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2.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2079605
3.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2079604
4.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2079603
5.
Vox Sang ; 116(2): 155-166, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-2078680

ABSTRACT

BACKGROUND AND OBJECTIVE: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus, first identified in China at the end of 2019 and has now caused a worldwide pandemic. In this review, we provide an overview of the implications of SARS-CoV-2 for blood safety and sufficiency. MATERIAL AND METHOD: We searched the PubMed database, the preprint sites bioRxiv and medRxiv, the websites of the World Health Organization, European Centre for Disease Prevention and Control, the US Communicable Diseases Center and monitored ProMed updates. RESULTS: An estimated 15%-46% of SARS-CoV-2 infections are asymptomatic. The reported mean incubation period is 3 to 7 days with a range of 1-14 days. The blood phase of SARS-CoV-2 appears to be brief and low level, with RNAaemia detectable in only a small proportion of patients, typically associated with more severe disease and not demonstrated to be infectious virus. An asymptomatic blood phase has not been demonstrated. Given these characteristics of SARS-CoV-2 infection and the absence of reported transfusion transmission (TT), the TT risk is currently theoretical. To mitigate any potential TT risk, but more importantly to prevent respiratory transmission in donor centres, blood centres can implement donor deferral policies based on travel, disease status or potential risk of exposure. CONCLUSION: The TT risk of SARS-CoV-2 appears to be low. The biggest risk to blood services in the current COVID-19 pandemic is to maintain the sufficiency of the blood supply while minimizing respiratory transmission of SARS-CoV-19 to donors and staff while donating blood.


Subject(s)
Blood Safety , COVID-19/blood , COVID-19/prevention & control , COVID-19/virology , Transfusion Reaction/prevention & control , Blood Transfusion , Geography , Humans , RNA, Viral/analysis , Risk Assessment , SARS-CoV-2 , Safety Management , World Health Organization
6.
Transfusion ; 62(11): 2271-2281, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2070536

ABSTRACT

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, the transfusion medicine community has experienced unprecedented blood supply shortages since March 2020. As such, numerous changes to everyday practice have occurred with a specific emphasis on blood conservation. We sought to determine the strategies used to mitigate blood shortages and promote blood conservation during the pandemic. METHODS: An anonymous, 37-question survey was developed using Research Electronic Data Capture and distributed via e-mail to transfusion medicine specialists across the US obtained via publicly available databases. RESULTS: Amongst surveyed [41.1% response rate (51/124 institutions)], 98.0% experienced a product shortage, with the greatest number reporting red blood cell (RBC) shortages (92.0%). This led to 35.3% of institutions altering the composition and/or number of blood product suppliers, including a 100% increase in the number of institutions acquiring blood from organizations that connect hospital transfusion services with blood collection centers (e.g., Blood Buy) compared to before March 2020. Prospective triaging of blood products was the most common blood conservation strategy (68.1%), though 35.4% altered their RBC exchange or transfusion program for patients receiving chronic RBC transfusion/exchange. As a result of these changes, 78.6% of institutions reported that these changes resulted in a reduction in blood product usage, and 38.1% reported a decrease in product wastage. CONCLUSIONS: Most hospitals experienced the effects of the supply shortage, and many of them implemented blood conserving measures. Conservation strategies were associated with decreased blood utilization and waste, and future studies could evaluate whether these changes persist.


Subject(s)
Bloodless Medical and Surgical Procedures , COVID-19 , Humans , United States/epidemiology , Pandemics , COVID-19/epidemiology , Prospective Studies , Blood Transfusion , Hospitals
7.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2065069
8.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2065068
9.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2065067
10.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2065066
11.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2065065
12.
Anesth Analg ; 135(3S Suppl 1): 1-92, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2065064
13.
Vox Sang ; 117(10): 1195-1201, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2063957

ABSTRACT

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic has led to a growing interest in hospital-at-home programmes, including home transfusion services. We studied whether the pandemic had influenced patients' perception of home transfusions. MATERIALS AND METHODS: We conducted a survey among haematology patients who receive transfusions in the hospital day care facility. Patients were asked about the burden of day care transfusions and whether they would prefer receiving home transfusions. The survey was conducted during the COVID-19 pandemic, and the results were compared with a survey performed before the pandemic (baseline). RESULTS: Sixty patients were included in the COVID-19 cohort and 31 patients in the baseline cohort. There was a non-significant decrease in the proportion of patients willing to receive home transfusions during the pandemic compared with baseline (35% vs. 47%, respectively, p = 0.28). More patients in the COVID-19 cohort were afraid to receive home transfusions (60% compared with 48% at baseline, p = 0.29), and fewer patients believed that hospital transfusion impaired their quality of life (19% compared with 36% at baseline, p = 0.09). These unexpected results may be partly attributed to the shorter time needed to arrive at the hospital during the pandemic and a greater fear of having transfusion-related adverse effects at home. CONCLUSIONS: Our results show that the pandemic did not increase the willingness of patients to receive home transfusions, with a non-significant drift towards refusal of home transfusions. Patients' opinions should be taken into consideration when planning for future home transfusion services, by creating a comprehensive approach to patients' needs.


