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Transfusion emergency preparedness is increasingly becoming an integrated part of major incident planning. The spectrum of planning extends from the sophisticated healthcare system dealing with multiple casualties, to the isolated healthcare facility resuscitating the critically ill patient with massive haemorrhage. Transfusion preparedness should follow risk assessment and be nested within the wider emergency planning system. The response should be designed to deliver both safety and sufficiency of transfusion support and includes diagnostics, donation and distribution. The biggest transfusion risks in emergency situations are those of red cell ABO incompatibility and delayed provision. Sufficiency and supply may be compromised when communities are isolated and cannot access mutual support. Planning may need to consider local collection and testing of blood as a further resilience measure. Considerations include demand planning; inventory management and transfusion triage; a whole blood preparedness model; resilience and resupply and the human factor. We suggest a whole blood programme can simplify the whole vein‐to‐vein process for production, laboratory and clinical staff and can be integrated into a range of healthcare systems. 相似文献
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The activity of Polish Blood Transfusion Service (BTS) is based on the Public Blood Transfusion Service Act voted by the Polish Parliament. There are 21 regional blood transfusion centers, one military blood transfusion center and one blood transfusion center (BTC) of the Ministry of Internal Affairs. The Institute of Haematology and Transfusion Medicine (IHTM) is responsible for issuing guidelines for blood transfusion medicine. All BTCs must have an accreditation from the Ministry of Health. In Poland, there is a national system of haemovigilance. Hospitals are obliged to immediately report all post‐transfusion complications and ‘near‐miss’ events. Immunological, viral, bacterial as well as transfusion‐related acute lung injury reactions are supervised by IHTM. Qualification improvement and training of personnel is one of the priorities of Polish BTS. 相似文献
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Hans Erik Heier 《ISBT科学丛刊》2020,15(2):207-211
The ISBT/SITS was founded at the second international congress of blood transfusion in Paris in 1937. The world was influenced heavily by totalitarian ideologies, which a.o. tried to use science to confirm their superiority. The Nazi ideology was built on peculiar speculations on human blood, race and heritage, but although similar ideas were widespread, our society was founded as a purely scientific organization independent of ideological influence. The designation ‘International’ initially signified ‘European’, but after the end of World War 2, our society has become more and more of a global one. 相似文献
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Nareg H. Roubinian Steven Kleinman Edward L. Murphy Simone A. Glynn Gustaf Edgren 《ISBT科学丛刊》2020,15(1):185-193
In recent years, there has been a concerted effort to improve our understanding of the quality and effectiveness of transfused blood components. The expanding use of large datasets built from electronic health records allows the investigation of potential benefits or adverse outcomes associated with transfusion therapy. Together with information regarding blood donor demographics and component collection and manufacturing, these datasets permit evaluation of associations between donor or component factors and transfusion recipient outcomes. Large linked 'vein‐to‐vein' datasets provide the power to study exposures relevant to transfusion efficacy and safety, many of which would not otherwise be amenable to study for practical or sample size reasons. Analyses of these large donor‐component‐recipient datasets allow for characterization of the populations under study and provide an evidence base for future clinical studies. Knowledge generated from linked analyses has the potential to change the way donors are selected and how components are processed, stored and allocated. However, unrecognized confounding and biased statistical methods continue to be limitations in the study of transfusion exposures and patient outcomes. Given these challenges, results of observational studies of blood donor demographics, storage age and transfusion practice have been conflicting. This review summarizes statistical and methodological challenges in analyses of linked blood donor, component and transfusion recipient outcomes. 相似文献
