Esse estudo teve por objetivo avaliar a viabilidade e qualidade in vitro do concentrado de hemácias felino (CHF), colhido e armazenado em bolsas e produtos nacionais, remanufaturadas, pelo Laboratório de Hemoterapia do Serviço de Anestesia da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, de acordo com normas definidas por órgãos regulamentadores como a ANVISA. Foram analisados parâmetros bioquímicos e hematológicos de 24 unidades de CHF nos dias 0, 14 e 21 de armazenamento. Utilizou-se sistema fechado para colheita e armazenamento do sangue com solução de anticoagulante-preservativa CPDA-1. A avaliação consistiu na mensuração de porcentagem de hematócrito, hemoglobina total, hemoglobina extracelular, porcentagem de hemólise, concentrações de potássio, lactato, glicose, ATP, pH, bicarbonato, pressão de CO2 e O2, inspeção visual da bolsa e cultura microbiológica aeróbia e anaeróbia. Os resultados obtidos foram avaliados estatisticamente por meio de testes paramétricos, sendo que as determinações de hematócrito, hemoglobina total não apresentaram variação significante nos 21 dias de preservação, enquanto os de potássio, lactato, pO2 aumentaram gradativamente de forma significante. Os níveis de ATP, glicose, pH, bicarbonato e pCO2 reduziram de forma significante com o decorrer do tempo. Não houve alteração à inspeção visual das bolsas de sangue, nem crescimento de microorganismos nas culturas realizadas. Por meio destas avaliações constatouse que o sistema remanufaturado com produtos nacionais pode ser empregado com segurança para obtenção de sangue felino tendo-se em vista que se manteve estéril, com eficiente conservação do concentrado de hemácias felino em CPDA-1 até o 21º dia de armazenamento. / This study aimed to evaluate the feasibility and quality of in vitro feline packed red blood cells (CHF), harvested and stored in bags and domestic products, manufactured, Hematology Laboratory at the Department of Anesthesia, Faculty of Veterinary Medicine, University of São Paulo, according to standards set by regulatory bodies such as ANVISA. Were analyzed biochemical and hematological parameters 24 units of CHF on days 0, 14 and 21 of storage. We used a closed system for collection and storage of blood with preservative-anticoagulant solution CPDA-1. The evaluation consisted in measuring percentage of hematocrit, total hemoglobin, extracellular hemoglobin, percentage of hemolysis, potassium concentrations, lactate, glucose, ATP, pH, bicarbonate, CO2 and O2 pressure, visual inspection of the bag and aerobic and anaerobic microbiological culture . The results were statistically analyzed using parametric tests, and determinations of hematocrit, total hemoglobin showed no significant variation within 21 days of preservation, while potassium lactate, pO2 gradually increased significantly. ATP levels, glucose, pH, pCO2 and bicarbonate decreased significantly with time. There was no change to the visual inspection of blood bags, or growth of microorganisms in the cultures performed. Through these evaluations it was found that the system refilled with domestic products can be used safely for obtaining blood feline bearing in mind that remained sterile, efficient storage of red blood cells feline in CPDA-1 until the 21 th days of storage.

