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Garcia J, Carneiro ACDM, Silva SS, da Silva KFN, Meneguci J, Moraes-Souza H. Underreporting of transfusion incidents. Hematol Transfus Cell Ther 2024; 46:186-191. [PMID: 38485548 DOI: 10.1016/j.htct.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/22/2023] [Accepted: 01/17/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Blood transfusion is an effective therapeutic practice. However, even adopting all procedures for transfusion safety, there are risks, one of which is immediate adverse reactions. The aim of this study was, by active search, to evaluate the occurrence of immediate adverse reactions estimating the occurrence rate within the first 24 h. METHODS An exploratory, descriptive, prospective study with quantitative analysis was carried out of patients undergoing surgery who received blood component transfusions during hospitalization from October 2018 to August 2019. Data on blood component request forms were collected from the transfusion agency by reviewing medical records and interviewing the patient or family members. Descriptive statistics and the chi-square test were used to analyze the association of demographic variables with the presence or absence of transfusion reactions. RESULTS A total of 1042 blood component units were transfused in 393 transfusions performed on 184 patients. The main transfused blood component was packed red blood cells. Seventeen reactions were identified in the medical records, using the active search method, none of which had been reported. The transfusion reaction rate was 16.3 occurrences per 1000 transfused units, while the notification rate for the 9389 blood component units transfused by the transfusion agency in the study period was 3.83/1000. There was no statistically significant association between the occurrences or not of transfusion reactions and demographic variables. CONCLUSION Through the active search method, it was possible to observe the underreporting of adverse reactions, showing inadequate compliance with current legislation, which is essential to minimize errors and increase transfusion safety.
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Affiliation(s)
- Josiane Garcia
- Health Surveillance Unit, Quality Management Sector, Clinical Hospital of the Federal University of Triângulo Mineiro (HC-UFTM/Ebserh), Uberaba, MG, Brazil
| | | | - Sheila Soares Silva
- Medical Clinical Department, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Karla Fabiana Nunes da Silva
- Technical Course in Nursing at the Center for Professional Education, Federal University of Triângulo Mineiro (CEFORES/UFTM), Uberaba, MG, Brazil
| | - Joilson Meneguci
- Telehealth Unit, Teaching and Research Management, of the Clinical Hospital of the Federal University of Triângulo Mineiro (HC-UFTM/Ebserh), Uberaba, MG, Brazil
| | - Helio Moraes-Souza
- Medical Clinical Department, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil.
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White SK, Walker BS, Schmidt RL, Metcalf RA. The incidence of transfusion-related acute lung injury using active surveillance: A systematic review and meta-analysis. Transfusion 2024; 64:289-300. [PMID: 38116828 DOI: 10.1111/trf.17688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion-related mortality. A concern with passive surveillance to detect transfusion reactions is underreporting. Our aim was to obtain evidence-based estimates of TRALI incidence using meta-analysis of active surveillance studies and to compare these estimates with passive surveillance. STUDY DESIGN AND METHODS We performed a systematic review and meta-analysis of studies reporting TRALI rates. A search of Medline and Embase by a research librarian identified studies published between January 1, 1991 and January 20, 2023. Prospective and retrospective observational studies reporting TRALI by blood component (red blood cells [RBCs], platelets, or plasma) were identified and all inpatient and outpatient settings were eligible. Adult and pediatric, as well as general and specific clinical populations, were included. Platelets and plasma must have used at least one modern TRALI donor risk mitigation strategy. A random effects model estimated TRALI incidence by blood component for active and passive surveillance studies and heterogeneity was examined using meta-regression. RESULTS Eighty studies were included with approximately 176-million blood components transfused. RBCs had the highest number of studies (n = 66) included, followed by platelets (n = 35) and plasma (n = 34). Pooled TRALI estimates for active surveillance studies were 0.17/10,000 (95% confidence intervals [CI]: 0.03-0.43; I2 = 79%) for RBCs, 0.31/10,000 (95% CI: 0.22-0.42; I2 = <1%) for platelets, and 3.19/10,000 (95% CI: 0.09-10.66; I2 = 86%) for plasma. Studies using passive surveillance ranged from 0.02 to 0.10/10,000 among the various blood components. DISCUSSION In summary, these estimates may improve a quantitative understanding of TRALI risk, which is important for clinical decision-making weighing the risks and benefits of transfusion.
