Transfusion Medicine最新文献_第5页

Validation of current commercially-available devices to thaw pooled, solvent/detergent-treated human plasma. 对目前市售的用于解冻经溶剂/洗涤剂处理的集合人血浆的设备进行验证。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-02-01 Epub Date: 2024-11-25 DOI: 10.1111/tme.13116

Andrea Heger, Michelle Gareis

{"title":"Validation of current commercially-available devices to thaw pooled, solvent/detergent-treated human plasma.","authors":"Andrea Heger, Michelle Gareis","doi":"10.1111/tme.13116","DOIUrl":"10.1111/tme.13116","url":null,"abstract":"Background: Proper thawing procedures are required to preserve the quality of human fresh frozen plasma (FFP). octaplasLG (Octapharma AG, Switzerland) is a frozen solution of solvent/detergent (S/D)-treated human plasma, produced to improve pathogen safety. This study aimed to validate the S/D plasma thawing process using the latest-generation of commercially-available thawing devices and to determine S/D plasma quality after thawing.Study design and methods: Thawing of S/D plasma units was investigated using a microwave oven (Transfusio-therm 3000) and dry tempering systems (SAHARA 4 and Plasmatherm V). Times to defrost plasma and reach 30°C product temperature, using the 37°C thawing programmes, were defined for all devices. Thawed S/D plasma units were tested against product release parameters, as well as for hemostatic capacity tested indirectly via global coagulation parameters, coagulation factors, protease inhibitors and markers of activated coagulation.Results: The fastest thawing was observed using the microwave oven; S/D plasma units were defrosted after 2-3 min. All S/D plasma units thawed by the different devices using optimised thawing conditions were clear and free of solid and gelatinous particles, indicating no local overheating or protein denaturation. Coagulation factor and inhibitor activities and hemostatic capacity of S/D plasma were comparable when thawed by the three different devices. With each device, all product parameters were within product release specification levels after thawing.Conclusions: S/D plasma can be thawed using the Transfusio-therm 3000, SAHARA 4 or Plasmatherm V thawing devices using the optimised settings defined for this plasma product, with no negative influence on plasma quality.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"97-102"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An evaluation of diethylhexyl phthalate free top & bottom in-line blood collection set with a new soft housing filter. 不含邻苯二甲酸二乙基己酯的顶部和底部在线采血装置与新型软外壳过滤器的评估。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-02-01 Epub Date: 2024-09-07 DOI: 10.1111/tme.13091

Elena Danilova, Farshid Ezligini, Connie Stöckel, Masafumi Asakawa, Geir Hetland

{"title":"An evaluation of diethylhexyl phthalate free top & bottom in-line blood collection set with a new soft housing filter.","authors":"Elena Danilova, Farshid Ezligini, Connie Stöckel, Masafumi Asakawa, Geir Hetland","doi":"10.1111/tme.13091","DOIUrl":"10.1111/tme.13091","url":null,"abstract":"Background and objectives: Di (2-ethylhexyl) phthalate (DEHP) plasticizer must be removed from polyvinylchloride (PVC) medical devices due to toxicity. DEHP/PVC blood bags were shown to provide stable quality under blood component production and to create good storage conditions for red blood cells concentrate (RBC). It is important that substitution of the DEHP maintains the RBC quality during storage, which should be achieved with Di (isononyl) cyclohexane-1,2-dicarboxylate (DINCH), although substitution of the plasticizer has been challenging.Materials and methods: A DEHP-free Top & Bottom in-line RBC set was validated in a tertiary hospital blood bank facility. Volunteer blood donors were randomly allocated for blood collection into DINCH/PVC or DEHP/PVC set. The groups were additionally divided according to additive solution/filter combination: PAGGS-M + DINCH/PVC filter (only with DINCH/PVC set), and SAG-M + DINCH/PVC filter and SAG-M + DEHP/PVC filter (only with DEHP/PVC set). Processing and storage effects were assessed in all components.Results: RBC concentrates, platelet concentrates and plasma that was processed and stored in DEHP-free set fulfilled European requirements for quality. The cells stored in PAGGS-M after filtration through DEHP-free PVC filter showed the same low haemolysis compared with conventional set at 49 days of storage. Platelets stored in DINCH/PVC bag provided a sufficient quality of platelets after 7 days of storage. Plasma maintained the coagulation factors during 12 months of storage.Conclusion: A new DINCH/PVC set allows production of blood components of satisfactory quality in DEHP-free environment.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"82-90"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transfusion sample mislabelling and wrong blood in tube in the UK: Insights from the national comparative audits of blood transfusion in 2012 and 2022. 英国输血样本贴错标签和输错血液：2012年和2022年全国输血比较审计的启示。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-02-01 Epub Date: 2024-08-27 DOI: 10.1111/tme.13092

