó la técnica Delphi, con la participación de 18 especialistas en hemoterapia en la primera etapa y 11 en la segunda. Para la validación del contenido se calculó el índice de validez de contenido, con un acuerdo ≥ 80% en la primera y ≥ 90% en la segunda ronda de valoración. Resultados: en la primera fase, de los 67 ítems iniciales, se eliminaron 15 por tener un índice de validez de contenido < 80%. Se reformuló el instrumento para una nueva evaluación por expertos, con 53 ítems y 11 observaciones e intervenciones. De éstos, se eliminaron 8 ítems por tener un índice de validez de contenido < 90%. El coeficiente alfa de Cronbach calculado para lo checklist fue de 0,8940. Conclusión: Lo checklist podría contribuir a garantizar la seguridad de los cuidados de enfermería en hemoterapia, ya que presenta una buena fiabilidad.

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Introduction : la transfusion sanguine est un acte thérapeutique capital dans la pratique médicale et constitue une préoccupation majeure de santé publique Objectif : identifier les facteurs associés au décès chez les patients transfusés Patients et méthode : il s'est agi d'une étude transversale descriptive et analytique à collecte de données rétrospective, menée du 1 er Janvier 2018 au 31 Juillet 2023. Etaient inclus les patients hospitalisés et ayant bénéficié d'une transfusion sanguine. Résultats : 645 patients étaient inclus sur 3639 patients hospitalisés, correspondant à un taux transfusionnel de 17,7%. L'âge moyen des patients était de 49 ± 16 ans et 66,1% étaient de sexe masculin (sex-ratio = 1,95). La transfusion sanguine était indiquée pour une hémorragie digestive dans 65,6% des cas. Les produits sanguins les plus utilisés étaient le concentré de culot globulaire et le plasma frais congelé respectivement dans 93,6% et 6,5% des cas. Le délai entre la prescription des produits sanguins et la transfusion sanguine était supérieur à 24 heures dans 46,5% des cas. Sur les 645 patients transfusés, 150 (23,2%) étaient décédés. Un délai de transfusion supérieur à 24 heures était associé au décès chez les patients transfusés.

Introduction: blood transfusion is an important therapeutic procedure in medical practice and a major public health concern Objective: identify factors associated with death in transfuses patients Patients and method: This was a descriptive and analytical cross-sectional study with retrospective data collection, conducted from January 1, 2018 to July 31, 2023. Patients who were hospitalized and received a blood transfusion were included. Results: 645 patients were included out of 3639 hospitalized, corresponding to a transfusion rate of 17.7%. The mean age of the patients was 49 ± 16 years, and 66.1% were male (sex ratio = 1.95). Blood transfusion was indicated for gastro-intestinal bleeding in 65.6% of cases. The blood products most frequently used were packed red blood cells and fresh frozen plasma in 93.6% and 6.5% of cases respectively. The time between blood product prescription and blood transfusion was greater than 24 hours in 46.5% of cases. Of the 645 patients transfused, 150 (23.2%) died. A transfusion delay of more than 24 hours was associated with death in patients transfused. Conclusion: Blood transfusion is a frequent therapeutic procedure of vital importance in the management of gastroenterology emergencies

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Introducción. Se describe la utilidad del umbral crítico de administración (CAT por su denominación en inglés) como herramienta para la reanimación hemostática en pacientes con trauma severo y oclusión endovascular aórtica. Métodos. Revisión retrospectiva de pacientes adultos con hemorragia por trauma, con o sin oclusión endovascular aórtica (REBOA), atendidos entre enero de 2015 y junio de 2020, en un centro de trauma nivel I en Cali, Colombia. Se registraron variables demográficas, severidad del trauma, estado clínico, requerimiento transfusional, tiempo hasta CAT+ y CAT alcanzado (1, 2 ó 3). Resultados. Se incluyeron 93 pacientes, se utilizó REBOA en 36 y manejo tradicional en 57. El grupo REBOA presentó mayor volumen de sangrado (mediana de 3000 ml, RIC: 1950-3625 ml) frente al grupo control (mediana de1500 ml, RIC: 700-2975ml) (p<0,001) y mayor cantidad de glóbulos rojos transfundidos en las primeras 6 horas (mediana de 5, RIC:4-9); p=0,015 y en las primeras 24 horas (mediana de 6, RIC: 4-11); p=0,005. No hubo diferencias estadísticamente significativas en número de pacientes CAT+ entre grupos o tiempo hasta alcanzarlo. Sin embargo, el estado CAT+ durante los primeros 30 minutos de la cirugía fue mayor en grupo REBOA (24/36, 66,7 %) frente al grupo control (17/57, 29,8 %; p=0,001), teniendo este mayor tasa de mortalidad intrahospitalaria frente a los pacientes CAT-. Conclusión. El umbral crítico de administración es una herramienta útil en la reanimación hemostática de pacientes con trauma y REBOA, que podría predecir mortalidad precoz.