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Affiliation(s)
- Sandra K White
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | | | - Robert L Schmidt
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- ARUP Laboratories, Salt Lake City, Utah, USA
| | - Ryan A Metcalf
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
- ARUP Laboratories, Salt Lake City, Utah, USA
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Rehan M, Iqbal T, Sarwar M, Khan M, Tariq M, Ain Q, Waheed U. Pattern of Acute Adverse Transfusion Reactions in Patients With Burn Injuries: A Novel Initiative Towards Haemovigilance at the National Burn Centre of Pakistan. ANNALS OF BURNS AND FIRE DISASTERS 2023; 36:261-265. [PMID: 38680442 PMCID: PMC11042048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/16/2022] [Indexed: 05/01/2024]
Abstract
The transfusion of blood and blood components is a life-saving medical procedure, however, it is linked with adverse reactions to transfusions. Information about different types of adverse transfusion reactions (ATRs) will assist in their early identification and subsequent management, as well as in devising strategies to minimize the occurrence of adverse reactions related to blood component transfusion. The current study was therefore executed to analyze the pattern of ATRs in patients with burn injuries at a national burn center. This was a cross-sectional, prospective study involving an analysis of immediate ATRs from January 2020 to June 2021 (18 months). ATRs observed during the study period were documented and analyzed. During the study period, 2,220 units of blood and blood components were transfused to 1,075 burn patients (2.06 transfusions per patient). A total of 27 ATRs were recorded (1.21%). Allergic reactions were the commonest (55.55%) followed by febrile non-haemolytic transfusion reaction (37.03%). The mean volume of blood unit transfused, when the reactions were noted, was approximately 75 ml (range: 15-230 ml). The mean time at which transfusion reactions were noted was 17 min (range: 5-220 minutes). The ATRs were more common in patients with multiple transfusions compared to those receiving a single transfusion. The common adverse reactions were allergic and febrile non-haemolytic transfusion reactions. It is vital to report all transfusion reactions to the attached blood center and hospital transfusion committee (HTC) on standardized reporting forms. Continuous medical education through seminars and sensitization workshops will support consolidating haemovigilance systems.
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Affiliation(s)
- M. Rehan
- Department of Burn and Reconstructive Surgery, National Burn Care Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
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Muche Y, Gelaw Y, Atnaf A, Getaneh Z. Blood Transfusion Complications and Associated Factors Among Blood-Transfused Adult Patients at Debre Markos Comprehensive Specialized Hospital, Ethiopia: A Cross Sectional Study. J Blood Med 2023; 14:389-398. [PMID: 37313438 PMCID: PMC10259606 DOI: 10.2147/jbm.s412002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/26/2023] [Indexed: 06/15/2023] Open
Abstract
Background Blood transfusion is the infusion of whole blood or its components into the veins of the patient to improve tissue oxygenation and maintain hemostasis. Besides its clinical use, it can pose a risk of transfusion complications with different factors. Purpose The aim of this study was to assess blood transfusion complications, and associated factors among transfused adult patients at Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2022. Materials and Methods An institution-based cross-sectional study design was conducted on a total of 182 patients from March 20 to June 15, 2022. Patients were enrolled in the study using consecutive sampling method. The socio-demographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 3 ml of anti-coagulated blood and 30 ml of urine samples were collected to assess transfusion complications. CBC and Coombs test were performed from blood and urinalysis from urine, respectively. Chi-square, Fisher's exact test, and binary logistic regression were done using SPSS version 25. P-values less than 0.05 are declared as statistically significant. Results An acute transfusion reaction (ATR) was encountered in 12 (6.6%) patients. It was 4.13, 7.78 and 3.96 times more likely to occur among patients with a previous history of transfusion, abortion, and transfused blood stored for more than 20 days compared to their counterparts, respectively. In addition, the odds of developing ATR increase by 2.07 as the number of transfused blood units increases by 1 unit. Conclusion The incidence of acute transfusion reactions was high. During transfusion, clinicians should closely monitor patients who had history of transfusion, abortion, transfused old blood and more than 1 unit.
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Affiliation(s)
- Yalew Muche
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aytenew Atnaf
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Jiang L, Zhang G, Hao K, Xiang W, Zhang Q, Xie Y, Wang Z, Chen B, Du Y. Electronic transfusion consent and blood delivering pattern improve the management of blood bank in China. BMC Health Serv Res 2022; 22:561. [PMID: 35473708 PMCID: PMC9044836 DOI: 10.1186/s12913-022-07825-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/22/2022] [Indexed: 11/22/2022] Open
Abstract
Background The aim of this study was to improve the blood transfusion treatment consent accuracy, simplify the verification process, prolong the temperature control time before the blood transfusion, and save the blood transportation labor cost. Methods We designed the blood transfusion consent electronic signing process, which can generate personalized the text content and can automatically check the filling accuracy. The signal can be transmitted to the blood transfusion management system (TMS) to relieving the blood distribution. For blood delivering pattern, we established the blood transport center, recruited full-time nurses and used temperature-controlled blood transfer boxes to deliver blood in batches on a regular basis. Results A quarterly data analysis of blood transfusion quality showed a 100% blood transfusion consent accuracy after an electronic signing process was implemented. The average confirmation time savings between the electronic content and paper content was 26 min for the Department of Emergency (estimated difference 95% CI = 26 (20 to 36), p < 0.05). The blood delivering pattern reduced the time for each unit by leaving the average temperature control by 7.24 min (estimated difference 95% CI = 7.24 (6.92 to 7.56), p < 0.05). Furthermore, $3.67 was saved for the blood transportation labor cost for each unit as well. Conclusion Blood transfusion consent electronic signing process not only ensures the accuracy, but also saves the verification time. Moreover, the blood delivering pattern prolongs the blood temperature control time and saves blood transportation labor costs. Thus, these two improvements could enhance transfusion management. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07825-6.
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Affiliation(s)
- Luxi Jiang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Guobing Zhang
- XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, No.53 Chengbei East Road, Xianju, Zhejiang, China.,Department of Quality Management, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Ke Hao
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Weiling Xiang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Qin Zhang
- Department of Quality Management, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Yiwei Xie
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China
| | - Zhen Wang
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China.
| | - Bingyu Chen
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China.
| | - Yaoqiang Du
- Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No.158 Shangtang Road, Hangzhou, Zhejiang, China.
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