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成分输血在25例外科手术患者大出血的应用 总被引：1，自引：0，他引：1
目的探讨成分输血在抢救外科手术患者手术中大出血的临床疗效。方法回顾性分析25例大量输血手术患者的临床资料,根据患者病情分为择期手术组和急诊手术组,统计分析患者输注红细胞悬液（CRCs）、新鲜冰冻血浆（FFP）、浓缩血小板（PC）和冷沉淀（Cryo）等成分血的种类和剂量以及输注后的不良反应。结果25例大出血患者经成分输血抢救后出血症状均得到控制,并获得良好的疗效;输注量最大的血液品种是红细胞悬液,两组大量输血手术患者手术前、后实验室检查结果比较无显著性差异（P〉0．05）。结论成分输血在外科手术患者手术中大出血时应用可获得良好的止血效果,为手术继续进行提供了很好的机会,但在各种成分血液用量上有很大差异,应根据患者的出血情况和实验室检查结果输注不同的成分血液。 相似文献
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Automated identification and data capture systems, such as bar code and radio frequency identification (RFID), can be a key enabler for reducing errors and enhancing safety throughout the blood product supply chain. This project was funded by a Small Business Technology Transfer grant from the US National Institutes for Health. It represents the first comprehensive investigation to introduce RFID technology for automatic identification, tracking and monitoring of blood products across the blood banking spectrum. The System covers both blood center and hospital domains. The focus of this paper is to share lessons learned from our pilot, in a hospital domain, as performed at the University of Iowa Hospitals and Clinics (UIHC), in USA. UIHC is a Level I Trauma Center with over 760 beds; it administers more than 34,000 blood products per year. In 2005, UIHC developed a system using bar-code technology named INFORMM Patient Record (IPR) to prevent patient identification errors in blood transfusion. After implementing IPR, UIHC realized substantial improvements in prevention and detection of transfusion errors. The objective of the pilot was to assess RFID technology in transfusion services from four perspectives: safety, operational efficiency, performance reliability, and organizational impact. A significant outcome of this pilot was a comparison between IPR and the RFID System in terms of safety standards and performance. For this purpose, the two systems were run side-by-side using IPR as the benchmark, thus allowing extrapolation of the proven benefits of IPR to the RFID System. The pilot was performed from May 1 until May 28, 2012. The scope was limited to the “Blood and Marrow Transplant Unit” (14-beds) and to a remote storage location in the “Emergency Department”. During the pilot, the RFID and IPR systems collected over 35 samples and processed a total of 144 units. Data was collected from various reports and exception extracts from both systems, and from weekly user survey responses of UIHC personnel involved in the pilot. The RFID System successfully performed all the trace, tracking and safety checks as specified in the processes selected for this pilot. Both the RFID System and the IPR system executed every transaction back-to-back, equally detecting and preventing process errors. Both systems achieved an 83% reduction in process errors by replacing the manual based procedures for tracking and identification purposes. Error reduction also resulted in savings in labor costs. With the RFID System, the visibility and traceability of specimens and products were greatly improved. Our ROI analysis predicts a productivity gain of 10% with a Payback period of 2·5 years and a net present value of benefits equal to $485,000 in a 5 year horizon. The pilot was executed as planned and the assessment of the RFID System was successfully accomplished. Throughout the pilot, the System provided robust functionality equivalent to IPR. The pilot showed that the RFID System can provide high standards of safety for prevention and detection of errors, along with productivity gains. 相似文献
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Transfusion medicine is a clinical discipline characterized by one of the most advanced quality management systems, which is structured so as to assure the production of blood components and raw materials, for biopharmaceutical fractionation, that are safe, efficient and effective. During the production, pathogen inactivation and storage processes there is the risk of changes in the integrity of blood components, especially at the protein level. These changes could be the cause of some of the negative effects of transfusion therapy. It is therefore a major challenge to identify significant alterations of these products, and, in this context, proteomics can play a potentially relevant role in transfusion medicine to assess the protein composition of blood-derived therapeutics, particularly for identifying modified proteins. Proteomics can also provide a more detailed understanding of the proteins found in plasma