Introduction. The objective is to describe the utility of the Critical Administration Threshold (CAT) as a tool in hemostatic resuscitation in patients with severe trauma and REBOA. Methods. Retrospective review between January 2015 and June 2020 of adult patients with hemorrhage secondary to trauma with or without REBOA in a level I trauma center in Cali, Colombia. Demographic variables, trauma severity, clinical status, transfusion needs, time to CAT+ and number of CAT achieved (1, 2 or 3) were recorded. Results. Ninety-three patients were included, in which REBOA was used in 36 and traditional management in 57. The REBOA group had a higher bleeding volume (3000 ml), IQR: 1950-3625 ml vs the control group (1500 ml, IQR: 700-2975 ml) (p<0.001) and a higher rate of PRBC units transfused in the first 6 hours (median 5, IQR: 4-9); p=0.015 and in the first 24 hours (median 6, IQR: 4-11); p=0.005. There were no statistically significant differences in the number of CAT+ patients between groups or time to CAT+. However, CAT+ status during the first 30 minutes of surgery was higher in the REBOA Group (24/36, 66.7%) vs. the control group (17/57, 29.8%; p=0.001), having this group a higher in-hospital mortality rate vs. CAT- patients. Conclusion. CAT is a useful tool in the hemostatic resuscitation of patients with trauma and REBOA that could predict early mortality.

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Abstract Postoperative anemia is a complex clinical issue that requires attention due to its ramifications on the patient's recovery and prognosis. Originating from multiple determinants, such as intraoperative blood loss, hemolysis, nutritional deficiencies, systemic inflammation and impact on the bone marrow, postoperative anemia has varied and often challenging presentations. Patients undergoing major surgical procedures, in particular, are susceptible to developing anemia due to the considerable associated blood loss. Accurate diagnosis plays a crucial role in the approach, requiring meticulous hematological analysis, including hemoglobin, hematocrit and reticulocyte count, as well as an in-depth investigation of the underlying causes. An additional challenge arises in the form of the excessive practice of phlebotomy during hospitalization for clinical monitoring. Although it is essential to assess the progression of anemia, frequent removal of blood may contribute to iatrogenic anemia, further delaying recovery and possibly increasing susceptibility to infection.

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Abstract Managing the patient's blood and hematopoietic system is like managing any of the other organs and organ systems during patient care. Specialists control the heart, kidneys, endocrine system, etc. and the patient's blood requires similar clinical treatment. The hematopoietic system and its circulatory products are fundamental for the healthy functioning of the human body. In simple terms, Patient Blood Management (PBM) is an organized, patient-centered approach in which the entire healthcare team coordinates efforts to improve outcomes by managing and preserving the patient's own blood. By reducing dependence on blood transfusions, PBM seeks to improve clinical outcomes, reduce the risks and costs associated with transfusions, and improve the safety and quality of patient care. Essentially, the concept of PBM is about the holistic management and preservation of the patient's own blood in the medical and surgical context.

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ABSTRACT Background: Blood transfusion is an effective therapeutic practice. However, even adopting all procedures for transfusion safety, there are risks, one of which is immediate adverse reactions. The aim of this study was, by active search, to evaluate the occurrence of immediate adverse reactions estimating the occurrence rate within the first 24 h. Methods: An exploratory, descriptive, prospective study with quantitative analysis was carried out of patients undergoing surgery who received blood component transfusions during hospitalization from October 2018 to August 2019. Data on blood component request forms were collected from the transfusion agency by reviewing medical records and interviewing the patient or family members. Descriptive statistics and the chi-square test were used to analyze the association of demographic variables with the presence or absence of transfusion reactions. Results: A total of 1042 blood component units were transfused in 393 transfusions performed on 184 patients. The main transfused blood component was packed red blood cells. Seventeen reactions were identified in the medical records, using the active search method, none of which had been reported. The transfusion reaction rate was 16.3 occurrences per 1000 transfused units, while the notification rate for the 9389 blood component units transfused by the transfusion agency in the study period was 3.83/1000. There was no statistically significant association between the occurrences or not of transfusion reactions and demographic variables. Conclusion: Through the active search method, it was possible to observe the underreporting of adverse reactions, showing inadequate compliance with current legislation, which is essential to minimize errors and increase transfusion safety.

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Abstract Objective To identify the predictive factors for the need for transfusion during and after surgery to treat hip fractures in the elderly and to evaluate a protocol to guide the request for blood reserves for surgery. Methods The medical records of 172 elderly patients undergoing surgical treatment for proximal femoral fractures were collected. Data on sex, age, preoperative hemoglobin level, diagnosis, and type of surgery were tested for correlation with blood transfusion. In our sample, we determined the number of units of packed red blood cells reserved, the transfusion rate, and the cross-test:transfusion ratio. We made the same calculations in a hypothetical situation in which the request for blood reserves for our sample followed the criteria of a defined protocol. Results We found a correlation between the American Society of Anesthesiologists (ASA) classification and the occurrence of transfusions, and an inverse correlation between the hemoglobin level on admission and the number of bags transfused. A reserve of 328 units of packed red blood cells was requested for 167 surgeries. Had the proposed protocol been applied, 72 units would have been requested for 61 surgeries. Conclusion We found a correlation regarding the variables ASA classification and preoperative hemoglobin level and the occurrence of transfusion. Applying a proposed protocol to decide between requesting a reserve and only typing for elderly individuals undergoing surgical treatment for hip fracture proved suitable to reduce the number of packed red blood cell reserves.