Catherine Booth, Paul Davies

{"title":"Transfusion sample mislabelling and wrong blood in tube in the UK: Insights from the national comparative audits of blood transfusion in 2012 and 2022.","authors":"Catherine Booth, Paul Davies","doi":"10.1111/tme.13092","DOIUrl":"10.1111/tme.13092","url":null,"abstract":"Background: Samples for transfusion rejected due to mislabelling can lead to harm when a patient has to be re-bled or has a transfusion or procedure delayed. Electronic labelling systems which scan the patient's identification band and generate a label at their side aim to reduce mislabelling and misidentification leading to wrong blood in tube (WBIT) errors. The 2022 National Comparative audit of sample collection aimed to compare national rates of sample mislabelling and WBIT to the 2012 audit and to examine the impact of electronic systems.Method: All UK hospitals were invited to provide data on rejected transfusion samples and WBIT incidents in 1 month (October 2022) and were asked if they had electronic labelling.Results: Twenty-three thousand five hundred and eighty-four rejected samples were reported by 179 sites in 1 month. The rejection rate of 4.4% represents a 47% increase compared to 2012 (2.99%). There were 92 WBIT incidents, an incidence of 1 in 5882 samples-a 45% increase compared to 1 in 8547 in 2012. Twenty-three percent of sites can print a sample label at the patient's side, up by 224%. The six sites using only electronic sample labelling had a 46.9% lower rejection rate than sites using only hand-labelling but still reported WBIT.Conclusions: The increase in sample rejection and WBIT may reflect pressures facing clinical staff, zero tolerance policies and the two-sample rule. A human factors approach to understanding and tackling underlying reasons locally is recommended. Electronic systems are associated with fewer labelling errors, but careful implementation and training is needed to maximise their safety benefits.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"41-47"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A prospective, multi-centric study on the prevalence of dengue, zika and chikungunya in asymptomatic blood donors from different geographical regions of Brazil. 一项关于巴西不同地理区域无症状献血者中登革热、寨卡和基孔肯雅热流行的前瞻性多中心研究。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-02-01 Epub Date: 2024-12-12 DOI: 10.1111/tme.13119

Dante M Langhi, José E Levi, Sidneia Sanches, Renato S Cerqueira, Alvina Clara Felix, Glaciano Ribeiro, José O Bordin

