[ effect of cool dialysate on intradiaytic hypotension among end stage renal disease patients]

Hypotension is the most frequent adverse event during hemodialysis. Cool dialysate is a simple and cost effective measure in treating intradialytic hypotension by stabilization of core body temperature. This study was designed to find out the effects of cool dialysate on the frequency of intradialytic hypotension, presenting symptoms and intervention measures used for patients undergoing hemodialysis In this randomized cross-over clinical trial, patients with intradialytic hypotension were detected based on the pre-defined inclusion criteria. Then, they were randomly assigned to treatment [cool dialysate] and control [conventional dialysis] groups. After 1 month, they crossed over as control and treatment groups. Data analysis [paired t-test] revealed that cool dialysate was associated with decrease in frequency of hypotension and number of interventions while improving symptoms and an increment in systolic and diastolic blood pressure. Cool dialysate is an effective tool in maintaining intradilaytic hemodynamic stability, alleviating symptoms of hypotension and the interventions applied for intradialysate hypotension. Therefore, cool dialysate is recommended in hemodialysis patient

Performance of hospital blood transfusion committees in Tehran [2005-2006]

Hospital blood transfusion committees supervise blood transfusion in hospitals. These committees could save time and cost by prevention of blood loss. This study was conducted to assess the performance of hospital blood transfusion committees in Tehran in 2005-2006. In this retrospective study, 46 reports from 13 hospitals [9 community and 4 private] being sent to Tehran Blood Transfusion Center in 2005-2006 were assessed. All reports were assessed from the perspective of duties entrusted by Iranian Ministry of Health. These duties were classified as [1] report of blood transfusion complications, [2] statistical report of blood transfusions, [3] statistical report of blood orders from different wards of hospitals, [4] report of blood transfusion indications, [5] report of educational programs, and [6] assessment of personnel problems and equipment of blood banks. Report of blood transfusion complications [77%] and report of blood transfusion indications [23%] were the most and the least reported duties, respectively. The most and the least relative frequencies for all hospitals, community, and private hospitals were 23%-77%, 33%-78% and 0%-75%, respectively. Committee reports in community hospitals were better than private ones, though the difference was not statistically significant [p>0.05]. Cross match to transfusion ratio was considerable only in one hospital [3.05]. This study showed that reports of hospital blood transfusion committees in Tehran in 2005-2006 are in a relatively poor condition. This condition in private hospitals was worse than community ones. More focus on reports of blood transfusion indications seems to be necessary. Since cross match to transfusion ratio is an important performance indicator for hospitals, it should receive a higher level of attention of hospital committees