Resumo Objetivo Identificar os fatores preditivos da necessidade de transfusão durante e após a cirurgia para o tratamento de fratura do quadril em idosos e avaliar um protocolo para orientar a solicitação de reserva de sangue para a cirurgia. Métodos Foram levantados os prontuários de 172 pacientes idosos submetidos a tratamento cirúrgico de fratura proximal do fêmur. Os dados relativos a sexo, idade, nível pré-operatório de hemoglobina, diagnóstico e tipo de cirurgia foram testados para a verificar a existência de correlação com a transfusão sanguínea. Determinamos o número de unidades reservadas de concentrado de hemácias, o índice de transfusão e a razão prova cruzada:transfusão em nossa casuística, e fizemos os mesmos cálculos em uma situação hipotética em que a solicitação de reserva de sangue para a nossa amostra seguisse os critérios de um protocolo definido. Resultados Encontramos correlação entre a classificação da American Society of Anesthesiologists (ASA) e a ocorrência de transfusão, e correlação inversa entre o nível de hemoglobina de entrada e o número de bolsas transfundidas. Foi solicitada reserva de 328 unidades de concentrado de hemácias para 167 cirurgias. Caso se tivesse aplicado o protocolo proposto, teriam sido solicitadas 72 unidades para 61 cirurgias. Conclusão Encontramos correlação entre as variáveis classificação da ASA e nível pré-operatório de hemoglobina e a ocorrência de transfusão. A aplicação de um protocolo proposto para decidir entre a solicitação de reserva e apenas a tipagem para indivíduos idosos que serão submetidos a tratamento cirúrgico de fratura do quadril mostrou-se adequada para diminuir o número de reservas de concentrado de hemácias.

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Abstract Objective Compare the number of puerperal women submitted to blood transfusion before and after the implementation of a care protocol for postpartum hemorrhage (PPH) with multidisciplinary team training. Methods Cross-sectional study in a university hospital, analyzing births from 2015 to 2019, compared the use of blood products before and after the adoption of a PPH protocol with multidisciplinary training. Results Between 2015 and 2019, there were 17,731 births, with 299 (1.7%) postpartum women receiving blood products and 278 postpartum women were considered for this analysis, 128 (0.7%) at Time 1 and 150 (0.8%) at Time 2. After the multiprofessional team training (T2), there was a difference in the complete use of the PPH protocol (use of oxytocin, misoprostol and tranexamic acid) (T1 = 5.1% x T2 = 49.5%, p≤0.0001). An individual categorized analysis revealed that, in the T2 period, there was lower use of blood component units per patient compared to T1 (Mann-Whitney, p=0.006). It should be noted that at T1 and T2, 54% and 24% respectively received two units of blood products. It is important to highlight that after the multidisciplinary team training for the PPH protocol, the goal of zero maternal death due to hemorrhage was reached. Conclusion The adoption of a specific protocol for PPH, combined with the training of a multidisciplinary team, had an impact on the ability to identify women at high risk of hemorrhage, resulting in a decrease in the use of blood components.

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Introducción: La transfusión de sangre es una terapia de reemplazo para la sangre o uno de sus componentes, dependiendo de los requerimientos del receptor. Objetivo: Describir los servicios más consumidores durante diez años. Métodos: Se realizó un estudio observacional descriptivo, transversal y retrospectivo en el Banco de Sangre del Hospital General Docente Comandante Pinares en el período comprendido de 2010 hasta el año 2020, a través del método de análisis documental, se escogieron los cinco servicios con mayores porcentajes de transfusiones, se utilizaron el cálculo porcentual, la media aritmética y la desviación estándar, así como la prueba de t de student y un nivel de significación de 5 por ciento (p< 0,05). Resultados: En los años 2010 y el 2011 las salas de medicina interna y cirugía fueron las que registraron el mayor porcentaje de transfusiones. A partir de este año se identificó que el servicio que más transfundió fue oncohematología, seguido por cirugía y medicina interna (sin diferencias entre sí), unidad de cuidados intensivos de adultos, y ortopedia, por ese orden. La tendencia fue a disminuir la cantidad de transfusiones en todos los servicios. Conclusiones: Al lograr describir los servicios más consumidores de transfusiones con tendencia a disminuir en el transcurso de los años, se permitió realizar otras investigaciones en la cuales se estudiaron los factores de riesgo que influyen en la incidencia transfusional e incluir en las variables para la confección del esquema de solicitud de sangre el motivo para la reserva, como recomienda la Organización Mundial de la Salud; además, de monitorizar, evaluar y verificar el cumplimiento de la propuesta(AU)

Introduction: Blood transfusion is a replacement therapy for blood or one of its components, depending on the recipient's requirements. Objective: To describe the most consumed services for ten years. Methods: A descriptive, cross-sectional and retrospective observational study was carried out in Comandante Pinares Blood Bank at General Teaching Hospital from 2010 to 2020 through the documentary analysis method. The five services with the highest percentages of transfusions were chosen. The percentage calculation, the arithmetic mean and the standard deviation were used, as well as the Student's t test and a significance level of 5percent (p< 0.05). Results: In 2010 and 2011, the highest percentage of transfusions were recorded at the internal medicine and surgery wards. From that year on, it was identified that oncohematology was the service that transfused the most, followed by surgery and internal medicine (with no differences between them), adult intensive care unit and orthopedics, correspondingly. The trend was to decrease the number of transfusions in all services. Conclusions: By being able to describe the services that consume most transfusions with a tendency to decrease over the years, it was possible to carry out other investigations in which the risk factors which influence the transfusion incidence were studied. Also it allows to include the reason for the reservation of blood in the variables for preparing those blood request schemes, as recommended by the World Health Organization, in addition to monitoring, evaluating and verifying compliance with the proposal(AU)