derivatives, with particular regard to peptide and protein changes related to the various procedures used for protein purification and pathogen inactivation during the modern plasma industrial factionation. The latter could cause protein modifications and/or degradation and neoantigen production, with the potential to induce adverse effects in recipients. At present, blood component quality control is mainly focused on standardized quantitative assessment, providing relatively limited information about products. Proteomics allows a comprehensive study of protein modifications, qualitative and quantitative analysis, and high-throughput protein identification. Moreover, being the only tool to evaluate structural changes in proteins (or their degradation products) after their manipulation, and having the capacity to identify many new proteins, proteomics seems to be the most promising tool for global quality assessment and possible improvement of the production process of blood components and plasma derivatives. It can also provide comprehensive information about possible contaminants and neoantigens that may influence the immunogenic capacity of blood-derived therapeutics. 相似文献
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Sally Lam 《ISBT科学丛刊》2011,6(2):277-279
A generic definition of quality system describes the organizational structure, responsibilities, processes, procedures and resources required to maintain high quality products and/or services. In blood transfusion chain setting, a quality system provides a framework in a supply chain setting from a donor’s vein to a patient’s vein through the collection, processing, testing, distribution and administration of high quality, safe and effective blood and blood products. 相似文献
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David Pi Andrew W. Shih Lawrence Sham David Zamar Kristine Roland Monika Hudoba 《ISBT科学丛刊》2019,14(2):226-238
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磷脂酶A2是一大类能催化水解磷脂特定酯键的酶,与哺乳动物神经系统存在密切的关系。磷脂酶A2在神经系统广泛表达,以海马最为丰富,在维持神经元的正常功能中起重要作用。在神经系统病理状态下,磷脂酶A2同工酶活性可增强或降低,引起不同程度的神经系统病变。一些磷脂酶A2抑制剂可能延缓病程的进展,达到治疗的目的。 相似文献
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Christine Cserti‐Gazdewich 《ISBT科学丛刊》2019,14(1):9-17
In endemic areas, the burden of malaria and anaemia converge together upon children, with severe malarial anaemia (SMA) accounting disproportionately for demands on limited blood supplies. The attributable morbidity and mortality from SMA remain high, and improved outcomes hinge in part on the timeliness, sufficiency and safety of transfusion support. The pathogenesis of SMA is complex, and depreciation kinetics (towards syndrome‐defining haemoglobin levels of <50 g/l) occur acutely or insidiously, and in relation to the parasite burden and host response. Beyond haemolysis of parasitized erythrocytes, mechanisms of bystander loss and reduced erythropoiesis figure prominently, with parallels to hyperhaemolysis syndrome. Involuntarily undertransfused children with SMA in low‐income countries (LIC) differ from those adults in high‐income countries (HIC) who deliberately renounce transfusion. Despite youth‐related advantages in the power to adapt to anaemia, critical reductions in oxygen‐carrying capacity illustrate the hierarchical impacts of organ anoxia, be it in terminal cardiorespiratory events or irreversible neurocognitive impairments in survivors. When resources permit, the dynamics of restored oxygen delivery by transfusion are particularly observable in SMA, as the triggers to transfuse are so much lower (and the odds of corresponding lactic acidosis are so much higher) than in HICs. Questions on the best haemotherapy approaches to SMA remain, be these in dosage, infusion rate, component preparation or matching options; these fundamental concerns now transcend those related to storage duration. As a persisting global scourge, SMA therefore keeps driving and facing the mandate to bank life‐preserving blood for those with the most to gain (and otherwise lose). 相似文献
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《Transfusion Clinique et Biologique》2022,29(3):250-252
