ABSTRACT
Background & Objective: Unnecessary pre-operative ordering of red blood cells (RBCs) in elective surgeries increases costs and waste of blood inventory. Maximum surgical blood order schedule (MSBOS) is a helpful strategy in the estimation of blood units needed for surgery and the prevention of overconsumption. In this study, an MSBOS for pediatric cardiac surgeries is designed. Methods: In this cross-sectional study, we included all pediatric patients who underwent elective cardiac surgery in Children's Medical Center in Tehran, Iran, from March 21, 2019, to September 22, 2019. Data consisted of the type of surgery and the number of blood units transfused and units cross-matched, based on which cross-match to transfusion ratio (CTR), the transfusion index (TI), and transfusion probability (T%) were calculated. Results: Overall 205 pediatric patients were included in the study. Four hundred and ten RBCs units were cross-matched, and 262 were transfused. The overall results of the CTR, T%, and TI for all the eight types of cardiac surgery were 1.56 (410/262), 76% (157/205), and 1.28 (262/205), respectively. The raw MSBOS for cardiac surgeries included ventricular septal defect, tetralogy of fallot, dextro-transposition of the great arteries, atrial septal defect, aortic coarctation, patent ductus arteriosus, pulmonary stenosis, and pacemaker insertion, which were 1.58, 1.03, 1.54, 1.66, 0.77, 0, 1.25, and 0 unit, respectively, and the figures were rounded up. Conclusion: Accurate MSBOS protocols reduce cross-match workload in laboratories, lead to the appropriate use of blood stocks with less wastage, save human and economic resources, and eventually, promote patient safety.
ABSTRACT
In present work, the treatment of aromatic compounds of simulated wastewater was performed by Fenton and NaOCl/Fe2+ processes. The model solution was prepared based on the wastewater composition of Diisocyanate unit of Karoon Petrochemical Company/Iran containing Diamino-toluenes, Nitro-phenol, Mononitro-toluene, Nitro-cresol, and Dinitro-toluene. Experiments were conducted in a batch mode to examine the effects of operating variables such as pH, oxidant dosages, ferrous ion concentration and numbers of feeding on COD removal. Taguchi experimental design was used to determine the optimum conditions. The COD removal efficiency under optimum conditions (suggested by Taguchi design) in Fenton and NaOCl/Fe2+ processes was 88.7% and 83.4%, respectively. The highest contribution factor in Fenton process belongs to pH (47.47%) and in NaOCl/Fe2+ process belongs to NaOCl/pollutants (50.26%). High regression coefficient (R2: 0.98) obtained for Taguchi method, indicates that models are statistically significant and are in well agreement with each other. The NaOCl/Fe2+ process utilizing a conventional oxidant, in comparison to hydrogen peroxide, is an efficient cost effective process for COD removal from real wastewater, although the removal efficiency is not as high as in Fenton process; however it is a suitable process to replace Fenton process in industrial scale for wastewater involved aromatic compounds with high COD. This process was successfully applied in Karoon Petrochemical Company/Iran.