{"title":"A prospective, multi-centric study on the prevalence of dengue, zika and chikungunya in asymptomatic blood donors from different geographical regions of Brazil.","authors":"Dante M Langhi, José E Levi, Sidneia Sanches, Renato S Cerqueira, Alvina Clara Felix, Glaciano Ribeiro, José O Bordin","doi":"10.1111/tme.13119","DOIUrl":"10.1111/tme.13119","url":null,"abstract":"Background and objectives: Arboviruses outbreaks are increasing in their frequency, geographical area and extension. Brazil is one of the most affected countries in the world, due to its tropical weather and favourable mosquito proliferation conditions. During outbreaks, the safety of the blood supply is a concern, in spite of the low number of transfusion-transmitted cases with clinical impact. The aim of this study was to evaluate the use of NAT for Dengue, Zika and Chikungunya RNA in actual screening.Materials and methods: Blood donors from services located in 4 Brazilian regions were invited to participate in the study and provide an extra blood sample during the collection period between February 7, 2020, and April 4, 2020. Plasma from 21 341 donations was tested in mini pools of 6 by a duplex NAT for Dengue and Chikungunya, in addition to a Zika single assay. Confirmed viremic samples were submitted to an alternative NAT and serological assays.Results: There were 33 (0.15%) Dengue RNA+ and 5 (0.02%) Chikungunya RNA+ donations. The South region showed the highest prevalence of Dengue-infected donors (0.29%). These results are in line with the incidence of these arboviruses on the respective geographical regions. Viremic units were discarded and blood services notified.Conclusion: Screening blood donors for arboviruses during the outbreak season in Brazil reveals a significant number of viremic individuals. Arbovirus NAT testing is feasible and may be incorporated to the current screening policy.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"91-96"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Practice of ABO antibody titration in a transplant center: From tube method to manual gel column testing to automated column agglutination technology. 移植中心ABO抗体滴定的实践：从试管法到手工凝胶柱检测再到自动柱凝集技术。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-01-29 DOI: 10.1111/tme.13127

Jun-Bo Sun, Li-Wen Chen, Li-Li Tao, Qing-Si Wu, Qian-Qian Yu, Zhi-Wei Xie

{"title":"Practice of ABO antibody titration in a transplant center: From tube method to manual gel column testing to automated column agglutination technology.","authors":"Jun-Bo Sun, Li-Wen Chen, Li-Li Tao, Qing-Si Wu, Qian-Qian Yu, Zhi-Wei Xie","doi":"10.1111/tme.13127","DOIUrl":"https://doi.org/10.1111/tme.13127","url":null,"abstract":"Background and objectives: High-quality ABO antibody titre testing is required for ABO-incompatible haematopoietic stem cell transplantation and kidney transplantation. To assess the feasibility of automated ABO titration as an alternative to manual and semi-automatic titration during the peri-transplant period, a comparative study was conducted internally in a transfusion medicine laboratory.Materials and methods: This study was performed in two stages. Firstly, the differences in anti-A/B detecting using conventional tube test (CTT) and manual column agglutination technology (CAT) were compared in group O pregnant women. Then, manual and automated CAT were applied to simultaneously detect ABO antibody levels in non-AB-group adult haematological oncology patients.Results: In the first stage, four groups of 192 comparable results were generated from 48 subjects, which showed a high correlation between CTT and manual CAT (p < 0.001). However, the detection sensitivity of the latter was at least 1 fold higher dilution than that of the former. Fifty-six patients were tested in the second stage by simultaneous manual and automated CAT, and the paired titers differed within an acceptable range (±1 fold dilution). However, the concordance was slightly higher in group IgM (85.4%) than in group IgG (80.5%). Blood group specificity of ABO titers was also observed in this population, and no association between titers and other factors was found.Conclusion: Automated CAT standardises ABO titre testing and saves labor costs, although manual review of weak positive reactions is still necessary. Due to the blood group specificity of ABO antibodies, special attention should be paid to the quality control and clinical relevance of titre testing for group O recipients in ABO-mismatched transplantation.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of conventional coagulation tests and ROTEM in identifying trauma-induced coagulopathy for massive haemorrhage protocol activation. 常规凝血试验与ROTEM鉴别外伤性大出血凝血功能障碍的比较

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-01-25 DOI: 10.1111/tme.13128

Sakara Hutspardol, Tyrone Borja, Jenna Kroeker, Xiu Qing Wang, Jian Mi, David Zamar, Geoffrey Chan, Tyler Smith, Harvey Hawes, Andrew W Shih