ObjectivesTo assess the impact of a closed-loop electronic blood transfusion system on transfusion errors and staff time.Materials and methodsBefore and after study in all wards of a children's hospital, involving patients and staff of all the wards. The changes were closed-loop electronic blood transfusion, barcode patient identification, electronic blood transfusion administration records and error pop-up warning. The main outcome measures were percentage of blood transfusion errors, time spent on transfusion tasks.ResultsTransfusion errors were identified in 3.87% of 2556 blood transfusion orders pre-intervention and 0.78% of 2577 orders afterwards (P < 0.01). Phlebotomists, nurses, and physicians may make mistakes, including wrong blood type when apply for blood, wrong patient when blood draw or transfusion, wrong dose when apply for blood and the wrong tube label when blood draw or cross-matching, which are significantly reduced after change (1.09% vs 0.31%, 1.13% vs 0%, 0.31% vs 0%, 1.33% vs.0.78%, P < 0.01). Time spent on blood apply was 5.3 ± 1.2 min, hand over blood bag at the transfusion department was 14.9 ± 1.4 min and blood transfusion was 15.8 ± 2.4 min. Time per transfusion round decreased to 2.6 ± 1.0 min, 6.3 ± 1.6 min and 9.3 ± 2.2 min respectively (P < 0.01).ConclusionsA closed-loop electronic blood transfusion, barcode patient identification and error pop-up warning reduced transfusion errors, and increased confirmation of patient and blood types identity before transfusion. Time spent on blood transfusion tasks reduced. 相似文献
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《中国组织工程研究》1870,23(25)
文章快速阅读:文题释义:肌萎缩侧索硬化症:是成人运动神经元病中最常见的形式;以进行性上、下运动神经元损害为主;病情逐步发展。临床上表现为骨骼肌肉萎缩、无力、直至呼吸麻痹而死亡;目前病因尚不明确。自闭症谱系障碍:大部分病例在5岁前就显现出来相关特征;是某种程度的社会行为、沟通和语言能力受损;兴趣和活动范围狭窄并且刻板重复。患者往往还有其他同时出现的症状;包括癫痫、抑郁、焦虑和注意缺陷多动障碍。患者的智力运行水平差异极大;既有深度受损者也有具备出众技能者。 摘要背景:人类脐血中含有大量干细胞;这些干细胞在体内外具有分化成为造血、上皮、内皮、神经等多种组织的能力;因此脐血具有治疗多种疾病的潜能。目的:综述脐血干细胞治疗各种非血液学疾病的临床应用研究进展。方法:以“umbilical cord stem cells;umbilical cord blood mesenchymal stem cells;umbilical cord blood”等为关键词检索PubMed等外文数据库;以“脐血干细胞、脐血间充质干细胞、临床研究”等关键词检索CNKI等中文数据库从2001年至今的相关文献;排除与文章研究目的无关及重复性文章;纳入符合标准的64篇文献进行综述。结果与结论:脐血干细胞的临床研究涉及到循环系统、内分泌系统、神经系统等多个领域;且多数已经取得了良好的试验结果;相信随着脐血生物学和免疫特性的基础研究以及临床研究的深入;脐血干细胞的临床应用前景必将更为广阔;成为更多患者的一种新的治疗选择。中国组织工程研究>>杂志出版内容重点:干细胞>>;骨髓干细胞;造血干细胞>>;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程>>ORCID: 0000-0001-5902-6342(刘洋)> 相似文献
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H. E. Heier 《ISBT科学丛刊》2015,10(1):2-10
The history of the ISBT since its foundation in 1937 may be divided into four phases: (i) Formation and development (1935–1985), (ii) Years of crisis (1985–2000), (iii) Reformation (2000–2010), (iv) A professional organization (2010–present). While the ISBT was initially founded to organize congresses, today it stands forth as a global, diversified and respected scientific organization in the field of transfusion, also having an educational branch and governing international reference functions. During the last 25 years, women have taken a more prominent role in the organization. The challenge for the future is for ISBT to be the Society of first choice for professionals in the field of transfusion medicine and cellular therapies. 相似文献
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As a consequence of the September 2001 terrorist events, programs to protect against further such acts including potentially the use of biological warfare agents have been launched in the USA and elsewhere. As part of these initiatives, Vaccinia virus was procured for the pre-emptive vaccination of key personnel against smallpox as well as population-wide protection after an eventual exposure. The introduction of this live virus into a population at a relatively large scale represents a theoretical challenge for the safety of the blood supply, and potentially for plasma for fractionation. To strengthen further the demonstration of safety margins for plasma derived products against Vaccinia virus, the capacity of sterile filtration procedures to remove the virus was investigated. An infectivity assay for the Vaccinia virus strain which represents the majority of smallpox vaccine stocks available currently was used to investigate the potential removal of this virus by sterile filtration processes during the manufacture of plasma derivatives. Vaccinia virus behaves as predicted based on its size, i.e., an artificially added virus load is removed about 10,000-fold by the sterile filtration procedures tested. As the current investigation covered a range of different protein concentrations, filter materials and filters from different manufacturers, the results obtained are considered to be widely applicable. The current investigation supports further the high safety margins of plasma derivatives against any potential Vaccinia virus content of plasma for fractionation. As the large size is a general feature of Orthopox viruses, the results would also provide assurance against poxviruses identified more recently, for example, Monkeypox virus. 相似文献