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Introducción: Las características de los donantes de sangre pueden variar entre centros de hemoterapia y pueden relacionarse con la seropositividad de marcadores infecciosos. Objetivo: Relacionar la seropositividad de marcadores infecciosos con los factores demográficos de los donantes de sangre peruanos. Métodos: Estudio observacional en los bancos de sangre del hospital nacional Cayetano Heredia y el Instituto Nacional Materno Perinatal durante el año 2019. La población la conformaron los 11 936 donantes que fueron tamizados para 7 agentes infecciosos según el Programa Nacional de Hemoterapia y Banco de Sangre. Se usó la prueba de correlación de Pearson para determinar la asociación entre las variables demográficas con los marcadores infecciosos. Resultados: Del total 8449 (70,8 por ciento) fueron varones y el grupo etario de 35 a 55 años fue el más frecuente en ambos hospitales (~ 44,5 por ciento). La mayoría de donantes procedían de la costa (4944; 41,4 por ciento), aunque en el Hospital Nacional Cayetano Heredia hubo 734 (8,9 por ciento) de la selva. La seropositividad fue de 507 (4,25 por ciento) donaciones; los más frecuentes fueron el antígeno del core del virus de Hepatitis B, los anticuerpos contra el virus linfotrópico de células T humanas 1-2, y sífilis, con 51,2 por ciento, 16,8 por ciento y 14,9 por ciento, respectivamente. La seropositividad de los marcadores infecciosos se asoció con factores demográficos como la edad, sexo y lugar de procedencia (p< 0,05). Conclusiones: Existe relación entre los factores demográficos con la seropositividad de los marcadores infecciosos en donantes peruanos(AU)

Introduction: The characteristics of blood donors may vary between hemotherapy centers and may be related to the seropositivity of infectious markers. Objective: To related the seropositivity of infectious markers with the demographic factors of Peruvian blood donors. Methods: Observational in the blood banks of the Hospital Nacional Cayetano Heredia and the Instituto Nacional Materno Perinatal during 2019. The population consisted of 11,936 donors who were screened for the seven infectious agents according to the National Hemotherapy and Blood Bank Program. Pearson's correlation test was used to determine the association between demographic variables and infectious markers. Results: Of the total, 8,449 (70.8 percent) were male and the age group from 35 to 55 years was the most frequent in both hospitals (~ 44.5 percent). Most donors came from the coast (4,944; 41.4 percent), although at the Cayetano Heredia National Hospital, there were 734 (8.9 percent) from the jungle. Seropositivity was 507 (4.25 percent) donations, then most frequent was Hepatitis B virus core antigen, antibodies against human T-cell lymphotropic virus 1-2, and syphilis, with 51.2 percent, 16.8 percent, and 14.9 percent, respectively. Seropositivity of infectious markers was associated with demographic factors such as age, gender, and place of origin (p< 0.05). Conclusions: There is a relationship between demographic factors with the seropositivity of infectious markers in Peruvian donors(AU)

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Introduction: External quality assessment is a crucial component in ensuring the quality of blood transfusion testing laboratories. Objectives: To develop a procedure for generating external quality assessment items for blood transfusion testing to evaluate participants' performance. Methods: Experimental research was conducted at Quality Control Center for Medical laboratory- University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. Three items, including red blood cell, serum, and atypical antibody serum samples, were assessed for homogeneity and stability; 5 assessment areas, including ABO grouping, Rh grouping, compatible cross matches, Coombs test, and screening of atypical antibodies, were utilized to evaluate the performance of 38 participants in the 2020-2021 period. Results: Red blood cell and serum samples maintained quality for a specific period at controlled temperatures, while serum samples with atypical antibodies showed stability at different temperatures. The participants demonstrated high satisfactory performance in ABO grouping, Rh grouping, Coombs test, and screening for atypical antibodies. However, the most unsatisfactory performance was reported in crossmatching, with 15 percent of participants unsatisfactory results. Conclusion: The procedure of production of proficiency testing items has been successfully developed, and its application at the national level is suggested to improve the quality of blood transfusion laboratories(AU)

Introducción: La evaluación externa de calidad es esencial para asegurar la calidad de los laboratorios de pruebas de transfusión sanguínea. Objetivos: Desarrollar un procedimiento para generar elementos de evaluación externa de calidad y evaluar el rendimiento de los participantes en pruebas de transfusión sanguínea. Métodos: Estudio experimental realizado en el Centro de Control de Calidad para Laboratorios Médicos de la Universidad de Medicina y Farmacia en la Ciudad de Ho Chi Minh, Vietnam. Se evaluaron muestras de glóbulos rojos, suero y suero con anticuerpos atípicos para homogeneidad y estabilidad. Se utilizaron 5 áreas de evaluación, incluida la agrupación ABO, la agrupación Rh, las coincidencias cruzadas compatibles, la prueba de Coombs y la detección de anticuerpos atípicos, para evaluar el desempeño de 38 participantes, en el período 2020-2021. Resultados: Las muestras de glóbulos rojos y suero mantuvieron la calidad durante un período específico a temperaturas controladas, mientras que las muestras de suero con anticuerpos atípicos mostraron estabilidad a diferentes temperaturas. Los participantes obtuvieron un alto rendimiento en algunas áreas, como la agrupación ABO y Rh, la prueba de Coombs y la detección de anticuerpos atípicos. Sin embargo, las pruebas de compatibilidad reportaron un rendimiento insatisfactorio en un 15 por cientode los participantes. Conclusión: El procedimiento desarrollado cumple con los criterios de calidad, y se sugiere su aplicación a nivel nacional para mejorar la calidad de los laboratorios de transfusión sanguínea(AU)

