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1.
Transfusion ; 62 Suppl 1: S193-S202, 2022 08.
Article in English | MEDLINE | ID: covidwho-1901871

ABSTRACT

BACKGROUND: To increase preparedness and mitigate the risk of platelet shortage without increasing the number of collections, we introduced a dual platelet inventory with cold-stored platelets (CSP) with 14-days shelf life for actively bleeding patients during the COVID-19 pandemic. STUDY DESIGN AND METHODS: We collected apheresis platelet concentrates with blood type O or A. All patients receiving CSP units were included in a quality registry. Efficacy was evaluated by total blood usage and laboratory analysis of platelet count, hemoglobin, and TEG 6s global hemostasis assay. Feasibility was evaluated by monitoring inventory and a survey among laboratory staff. RESULTS: From 17 March, 2020, to 31 December, 2021, we produced 276 CSP units and transfused 186 units to 92 patients. Main indication for transfusion was surgical bleeding (88%). No transfusion reactions were reported. 24-h post-transfusion patient survival was 96%. Total outdate in the study period was 33%. The majority (75%) of survey respondents answered that they had received sufficient information and training before CSP was implemented. Lack of information about bleeding status while issuing platelets, high workload, and separate storage location was described as main reasons for outdates. DISCUSSION: CSP with 14-days shelf life is a feasible alternative for the treatment of patients with bleeding. Implementation of a dual platelet inventory requires thorough planning, including information and training of clinical and laboratory staff, continuous follow-up of practice and patients, and an easy-to-follow algorithm for use of CSP units. A dual platelet inventory may mitigate the risk of platelet shortage during a pandemic situation.


Subject(s)
Blood Component Removal , COVID-19 , Blood Platelets , Blood Preservation , COVID-19/therapy , Hemorrhage/therapy , Humans , Pandemics , Platelet Transfusion , Tertiary Care Centers
2.
Transfusion ; 60(12): 2793-2800, 2020 12.
Article in English | MEDLINE | ID: covidwho-755264

ABSTRACT

Civilian and military guidelines recommend balanced transfusion to patients with life-threatening bleeding. Early start of transfusion has shown improved survival. Thus, a balanced blood inventory must be available in all levels of health care to ensure early stabilization and damage control resuscitation of patients with bleeding. Whole blood has been reintroduced as a blood product for massive bleeding situations because it affords plasma, red blood cells, and platelets in a balanced ratio in a logistically advantageous way. In this article, we describe how to establish a whole blood-based blood preparedness program in a small rural hospital with limited resources. We present an implementation tool kit, which includes discussions on whole blood program strategies and the process of developing detailed procedures on donor selection, collection, storage, and transfusion management of whole blood. The importance of training and audit of the routines is highlighted, and establishment of an emergency walking blood bank is discussed. We conclude that implementation of a whole blood program is achievable in small rural hospitals and recommend that rural health care facilities at all treatment levels enable early balanced transfusion for patients with life-threatening bleeding by establishing protocols for whole blood-based preparedness.


Subject(s)
Blood Banks , Blood Component Transfusion , Donor Selection , Hemorrhage/therapy , Hospitals, Rural , Resuscitation , Hemorrhage/blood , Humans
3.
Lancet Haematol ; 7(10): e756-e764, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-624236

ABSTRACT

The COVID-19 pandemic has major implications for blood transfusion. There are uncertain patterns of demand, and transfusion institutions need to plan for reductions in donations and loss of crucial staff because of sickness and public health restrictions. We systematically searched for relevant studies addressing the transfusion chain-from donor, through collection and processing, to patients-to provide a synthesis of the published literature and guidance during times of potential or actual shortage. A reduction in donor numbers has largely been matched by reductions in demand for transfusion. Contingency planning includes prioritisation policies for patients in the event of predicted shortage. A range of strategies maintain ongoing equitable access to blood for transfusion during the pandemic, in addition to providing new therapies such as convalescent plasma. Sharing experience and developing expert consensus on the basis of evolving publications will help transfusion services and hospitals in countries at different stages in the pandemic.


Subject(s)
Betacoronavirus , Blood Banks/statistics & numerical data , Blood Donors/supply & distribution , Blood Transfusion , Coronavirus Infections , Pandemics , Pneumonia, Viral , Antibodies, Viral/therapeutic use , Blood Coagulation Disorders/etiology , Blood Coagulation Disorders/therapy , Blood Preservation , Blood Safety , Blood Transfusion/statistics & numerical data , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/complications , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Donor Selection , Elective Surgical Procedures , Health Care Rationing , Health Policy , Health Services Needs and Demand , Hemoglobinopathies/complications , Hemoglobinopathies/therapy , Humans , Immunization, Passive , Pandemics/prevention & control , Pneumonia, Viral/blood , Pneumonia, Viral/complications , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Randomized Controlled Trials as Topic , SARS-CoV-2 , COVID-19 Serotherapy
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