{"title":"Comparison of conventional coagulation tests and ROTEM in identifying trauma-induced coagulopathy for massive haemorrhage protocol activation.","authors":"Sakara Hutspardol, Tyrone Borja, Jenna Kroeker, Xiu Qing Wang, Jian Mi, David Zamar, Geoffrey Chan, Tyler Smith, Harvey Hawes, Andrew W Shih","doi":"10.1111/tme.13128","DOIUrl":"https://doi.org/10.1111/tme.13128","url":null,"abstract":"Objectives: Trauma-induced coagulopathy (TIC) can be fatal but preventable if recognised early. With emerging uses of rotational thromboelastometry (ROTEM) to guide transfusions in trauma, patient outcomes with TIC-defined by initial ROTEM and conventional coagulation tests (CCTs) during massive haemorrhage protocol (MHP) activations were evaluated at a primary trauma centre in British Columbia.Methods: This retrospective observational study included adult trauma patients requiring MHP from June 1, 2020, to May 31, 2022. TIC, defined by initial results including (1) ROTEM-based EXTEM A10 <40 mm, EXTEM CT >100 s, EXTEM ML30 >10%, FIBTEM A10 <10 mm; and (2) CCT-based INR ≥1.8, PTT ≥1.5 times of upper normal limit, platelets <50 x 109/L, and Clauss Fibrinogen <1.5 g/L, was assessed for its correlation with mortality. Modified Poisson regression was used to model 28-day mortality.Results: Twenty-two of sixty-eight patients (32%) had abnormal ROTEM but normal CCTs. TIC defined by CCTs was associated with increased mortality [24 h: 5/13 (38%) vs. 5/55 (9%), p = 0.025; 28d: 8/13 (62%) vs. 11/55 (20%), p = 0.002]; compared to ROTEM, which was not [24 h: 7/35 (20%) vs. 3/33 (9%), p = 0.307; 28d: 11/35 (31%) vs. 9/33 (27%), p = 0.594], despite requiring significantly higher blood component transfusion within the first 4 and 24 h of MHP (p-values<0.05).Conclusions: ROTEM is more sensitive in identifying TIC. Patients with abnormal CCTs had a higher death rate, and those with abnormal ROTEM had no significantly increased mortality. A prospective study is required to assess the effects of ROTEM further.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracellular vesicles in ageing cold-stored whole blood may not compensate for the decreasing haemostatic function in vitro. 老化的冷藏全血中的细胞外囊泡可能无法弥补体外止血功能的下降。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-01-24 DOI: 10.1111/tme.13122

Petra Ilvonen, Sanna Susila, Ulla Impola, Reetta Pusa, Tuukka Helin, Lotta Joutsi-Korhonen, Saara Laitinen, Jouni Lauronen, Minna Ilmakunnas

{"title":"Extracellular vesicles in ageing cold-stored whole blood may not compensate for the decreasing haemostatic function in vitro.","authors":"Petra Ilvonen, Sanna Susila, Ulla Impola, Reetta Pusa, Tuukka Helin, Lotta Joutsi-Korhonen, Saara Laitinen, Jouni Lauronen, Minna Ilmakunnas","doi":"10.1111/tme.13122","DOIUrl":"https://doi.org/10.1111/tme.13122","url":null,"abstract":"Background: Extracellular vesicles (EVs) have procoagulative properties. As EVs are known to accumulate in stored blood products, we compared the EV content and coagulation capacity of leukoreduced cold-stored whole blood (CSWB) with current prehospital and in-hospital component therapies to understand the role of EVs in the haemostatic capacity of ageing CSWB.Materials and methods: Blood was obtained from 12 O RhD-positive male donors. CSWB was compared with in-hospital component therapy of red blood cells (RBCs), OctaplasLG and buffy-coat platelets and prehospital component therapy of RBC and lyophilized plasma. Samples were drawn on Days 1 and 14 of CSWB and RBC cold storage. Blood count, haemolysis markers, rotational thromboelastometry, sonorheometry and thrombin generation were analysed. EVs were analysed using nanoparticle tracking analysis and cellular origin was determined using imaging flow cytometry.Results: There was a trend towards increased production of both platelet and RBC-derived EVs during CSWB storage. Particle count increased during storage, whereas thrombin generation slowed down and in viscoelastic assays, clotting times prolonged, clot formation became impaired, and stiffness of the resulting clot decreased.Conclusion: Both platelet and RBC-derived EVs increased in number in CSWB during storage. This did not appear to compensate for the in vitro decreasing haemostatic capacity of ageing CSWB, suggesting EVs produced during storage may not have active procoagulative effects, but rather reflect the ageing of blood cells.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors affecting the efficacy of human leukocyte antigen-selected platelet provision: A large retrospective study in the United Kingdom. 影响人类白细胞抗原选择血小板供应功效的因素：英国的一项大型回顾性研究。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2025-01-20 DOI: 10.1111/tme.13123

