The Use of Quadruple Blood Bags Transfusion of Low Birth Weight Neonates

PURPOSE: Low-birth-weight(LBW) neonates often need multiple transfusions during their neonatal period. The routine use of the 500ml mono-bag system in Korea, even in neonatal transfusions, results in a great waste of blood and exposes the neonate to multiple blood donors. To reduce the waste of blood and the number of exposures, we used quadruple blood bags in the transfusion of LBW neonates. METHODS: From November 1995 to April 1997, 86 neonates weighing less than 2,000gm were enrolled in this study. Forty-four of those neonates needed blood transfusions. Using quadruple blood bags, we were able to safely make 3 units of packed red blood cell(RBC) from each directed donors. RESULTS: Seventy-seven units of packed RBC could be made from 29 directed donors and 58 of those units were actually transfused to the 25 neonates. Blood age of the directed donor blood prepared in the quadruple blood bags were relatively older than those of bank bloods at the time of transfusion, thus, K+ concentration was higher but the total K+ amounts infused through transfusions were within tolerable ranges in both groups. CONCLUSION: Using quadruple blood bag in the transfusion of LBW neonates, we could reduce the number of donor exposures and also the waste of blood. K+ loads to the neonates through the transfusion of directed donor blood were within tolerable range in the neonatal physiology.

Differences of Incidence and Severity of Sore Throat and Hoarseness between the Methods of Airway Security / 대한구급학회지

Introduction: The sore throat and hoarseness are common complications during the postoperative period. We investigated differences of incidence and severity of sore throat and hoarseness according to methods of airway security. METHODS: One hundred twelve patients, in ASA physical status class 1~2, were included in this study (58 males and 54 females). They were divided into three groups: group 1 (n=42), intubated with endotracheal tube lubricated with normal saline; group 2 (n=40), intubated with endotracheal tube lubricated with 5% lidocaine ointment; group 3 (n=30), inserted with laryngeal mask airway (LMA) for airway security. RESULTS: The incidence of sore throat and hoarseness were 78.6% and 54.8% in group 1, 35% and 30% in group 2, and 33.3% and 20.0% in group 3. CONCLUSIONS: Both 5% lidocaine-lubricated endotracheal tube and laryngeal mask airway showed tendency of decreased incidence of postoperative sore throat and hoarseness but there are no statistical significance.

Pulmonary Aspergillosis in Cardiac Transplant Patients: The Report of Two Cases / 대한흉부외과학회지

Aspergillus Infection is a major cause of mortality in individuals with depressed cell-mediated immunity. Despite therapy with intravenous amphotericin B and oral antifungal agents, high mortality has been reported among heart transplant recipients. We experienced two cases of pulmonary aspergillosis among 15 cases of heart transplantation cases. Both cases were similiar in terms of age, time of diagnosis, diagnosis, and medication. Percutaneous needle aspiration biopsy revealed Aspergillus fumigatus in both cases. The first case showed multiple aspergilloma on both lung fields and were treated by IV Amphotericin B and oral itraconazole. After completion of treatment, the lesion completely disappeared and he has been followed up for more than one year in his good condition. The second case showed a single nodule on his right lower lung field and were treated by both medication and surgery. The patient recovered well and had been doing well until 4th postoperative month when he developed humoral rejection and expired.

A Family with -D- Phenotype Associated with Fatal Hemolytic Disease of the Newborn / 대한수혈학회지

-D- is a very rare haplotype which determines D without C, c, E or e and exalted D activity. The extremely rare homozygote propositi(-D-/-D-) are usually ascertained through their immune antibodies which react with red cells of all common Rh phenotypes. Authors experienced a woman with -D- phenotype for the first time in Korea. She had a history of abortion and intrauterine fetal death. She delivered a baby with severe hemolytic disease of the newborn at the third pregnancy. In spite of intensive medical interventions, the baby died of hydrops fetalis. An immune antibody to high incidence Rh antigen, namely anti-Hro, was demonstrated in the woman's serum. Family study revealed that all of the family had -D- gene complex and one of her sisters also was -D-homozygote. The sister also had anti-Hro in the serum.

A Case of Hernolytio Disease of the Newborn due to Anti-Dib Antibody / 대한수혈학회지

The Di(a+b-) phenotype is extremely rare among Caucaclans and mostly confined to mongoloids. The incidences of Di antigen among Koreans were reported to be 6.1 to 14.5%, with an average of 9.6%; it can be calculated that the frequency of Di(a+b-) is 0.25% on the average. Authors report the first case of hemolytic disease of the newborn due to anti-Dib in Korea. The Diego phenotypes of the mother, baby and father were Di(a+b-), Di(a+b+) and Di (a-b+), respectively. The mother's serum and eluate from infant's erythrocytes contained anti-DP antibody active in the antiglobulin phase. After transfusions of Di-negative red cells from the mother and mother's relative, the patient was recovered from anemia and jaundice.