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A Organização Mundial de Saúde estima que aproximadamente 30% das mulheres na menacme apresentam anemia ferropriva, com implicações significativas para a saúde e a qualidade de vida delas. A anemia é definida com base nos níveis de hemoglobina e pode variar em gravidade. Essa condição resulta em comprometimento da capacidade de transporte de oxigênio, exigindo mecanismos compensatórios do organismo. Além disso, pacientes que enfrentam perda sanguínea aguda e crônica e distúrbios hemorrágicos estão em risco elevado de desenvolver anemia. O Programa Patient Blood Management (PBM) surge como uma abordagem centrada no paciente, enfocando deficiência de ferro, anemia, coagulopatia e perda de sangue. O Patient Blood Management propõe a otimização da gestão do sangue do paciente, evitando transfusões desnecessárias e promovendo uma abordagem mais conservadora. Este artigo aborda a relevância da deficiência de ferro durante a gestação e a menacme, bem como as estratégias de tratamento no período pré-operatório. A suplementação de ferro, seja por via oral ou endovenosa, é fundamental para tratar a anemia ferropriva, enquanto as hemotransfusões são reservadas para casos mais graves. A abordagem sistemática da anemia é crucial para garantir melhores desfechos em cirurgias ginecológicas e no período gestacional. A suplementação de ferro, principalmente via intravenosa, surge como uma opção terapêutica eficaz e rápida, enquanto a hemotransfusão, apesar de útil em situações específicas, apresenta riscos associados que devem ser cautelosamente avaliados.

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Introduction: The rates of request and use of blood concentrates are still poorly reported in the literature. This study aimed to analyze the rates of requests for blood concentrates and their use in patients undergoing emergency surgery in a teaching hospital. Methods: A retrospective, quantitative and descriptive study was conducted in 359 medical records of patients in urgent surgery scheduled with a request for a reserve of blood concentrate. The ratios between crossmatched and transfused units (C/T), transfusion index (TI), and probability (TP) were calculated, and the times between request and delivery at the transfusion agency (TA) and patient admission to the surgical center (SC). Results: The mean age was 58.5 ± 22.2 years, with the majority being male (53.1%). There was an average of 27.5 monthly requests (min 12, max 44). Ninety-seven units of blood concentrates were transfused into 44 patients (C/T ratio 7.59; TI 0.27; TP 12.3%). Only seven patients had their requests made after admission to the OR. The median time between the request and arrival at the TA was 1h15min, while that between the request and the patient's arrival at the SC was 5h23min. There was greater transfusion in major surgery (major 37, 14.8% vs. medium 7, 6.5%; p = 0.027) and non-orthopedic surgery (orthopedic 9, 4.0% vs. non-orthopedic 35, 26.9%; p < 0.001). Conclusion: there was a significant discrepancy between the number of requests for blood reservation and its real use and an increased time between reservation requests and their arrival at the TA.

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O objeto deste estudo é a comunicação proxêmica da equipe da enfermagem ao longo do procedimento transfusional em clientes na hemoterapia. Para sua realização, foram estabelecidos os seguintes objetivos: (I) identificar na comunicação da equipe de enfermagem os fatores proxêmicos que influenciam no cuidado de clientes ao longo do procedimento transfusional na hemoterapia; (II) analisar como essa comunicação com os clientes determina os cuidados ao longo do procedimento; (III) discutir a dimensão sensível e técnica do cuidado de enfermagem ao longo do procedimento transfusional. O método empregado foi o qualitativo, exploratório, descritivo e observacional. O cenário foi um hemocentro localizado na região Sudeste do Brasil. Participaram sete enfermeiros e 18 técnicos de enfermagem responsáveis pelos cuidados aos clientes na hemoterapia. A coleta de dados aconteceu em três momentos e contou com a observação individual, registro dos fatores proxêmicos descritos por Hall (2005) e entrevista gravada em meio magnético. O projeto foi provado pelo comitê de ética do município do Rio de Janeiro, com número 4.376.390, conforme preconizado pela resolução 466/12. O tratamento e análise dos dados se deram a partir da análise temática de conteúdo. Destes, emergiram três categorias, seguidas de suas respectivas subcategorias. Categoria I: Rastreamento proxêmico da equipe de enfermagem ao longo do procedimento transfusional; Categoria II: Os sentidos sociocomunicantes do corpo da equipe de enfermagem e clientes na hemoterapia; Subcategorias: i) Comunicação não verbal proxêmica: o contato visual da equipe de enfermagem como catalizador do cuidado ao cliente; ii) Proxêmica: sentido olfativo como condutor de sensações e emoções; iii) Proxêmica: o volume da voz como elemento afetivo do cuidado; Categoria III: A comunicação não verbal tacésica: significados, sinais e expressões corporais da equipe de enfermagem. Subcategorias: i) Significados do toque para a equipe de enfermagem ao cliente; ii) Sinais e expressões corporais não verbais na hemoterapia; e iii) Tipos de toque no cuidado da equipe de enfermagem ao longo do procedimento transfusional. Conclusão: os comportamentos proxêmicos da equipe de enfermagem ao longo do procedimento transfusional são influenciados, a todo tempo e o tempo todo, pelo espaço físico da hemoterapia. O toque e a voz foram identificados como recursos importantes para o acolhimento da equipe de enfermagem aos clientes e sua utilização requer o despertar da consciência para o potencial afetivo que possuem na hospitalização.