W M Howell, L Quaye, L Mumford, S Phillips, K Mepani, S Mohamed, C J Brown

{"title":"Factors affecting the efficacy of human leukocyte antigen-selected platelet provision: A large retrospective study in the United Kingdom.","authors":"W M Howell, L Quaye, L Mumford, S Phillips, K Mepani, S Mohamed, C J Brown","doi":"10.1111/tme.13123","DOIUrl":"https://doi.org/10.1111/tme.13123","url":null,"abstract":"Background: A large, retrospective study was designed to interrogate current NHS Blood and Transplant (NHSBT) HLA matching strategies for the provision of HLA selected platelets (HLA SP) and to determine whether additional factors such as ABO blood group matching, patient diagnosis, patient and/or donor age, sex, ethnicity, age of platelet unit at transfusion and possibly seasonal variation also play a role in transfusion efficacy.Materials and methods: Data for 56 640 HLA SP transfusions over a 3-year period were collected. Transfusions with missing data for any factor under consideration were excluded, resulting in a cohort of 13 044 transfusions for analysis. Univariable and multivariable regression models were used to determine if any factors influenced an increase in platelet count of ≥10 × 109/L. A stepwise logistic regression was applied, such that each influential factor was adjusted for effects on other factors included in the study.Results: HLA match grade was confirmed as a significant factor in transfusion efficacy, with ABO mismatched units 20% less likely to give an adequate platelet increment (≥10 × 109/L). Platelet donor age, gender and ethnicity were not significant. Conversely, patient diagnosis, ethnicity, gender and age showed significant associations with platelet increments. Some seasonal variation in efficacy of platelet transfusion was also demonstrated.Conclusion: This study has demonstrated the efficacy of HLA SP transfusions in refractory patients with a wide range of diagnoses, the importance of HLA match grade, plus the marginal effect of ABO matching. A wide range of donor-related factors was excluded, while a number of patient-related factors were identified, requiring more extensive investigation in ongoing and independent studies, with implications for donor registry, clinical and laboratory practices.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resuscitation of adult shocked trauma patients using major haemorrhage protocol guided by viscoelastic haemostatic assays versus formulaic approach. 使用粘弹性止血测定法指导的大出血方案与公式化方法对成人休克创伤患者进行复苏。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2024-12-01 Epub Date: 2024-11-08 DOI: 10.1111/tme.13109

Biswadev Mitra, Elizabeth Wake, Carly Talarico, Sarah Czuchwicki, Christine Koolstra, Don Campbell, Simon Hendel, James Winearls

