Change of the Disposal and the Cancellation Ratio after Enforcement of a Precedent Antibody Screening Test / 대한수혈학회지

BACKGROUND: In the clinical setting, for convenience of transfusion, blood is requested in advance, even though 'the type and screen' method has been used for the efficient supply of blood. We employed the precedent antibody screening test method for all patients who were scheduled for surgery, and compared the disposal rate and the clear rate pre and post-activity. METHODS: We evaluated the disposal rate and the cancellation ratio before and after employment of the precedent antibody screening test method for all patients expected to undergo surgery. A comparison of the frequency and type of side effects of transfusion was also performed. RESULTS: The disposal rate and the cancellation ratio showed a decrease, from 1.48% to 1.29%, and from 17.0% to 11.0%. No significant change was observed in the cause of disposal and the side effects of transfusion. CONCLUSION: Enforcement of a precedent antibody screening test resulted in a decrease in the disposal and clear rates. In addition, it aided in reduction of the amount of work performed at the blood bank by establishing the proper utilization of blood and reducing unnecessary cross match testing. There appears to be no problem regarding the stability of transfusion. However, for the sample showing a positive result on the antibody screening test, an effort to decrease the side effects of transfusion, such as exhaustive cross-matching and increasing the rate of identification, would be needed.

Change of the Disposal and the Cancellation Ratio after Enforcement of a Precedent Antibody Screening Test / 대한수혈학회지

BACKGROUND: In the clinical setting, for convenience of transfusion, blood is requested in advance, even though 'the type and screen' method has been used for the efficient supply of blood. We employed the precedent antibody screening test method for all patients who were scheduled for surgery, and compared the disposal rate and the clear rate pre and post-activity. METHODS: We evaluated the disposal rate and the cancellation ratio before and after employment of the precedent antibody screening test method for all patients expected to undergo surgery. A comparison of the frequency and type of side effects of transfusion was also performed. RESULTS: The disposal rate and the cancellation ratio showed a decrease, from 1.48% to 1.29%, and from 17.0% to 11.0%. No significant change was observed in the cause of disposal and the side effects of transfusion. CONCLUSION: Enforcement of a precedent antibody screening test resulted in a decrease in the disposal and clear rates. In addition, it aided in reduction of the amount of work performed at the blood bank by establishing the proper utilization of blood and reducing unnecessary cross match testing. There appears to be no problem regarding the stability of transfusion. However, for the sample showing a positive result on the antibody screening test, an effort to decrease the side effects of transfusion, such as exhaustive cross-matching and increasing the rate of identification, would be needed.

Evaluation of the Analytical Performance of NOVA StatStrip(R) Blood Glucometer in a Peritoneal Dialysis Setting / 임상검사와정도관리

BACKGROUND: The use of point of care glucometer is widely established. However, the reliability of glucometer can vary according to the type of patients tested. Chemical interference with some current glucometer has been observed in patients undergoing peritoneal dialysis. StatStrip(R) (Nova Biomedical, USA) has been designed to compensate for this interference effect. So we compared the analytic performance and interference response of StatStrip(R) to two conventional glucometers. And we also evaluated the interference response with samples in patients undergoing peritoneal dialysis. METHODS: StatStrip(R) and two other glucometers were compared for linearity, imprecision, correlations with Advia 2400(TM) (Bayer Diagnostics, USA). Interference by lactate, maltose, were evaluated. Interferences in 20 samples of patients undergoing peritoneal dialysis were also evaluated. RESULTS: The coefficients of variation (CVs) of within-run precision were 1.70-3.77% and CVs of total precision were 1.98-3.99%. The linearity was R2=0.9776-0.988 (P<0.001). High correlation was found in each glucometer and the Advia 2400(TM). But all the glucometers showed a variable positive or negative bias compared with reference method. Including samples of patients undergoing peritoneal dialysis, maltose did not significantly influence the glucose concentration in StatStrip(R) and one of the conventional glucometers within 20% difference range. Lactate and hematocrit did not significantly influence the glucose concentration in all glucometers. CONCLUSIONS: StatStrip(R) shows good linearity, precision, correlation with the reference method and shows minimal interference effects. Our results indicate that StatStrip(R) also has clinical reliability when used in a peritoneal dialysis setting.

Cytogenetic Analysis of Amniotic Fluid, CVS, and Abortus in a University Hospital for Ten Years / 임상검사와정도관리

BACKGROUND: This study was conducted to analyze, compare, and assess the indications, incidences, and types of chromosomal abnormalities in the amniotic fluid, chorionic villus sampling (CVS), and abortus and to compare these with those previously reported. METHODS: The study subjects included 1,995 cases of amniocentesis and 169 cases of abortus, 20 cases of CVS, 21 cases of cord blood, and 2 cases of cardiac-puncture fluid in the last ten years (June 1999 to May 2009). RESULTS: Among the indications, the maternal serum and triple/quad markers testing positive emerged the highest (57.5%). Other factors those were found were an advanced maternal age (over35) (19.5%) and abnormal ultrasonography findings (8.2%). The frequency of chromosomal abnormality in the amniotic fluid was 4.5%, wherein the numerical abnormality was 3.1% and the structural abnormality was 1.4%. Among the numerical abnormalities, trisomy of chromosome 21 emerged the highest (1.4%). The frequency of the chromosomal abnormality of CVS and abortus was 39.1%, the numerical abnormality was 23.7%, and the order of frequency for trisomy was obtained chromosomes 16, 22, and 21. In the sex ratio of the normal chromosomes, it was 1.1%, but it resulted in 0.5% in CVS. CONCLUSIONS: The results of this chromosomal study on amniotic fluid, CVS, and abortus could serve as useful data regarding the prenatal genetic abnormalities of fetuses and for genetic consultation.

Evaluation of an Automatic Cancellation Program to Reduce Wastage of Blood Components / 대한수혈학회지

BACKGROUND: Ordering an excessive quantity of blood for elective surgery beyond the actual need causes unnecessary cross-matching and wastage or shortage of blood products. To prevent this problem, a maximum surgical blood order schedule (MSBOS) is beneficial. However, the application of a MSBOS is limited due to the complexity of accurate classification based on the name of the operation alone. In this study, we introduced an automatic cancellation program, in which the assigned blood is automatically cancelled after a certain period of time, andevaluated the practicality of a revised MSBOS. METHODS: We analyzed our hospital data involving transfused RBCs for each elective surgical procedure performed between January and June 2007. The MSBOS was organized based on the average number of units of RBCs transfused for the types of surgeries that had been performed >50 times during a certain period of time. The blood cancellation ratio, blood wastage ratio, and the causes of blood wastage were compared before and after adopting the automatic cancellation program and the revised MSBOS. RESULTS: After adopting the automatic cancellation program, the blood cancellation ratio decreased from 18.3% to 17.6% and the blood wastage ratio decreased from 2.67% to 2.00%. There was no significant change with respect to the causes of blood wastage before and after adoption of the automatic cancellation program. CONCLUSION: The implementation of an automatic cancellation program facilitates the efficient use of blood products during elective surgery. It would be useful to apply a revised MSBOS continuously, which is easily applicable and practical in order to decrease the blood wastage rate.