The object of this study is the close communication of the sick team during the entire transfusion procedure in hemotherapy clients. For its implementation, the following objectives were established: (I) to identify in the communication of the nursing team the proximal factors that influence the care of the client during the transfusional procedure in hemotherapy; (II) analyze how this communication with customers determines the attention throughout the procedure; (III) discuss the sensible dimension and the technique of nursing care in relation to the transfusion procedure. The method used was qualitative, exploratory, descriptive and observational. The stage is a blood center located in the southeastern region of Brazil. 07 nurses and 18 nursing technicians responsible for assisting clients in hemotherapy will participate. The data collection was carried out in 3 moments and included individual observation, recording of the proxemic factors described by Hall (2005) and an interview recorded on magnetic support. The project was tested by the Ethics Committee of the Municipality of Rio de Janeiro, under number 4.376.390, as recommended by resolution 466/12. The treatment and analysis of the data are derived from the thematic content. From these, three categories will appear, followed by their respective subcategories. Category I): Proxemic mapping of the nursing team during the entire transfusion procedure; Category II: The sociocommunicating senses of the body of the nursing team and the client in hemotherapy; Subcategories: i) Proxemic non-verbal communication: the visual contact of the nursing team as a catalyst for customer care; ii) Proxemics: olfactory sense as a conductor of sensations and emotions; iii) Proxemics: the volume of the voice as an affective element of care; Category III: Comprehension of tactical non-verbal communication: meanings, signs and body expressions of the nursing team. Subcategories: i) Meanings of touch for the nursing team or the client; ii) Non-verbal body signs and expressions in hemotherapy; and iii) Types of contact not attended by the nursing team during the transfusion procedure. Conclusion: the proximal behaviors of the nursing team along the transfusion procedure are influenced at all times, and at all times, by the physical space of hemotherapy. Touch and voice are identified as important resources for the nursing team to support clients, and their use requires creating awareness about the emotional potential they have during hospitalization.

El objeto de este estudio es la comunicación proxémica del equipo de enfermería durante todo el procedimiento de transfusión en clientes de hemoterapia. Para su realización se establecieron los siguientes objetivos: (I) identificar en la comunicación del equipo de enfermería los factores proxémicos que influyen en el cuidado del cliente durante el procedimiento de transfusión en hemoterapia; (II) analizar cómo esa comunicación con los clientes determina los cuidados a lo largo del procedimiento; (III) discutir la dimensión sensible y la técnica del cuidado de enfermería a lo largo del procedimiento de transfusión. El método utilizado fue cualitativo, exploratorio, descriptivo y observacional. El escenario fue un hemocentro ubicado en la región sureste de Brasil. Participaron siete enfermeros y 18 técnicos de enfermería responsables de la asistencia a los clientes en hemoterapia. La recolección de datos se realizó en tres momentos e incluyó observación individual, registro de los factores proxémicos descritos por Hall (2005) y entrevista grabada en soporte magnético. El proyecto fue aprobado por el Comité de Ética del municipio de Río de Janeiro, bajo el número 4.376.390, según lo recomendado por la resolución 466/12. El tratamiento y análisis de los datos fueron realizados a través del análisis de contenido temático. De ellos, emergieron tres categorías, seguidas de sus respectivas subcategorías. Categoría I): Rastreo proxémico del equipo de enfermería durante todo el procedimiento de transfusión; Categoría II: Los sentidos sociocomunicantes del cuerpo del equipo de enfermería y del cliente en hemoterapia; Subcategorías: i) Comunicación no verbal proxémica: el contacto visual del equipo de enfermería como catalizador de la atención al cliente; ii) Proxémica: sentido olfativo como conductor de sensaciones y emociones; iii) Proxémica: el volumen de la voz como elemento afectivo del cuidado; Categoría III: La comunicación no verbal tactésica: significados, signos y expresiones corporales del equipo de enfermería. Subcategorías: i) Significados del toque para el equipo de enfermería al cliente; ii) Signos y expresiones corporales no verbales en hemoterapia; y iii) Tipos de toque en el cuidado del equipo de enfermería durante el procedimiento de transfusión. Conclusión: los comportamientos proxémicos del equipo de enfermería a lo largo del procedimiento de transfusión son influenciados, a todo tiempo y el tempo entero, por el espacio físico de la hemoterapia. El toque y la voz fueron identificados como recursos importantes para que el equipo de enfermería apoye a los clientes, y su uso requiere crear conciencia sobre el potencial afectivo que tienen durante la hospitalización.

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According to the World Health Organization, trauma from external causes remains the major cause of death and disability among people aged from 5 to 29 years old.1 In order to reestablish hemodynamic stability and adequate hemostasis of these patients, without the dilutional effects of infusing large volumes of crystalloids, the concept of hemostatic resuscitation was developed.2 The purpose of this report is to discuss a case in which hemostatic resuscitation was performed quickly, resulting in a good macro-hemodynamic response of the patient at the first prehospital transfusion service in Latin America.