{"title":"Resuscitation of adult shocked trauma patients using major haemorrhage protocol guided by viscoelastic haemostatic assays versus formulaic approach.","authors":"Biswadev Mitra, Elizabeth Wake, Carly Talarico, Sarah Czuchwicki, Christine Koolstra, Don Campbell, Simon Hendel, James Winearls","doi":"10.1111/tme.13109","DOIUrl":"10.1111/tme.13109","url":null,"abstract":"Background: The resuscitation of trauma patients with critical bleeding may follow a formulaic approach using high ratios of blood components or a viscoelastic haemostatic assay (VHA) guided approach. The aim of this study was to compare the two strategies for resuscitation of shocked trauma patients.Methods: This was a registry-based cohort study including shocked trauma patients from two trauma centres-one practising a formulaic approach, with VHA unavailable during trauma resuscitation and the other practicing a VHA-guided resuscitation strategy. The primary outcome was the total units of blood components transfused in 24 h after adjusting for differences in baseline characteristics and time to death.Results: Between 01 Jan 2020 and 31 Dec 2022, 152 eligible patients were categorised to the formulaic group and 40 to the VHA group. Prehospital times were longer in the formulaic group (2.0 vs. 1.4 h), and more patients in the VHA group (38% vs. 17%) were transfused prehospital blood components. Formulaic resuscitation was associated with significantly more blood components transfused (adjusted incidence rate ratio 1.5; 95%CI: 1.4-1.7, p < 0.001). Using a formulaic approach, patients were administered more red blood cells, plasma and platelets, but fewer cryoprecipitate. There was no significant association of the formulaic approach with in-hospital mortality (adjusted odds ratio 2.4; 95%CI: 0.7-8.0, p = 0.17).Conclusions: Given the cost and potential adverse effects of blood component transfusions, VHA-guided transfusion strategies present an attractive option, particularly among centres managing high volumes of shocked patients. Further trials, enrolling the population most likely to benefit from precision transfusion strategies, are indicated.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"514-519"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Determining the strength of evidence for an association between sexual indicators and risk of acquiring HIV and sexually transmitted infections: Providing evidence for blood donation policy change. 确定性指标与感染艾滋病毒和性传播疾病风险之间关联的证据强度：为改变献血政策提供证据。

IF 1.5 4区医学

Transfusion Medicine Pub Date : 2024-12-01 Epub Date: 2024-07-22 DOI: 10.1111/tme.13062

Joe Flannagan, Katy L Davison, Claire Reynolds, Susan R Brailsford

{"title":"Determining the strength of evidence for an association between sexual indicators and risk of acquiring HIV and sexually transmitted infections: Providing evidence for blood donation policy change.","authors":"Joe Flannagan, Katy L Davison, Claire Reynolds, Susan R Brailsford","doi":"10.1111/tme.13062","DOIUrl":"10.1111/tme.13062","url":null,"abstract":"In 2019 the For The Assessment Of Individualised Risk (FAIR) project began a review of UK blood donor selection policy to determine if a more individualised approach to donor selection could be safely implemented. An evidence base was required to inform selection policy to move from a population to a more individual based policy, specifically what sexual behaviours/indicators should be considered as screening questions to maintain the safety of the blood supply. Eight sexual behaviours/indicators were reviewed: history of bacterial sexually transmitted infections (STIs), chemsex, number of recent partners, condom use, type of sex, sexual health service (SHS) attendance, new sexual partner and exclusivity. We conducted searches in multiple databases to identify literature looking at the association between these behaviours/indicators and HIV/STI acquisition risk. A scoring system to determine strength of evidence was devised and applied to papers that passed screening. Key studies were identified which achieved the maximum score and more in-depth reviews were conducted for these. We identified 58 studies, including 17 key studies. Strong evidence was found linking a previous bacterial STI, chemsex and increasing numbers of sexual partners to acquisition risk. Condom use, type of sex and new partners were found to have some strength of evidence for this link. SHS attendance and exclusivity had minimal evidence. We recommended that the behaviours/indicators viewed as having strong or some strength of evidence should be considered as screening questions in a more individualised approach to donor selection criteria.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"466-477"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0