Subject(s)
COVID-19 , Blood Transfusion , COVID-19/epidemiology , Humans , Pandemics , Perception , Quality of Life
15.
Vox Sang ; 117(11): 1332-1344, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2038215

ABSTRACT

BACKGROUND AND OBJECTIVES: Under the ISBT, the Working Party (WP) for Red Cell Immunogenetics and Blood Group Terminology is charged with ratifying blood group systems, antigens and alleles. This report presents the outcomes from four WP business meetings, one located in Basel in 2019 and three held as virtual meetings during the COVID-19 pandemic in 2020 and 2021. MATERIALS AND METHODS: As in previous meetings, matters pertaining to blood group antigen nomenclature were discussed. New blood group systems and antigens were approved and named according to the serologic, genetic, biochemical and cell biological evidence presented. RESULTS: Seven new blood group systems, KANNO (defined numerically as ISBT 037), SID (038), CTL2 (039), PEL (040), MAM (041), EMM (042) and ABCC1 (043) were ratified. Two (039 and 043) were de novo discoveries, and the remainder comprised reported antigens where the causal genes were previously unknown. A further 15 blood group antigens were added to the existing blood group systems: MNS (002), RH (004), LU (005), DI (010), SC (013), GE (020), KN (022), JMH (026) and RHAG (030). CONCLUSION: The ISBT now recognizes 378 antigens, of which 345 are clustered within 43 blood group systems while 33 still have an unknown genetic basis. The ongoing discovery of new blood group systems and antigens underscores the diverse and complex biology of the red cell membrane. The WP continues to update the blood group antigen tables and the allele nomenclature tables. These can be found on the ISBT website (http://www.isbtweb.org/working-parties/red-cell-immunogenetics-and-blood-group-terminology/).


Subject(s)
Blood Group Antigens , COVID-19 , Erythrocytes , Humans , Blood Group Antigens/genetics , Blood Transfusion , Immunogenetics , Pandemics , Erythrocytes/immunology
16.
J Thorac Cardiovasc Surg ; 164(6): e449-e456, 2022 12.
Article in English | MEDLINE | ID: covidwho-2000583

ABSTRACT

For yet another year, our lives have been dominated by a pandemic. This year in review, we feature an expert panel opinion regarding extracorporeal support in the context of COVID-19, challenging previously held standards. We also feature survey results assessing the impact of the pandemic on cardiac surgical volume. Furthermore, we focus on a single center experience that evaluated the use of pulmonary artery catheters and the comparison of transfusion strategies in the Restrictive and Liberal Transfusion Strategies in Patients With Acute Myocardial Infarction (REALITY) trial. Additionally, we address the impact of acute kidney injury on cardiac surgery and highlight the controversy regarding the choice of fluid resuscitation. We close with an evaluation of dysphagia in cardiac surgery and the impact of prehabilitation to optimize surgical outcomes.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Humans , Erythrocyte Transfusion/methods , Cardiac Surgical Procedures/adverse effects , Cardiac Surgical Procedures/methods , Blood Transfusion/methods , Critical Care
18.
PLoS One ; 17(7): e0270916, 2022.
Article in English | MEDLINE | ID: covidwho-1933373