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Abstract Introduction Sickle cell anemia is a monogenic disorder caused by a mutation in the β-hemoglobin gene, resulting in sickle hemoglobin that can polymerize. Presentation and clinical course have significant inter-individual variability and classifying these patients for severity is a challenge. Methods We applied hierarchical clusters with 10 routine laboratory tests to understand if this grouping could be associated with clinical manifestations. We included 145 adult homozygous patients (SS) at an outpatient clinic in a retrospective study. Results We found five clusters by counting those that had been differentiated by unconjugated bilirubin, reticulocytes, LDH, leukocytes, lymphocytes and monocytes. When comparing groups to clinical findings, the clusters were different only for liver abnormality. Cluster 3 had the lower median of reticulocytes, LDH, leukocytes, lymphocytes and monocytes and a higher percentage of patients under treatment. Clusters 4 and 5 had higher frequencies of liver impairment and higher medians of reticulocytes, LDH, leukocytes, lymphocytes and monocytes. Hemolysis and inflammation seemed to influence the grouping. Conclusion In our study, cluster analysis showed five groups that exhibited different degrees of inflammation and hemolysis. When comparing clinical data, the result was different only for the criteria of liver abnormality.

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El acceso universal a las transfusiones de sangre depende de diversos factores localizados dentro y fuera de los servicios de salud. Motivados por ser este un tema infrecuente, el trabajo tiene el objetivo de analizar desde una perspectiva multidimensional y holística los determinantes externos de la disponibilidad de sangre para las transfusiones. El desarrollo socioeconómico constituye un importante factor dinamizador porque condiciona, de cierta manera, la infraestructura del sistema sanitario e incide sobre los factores epidemiológicos, sociodemográficos y jurídicos. A su vez, estos influyen en la organización de las actividades y la complejidad de la asistencia sanitaria, factores que otorgan un sentido positivo o negativo a la disponibilidad de sangre. Tomarlos en consideración al diseñar las políticas de salud relacionadas con el uso de la sangre permite una mayor precisión en las intervenciones locales que contribuyan a mejorar la seguridad de las transfusiones(AU)

Universal access to blood transfusions depends on a number of localized factors both inside and outside health services. Motivated by being an infrequent topic, this work aims to analyze from a multidimensional and holistic perspective the external determinants of the availability of blood for transfusions. Socio-economic development is an important dynamic factor because it conditions, in a certain way, the infrastructure of the health system and affects epidemiological, sociodemographic and legal factors. In turn, these influence the organization of activities and the complexity of health care, factors that give a positive or negative meaning to the availability of blood. Taking them into consideration when designing health policies related to the use of blood allows greater precision in local interventions that contribute to improving the safety of transfusions(AU)

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Introduction: Sexually transmitted infections (STIs) are a serious public health problem, and some of these infections are also transmitted through blood transfusions. Objective: To identify publications in scientific journals in Brazil and in the world showing if there is an important association between serological inadequacy due to sexually transmitted infections traced in blood and blood products used for medical use. Methods: Systematic review of articles published from 2018 to 2023, using the LILACS, SciELO and PubMed databases, with a concomitant approach to the issues of serological disability and STI. Original studies or review articles in Portuguese, English and Spanish with Brazilian and international data were included. Editorial publications, letter to the editor, letter from the editor or comments on the subject were excluded. Results: The search found 571 articles, of which 106 (18.40%) met the inclusion criteria, that is, Serological disability and STI. In studies with international data, the prevalence of donors with hepatitis C ranged from 0.12 to 4.8%; with hepatitis B, from 1.3 to 8.2%; with HIV, from 0.0021 to 2.5%; with syphilis, from 1.73 to 2.4%; with HTLV, 0.66%; and with Chagas disease, from 0.017 to 2.76%. Among articles with Brazilian data, the prevalence of donors with seroreactive tests for hepatitis C ranged from 0.18 to 1.76%; with hepatitis B, from 0.05 to 7.9%; with HIV, from 0.03 to 0.82%; with syphilis, from 0.37 to 3.51%; with HTLV, from 0.02 to 0.3%, and with Chagas disease, from 0.8 to 0.5%. Conclusion: STIs are rarely discussed in the scientific literature in studies on serological inadequacy. In addition, a minority of articles were with Brazilian data. However, results show that STIs, despite being little discussed in the scientific literature in studies on the subject of serological inadequacy, have statistically significant percentages of seropositivity for STIs. Moreover, hepatitis C and B have a relevant seroprevalence, reaching 8.2% and 4.8%, respectively, in the international scenario. In Brazil, hepatitis B continues to occupy a prominent place with a seroprevalence of up to 7.9%. However, syphilis now holds a very important role, with a maximum percentage of 3.51%. More studies are needed for further reflection: although STIs are little addressed in studies about serological inadequacy in human blood banks, would they contribute to the maintenance and non-reduction of the general frequency of infections transmitted by blood transfusion