ABSTRACT

BACKGROUND: Globally, blood donation has been disturbed due to the pandemic. Consequently, the optimization of preoperative blood preparation should be a point of concern. Machine learning (ML) is one of the modern approaches that have been applied by physicians to help decision-making. The main objective of this study was to identify the cost differences of the ML-based strategy compared with other strategies in preoperative blood products preparation. A secondary objective was to compare the effectiveness indexes of blood products preparation among strategies. METHODS: The study utilized a retrospective cohort design conducted on brain tumor patients who had undergone surgery between January 2014 and December 2021. Overall data were divided into two cohorts. The first cohort was used for the development and deployment of the ML-based web application, while validation, comparison of the effectiveness indexes, and economic evaluation were performed using the second cohort. Therefore, the effectiveness indexes of blood preparation and cost difference were compared among the ML-based strategy, clinical trial-based strategy, and routine-based strategy. RESULTS: Over a 2-year period, the crossmatch to transfusion (C/T) ratio, transfusion probability (Tp), and transfusion index (Ti) of the ML-based strategy were 1.10, 57.0%, and 1.62, respectively, while the routine-based strategy had a C/T ratio of 4.67%, Tp of 27.9%%, and Ti of 0.79. The overall costs of blood products preparation among the ML-based strategy, clinical trial-based strategy, and routine-based strategy were 30, 061.56$, 57,313.92$, and 136,292.94$, respectively. From the cost difference between the ML-based strategy and routine-based strategy, we observed cost savings of 92,519.97$ (67.88%) for the 2-year period. CONCLUSION: The ML-based strategy is one of the most effective strategies to balance the unnecessary workloads at blood banks and reduce the cost of unnecessary blood products preparation from low C/T ratio as well as high Tp and Ti. Further studies should be performed to confirm the generalizability and applicability of the ML-based strategy.


Subject(s)
Blood Grouping and Crossmatching , Blood Transfusion , Cost-Benefit Analysis , Humans , Machine Learning , Retrospective Studies
19.
BMJ Lead ; 6(2): 132-135, 2022 06.
Article in English | MEDLINE | ID: covidwho-1923290

ABSTRACT

INTRODUCTION: This report outlines a quality improvement (QI) project aiming to improve blood transfusion safety at Maluti Adventist Hospital (MAH), Lesotho, from August 2019 to January 2020.The project team comprised nine local staff members and two UK doctors working through the NHS 'Improving Global Health through Leadership Development' (IGH) programme. METHODS: Baseline data was gathered and a 'process mapping' meeting held to understand existing processes and identify methods for improvement.Improvements were implemented using Plan-Do-Study-Act (PDSA) methodology.The NHS Healthcare Leadership Model was used as a framework for leadership development and team members reflected on their personal learning. RESULTS: Varied interventions included introduction of a pre-transfusion bedside safety checklist and staff training.Documentation of critical patient identifiers for transfusion improved. Completion of the bedside safety checklist was 65.5% by 3 months. Knowledge scores improved post-transfusion training. 77% of staff strongly agreed and 21% agreed that the training was useful.Challenges and further work were reflected on. DISCUSSION: This collaborative system-strengthening project provided varied, reciprocal learning experiences including skills in leadership, teamwork, teaching, QI methodology, communication and IT.Our experiences will help to inform ongoing work at MAH and may be helpful to others conducting similar work in related settings.


Subject(s)
Leadership , Quality Improvement , Blood Transfusion , Hospitals , Humans , Lesotho , Mali
20.
J Paediatr Child Health ; 58(10): 1760-1765, 2022 10.
Article in English | MEDLINE | ID: covidwho-1916257

ABSTRACT

AIM: COVID-19 has presented an unprecedented challenge to health services and has significantly affected the management of non-Covid illnesses, like thalassemia. The present study documents the impact of Covid-associated restrictions and disruptions on working of the pediatric thalassemia day care centre (TDCC), and measures taken by TDCC and blood transfusion services to adapt to and mitigate the negative impact of Covid pandemic and associated lockdown on patient care. METHODS: Pre-transfusion haemoglobin and packed cell transfusion requirement were compared across three time periods, namely pre-lockdown, lockdown and post-lockdown in paediatric transfusion-dependent thalassaemia (TDT) patients. Caregivers were interviewed to document any problems faced by them. RESULTS: The study involved 181 TDT patients. There was a significant reduction in mean pre-transfusion haemoglobin and red cells transfused during lockdown phase as compared to pre-lockdown phase. Regular care was interrupted in 45% of patients and 76% of patients getting blood from outside could not get leukoreduced red cells. Investigations, monitoring and continuity of iron chelation were also affected. Blood centre faced 30.5% reduction in blood supply during lockdown. TDCC and blood centre took several steps, including prolongation of service hours and staggering of transfusions to ensure maximum transfusions while ensuring social distancing. CONCLUSION: The COVID-19 pandemic imposed many unprecedented challenges to the routine care of thalassaemic patients; however, some of them could be dealt with by a proactive approach and micro-planning at the institution level. Other similar resource-limited settings could learn from experiences for continued quality care for chronic medical conditions during pandemic like situations.


Subject(s)
COVID-19 , Thalassemia , Blood Transfusion , COVID-19/epidemiology , Child , Communicable Disease Control , Humans , Iron Chelating Agents , Pandemics , Thalassemia/complications , Thalassemia/epidemiology , Thalassemia/therapy
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