Introdução: As infecções sexualmente transmissíveis (IST) são um grave problema de saúde pública e algumas dessas infecções, também, transmitidas por intermédio de transfusões de sangue. Objetivo: Identificar publicações em periódicos científicos no Brasil e no mundo sobre se existe importante associação entre inaptidão sorológica por infecções sexualmente transmissíveis rastreadas em sangue e hemoderivados usados para uso médico. Métodos:Revisão sistemática de artigos publicados no período de 2018 a 2023, usando as bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Scientific Electronic Library Online (SciELO) e United States National Library of Medicine (PubMed) com abordagem concomitante para os assuntos de inaptidão sorológica e IST. Incluíram-se estudos originais ou artigos de revisão nos idiomas português, inglês e espanhol com dados brasileiros e internacionais. Foram excluídas publicações do tipo editorial, carta ao editor, carta do editor ou comentários sobre o tema. Resultados:A busca localizou 571 artigos dos quais 106 (18,40%) se encaixavam nos critérios de inclusão, ou seja, inaptidão sorológica e IST. Em estudos com dados internacionais, a prevalência de doadores com hepatite C variou de 0,12 a 4,8%; com hepatite B de 1,3 a 8,2%; com HIV de 0,0021 a 2,5%; com sífilis de 1,73 a 2,4%; com HTLV 0,66%; e com doença de Chagas de 0,017 a 2,76 %. Já entre os artigos com dados brasileiros, a prevalência de doadores com exames soro-reatores para hepatite C variou de 0,18 a 1,76%; com hepatite B de 0,05 a 7,9%; com HIV de 0,03 a 0,82%; com sífilis de 0,37 a 3,51%; com HTLV 0,02 a 0,3%, e com doença de Chagas de 0,8 a 0,5%. Conclusão: As IST são pouco abordadas na literatura científica em estudos com o tema inaptidão sorológica. Além disso, uma minoria de artigos era com dados brasileiros. Entretanto, resultados demonstram que, apesar de pouco abordadas na literatura científica em estudos com o tema inaptidão sorológica, as IST possuem percentuais de soropositividade estatisticamente significativos. Além disso, as hepatites C e B possuem soroprevalência relevante, podendo chegar a 8,2 e 4,8%, respectivamente, no cenário internacional. Já no cenário nacional, brasileiro, a hepatite B continua ocupando um lugar de destaque, com soroprevalência de até 7,9%. Todavia, a sífilis passa a ocupar um papel de altíssima relevância, com percentual máximo de 3,51%. São necessários mais estudos para mais reflexão: apesar de as IST serem pouco abordadas em estudos acerca da inaptidão sorológica em bancos de sangue humano, seriam elas contribuintes para a manutenção e a não redução da frequência geral de infecções transmitidas por transfusão sanguínea?

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OBJECTIVE@#To investigate the distribution of irregular blood group antibodies in patients with malignant tumors, and to analyze the relationship between it and efficacy of blood transfusion in patients.@*METHODS@#5 600 patients with malignant tumors treated in Shanxi Bethune Hospital from January 2019 to December 2021 were selected as the research subjects. All patients received blood transfusion, and cross matching test was conducted before blood transfusion, irregular antibody results of patients were tested; the irregular distribution of blood group antibodies was observed, and the relationship between it and efficacy of blood transfusion in patients was analyzed.@*RESULTS@#Among 5 600 patients with malignant tumors, 96 cases were positive for irregular antibody, and the positive rate was 1.71%; the main blood group systems involved in the irregular antibody positive of 96 patients with malignant tumors were RH, MNSs and Duffy system, among which Rh blood group was the most common, and the proportion of anti-E was the highest; among the malignant tumor patients with positive blood group irregular antibody, the proportion of female was higher than that of male; the proportion of patients aged >60 years was the highest, followed by patients aged >40 and ≤50 years, and the proportion of patients aged 18-30 years was the lowest; the patients with positive blood group irregular antibody were mainly in blood system (including lymphoma), digestive system, reproductive and urinary system; the positive rate of irregular antibody of patients in the ineffective group was higher than that of patients in the effective group, the difference was statistically significant (P<0.05). Logistic regression analysis results showed that, irregular antibody positive was a risk factor for ineffective blood transfusion in patients with malignant tumor (OR>1, P<0.05).@*CONCLUSION@#The irregular blood group antibody positive of patients with malignant tumor are mostly female, and the proportion of patients aged >60 is the highest, which is mainly distributed in malignant tumors of blood system, digestive system and urogenital system, and the positive blood group irregular antibody is related to the efficacy of blood transfusion in patients.

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OBJECTIVE@#To investigate a family with congenital dysfibrinogenemia, and analyze the risk of hemorrhage and thrombosis and blood transfusion strategies.@*METHODS@#Prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) of the proband and her family members were detected by automatic coagulometer, fibrinogen (Fg) activity and antigen were detected by Clauss method and PT algorithm respectively. Meanwhile, thromboelastometry was analyzed for proband and her family members. Then, peripheral blood samples of the proband and her family members were collected, and all exons of FGA, FGB and FGG and their flanks were amplified by PCR and sequenced to search for gene mutations.@*RESULTS@#The proband had normal APTT and PT, slightly prolonged TT, reduced level of Fg activity (Clauss method). The Fg of the proband's aunt, son and daughter all decreased to varying degrees. The results of thromboelastogram indicated that Fg function of the proband and her family members (except her son) was basically normal. Gene analysis showed that there were 6233 G/A (p.AαArg35His) heterozygous mutations in exon 2 of FGA gene in the proband, her children and aunt. In addition, 2 polymorphic loci were found in the family, they were FGA gene g.9308A/G (p.AαThr331Ala) and FGB gene g.12628G/A (p.BβArg478Iys) polymorphism, respectively. The proband was injected with 10 units of cryoprecipitate 2 hours before delivery to prevent bleeding, and no obvious bleeding occurred during and after delivery.@*CONCLUSION@#Heterozygous mutation of 6233G/A (p.AαArg35His) of FGA gene is the biogenetic basis of the disease in this family with congenital dysfibrinogenemia.