Esse estudo teve por objetivo avaliar a viabilidade e qualidade in vitro do concentrado de hemácias felino (CHF), colhido e armazenado em bolsas e produtos nacionais, remanufaturadas, pelo Laboratório de Hemoterapia do Serviço de Anestesia da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, de acordo com normas definidas por órgãos regulamentadores como a ANVISA. Foram analisados parâmetros bioquímicos e hematológicos de 24 unidades de CHF nos dias 0, 14 e 21 de armazenamento. Utilizou-se sistema fechado para colheita e armazenamento do sangue com solução de anticoagulante-preservativa CPDA-1. A avaliação consistiu na mensuração de porcentagem de hematócrito, hemoglobina total, hemoglobina extracelular, porcentagem de hemólise, concentrações de potássio, lactato, glicose, ATP, pH, bicarbonato, pressão de CO2 e O2, inspeção visual da bolsa e cultura microbiológica aeróbia e anaeróbia. Os resultados obtidos foram avaliados estatisticamente por meio de testes paramétricos, sendo que as determinações de hematócrito, hemoglobina total não apresentaram variação significante nos 21 dias de preservação, enquanto os de potássio, lactato, pO2 aumentaram gradativamente de forma significante. Os níveis de ATP, glicose, pH, bicarbonato e pCO2 reduziram de forma significante com o decorrer do tempo. Não houve alteração à inspeção visual das bolsas de sangue, nem crescimento de microorganismos nas culturas realizadas. Por meio destas avaliações constatouse que o sistema remanufaturado com produtos nacionais pode ser empregado com segurança para obtenção de sangue felino tendo-se em vista que se manteve estéril, com eficiente conservação do concentrado de hemácias felino em CPDA-1 até o 21º dia de armazenamento. / This study aimed to evaluate the feasibility and quality of in vitro feline packed red blood cells (CHF), harvested and stored in bags and domestic products, manufactured, Hematology Laboratory at the Department of Anesthesia, Faculty of Veterinary Medicine, University of São Paulo, according to standards set by regulatory bodies such as ANVISA. Were analyzed biochemical and hematological parameters 24 units of CHF on days 0, 14 and 21 of storage. We used a closed system for collection and storage of blood with preservative-anticoagulant solution CPDA-1. The evaluation consisted in measuring percentage of hematocrit, total hemoglobin, extracellular hemoglobin, percentage of hemolysis, potassium concentrations, lactate, glucose, ATP, pH, bicarbonate, CO2 and O2 pressure, visual inspection of the bag and aerobic and anaerobic microbiological culture . The results were statistically analyzed using parametric tests, and determinations of hematocrit, total hemoglobin showed no significant variation within 21 days of preservation, while potassium lactate, pO2 gradually increased significantly. ATP levels, glucose, pH, pCO2 and bicarbonate decreased significantly with time. There was no change to the visual inspection of blood bags, or growth of microorganisms in the cultures performed. Through these evaluations it was found that the system refilled with domestic products can be used safely for obtaining blood feline bearing in mind that remained sterile, efficient storage of red blood cells feline in CPDA-1 until the 21 th days of storage.

A lack of information is identified on the ability of professional nurses working in a neonatal intensive care unit to make competent clinical decisions pertaining to the employment of bedside blood product filters during neonatal transfusion. In addition, a lack of complete guidelines existed to aid professional nurses in instances where they are faced with such a decision. A descriptive survey was conducted to determine and describe the knowledge professional nurses working in neonatal intensive care unit have regarding the employment of bedside blood product filters during the transfusion of a neonate with blood or blood products, as well as their ability to make competent clinical decisions in the regard. A questionnaire was designed, which was validated by experts in neonatal intensive care nursing and blood transfusion. The questionnaires were distributed to 10 nominated public and private hospitals with neonatal intensive care units in Gauteng, South Africa, for completion. Participants were self-nominated; they participated in the study of their own free will. Neither the participants’ nor the hospitals’ names were revealed at any stage. Numbers were used to identify the questionnaires. 120 questionnaires were completed and were analysed using descriptive statistics. In the following step, the results obtained from the questionnaires together with literature were used to recommend guidelines for neonatal transfusion utilisation by professional nurses working in neonatal intensive care units. The recommended guidelines were divided into two categories: General guidelines and Specific blood products guidelines. Validity and reliability was enhanced by using staff from ten neonatal intensive care units from the private and public health care sector in Gauteng, South Africa; obtaining a sufficient sample size (n=120); involvement of experts in the field of neonatal nursing science and blood transfusion, as well as a statistician from the University of Pretoria; and verification of results with literature. Ethical principles were adhered to: confidentiality was maintained as no names of any of the hospitals or the participants were disclosed. All information regarding the study was provided to the relevant parties and the participants voluntarily signed an informed consent form. Permission to conduct the study was obtained from the selected hospitals’ management. Approval to conduct the study was obtained from the Ethics Committee of the Faculty of Health Science, University of Pretoria. There were no known risks involved in the study. Recommendations were made for more research on the same topic to be conducted and their outcomes be compared to the results yielded by this study and research to be conducted to related topics. The findings of this study were meant to improve the clinical practice of nursing in neonatal intensive care units. It was therefore recommended that these guidelines be implemented by neonatal intensive care units, training institutions and the South African Blood Transfusion Services. AFRIKAANS : Die navorser het ’n intensiewe oorsig van die bestaande literatuur rakende die kliniese besluitneming van professionele verpleegkundiges in neonatale intensiewe sorgeenhede gedoen. Dit het duidelik uit dié navorsingsoorsig geblyk dat daar baie min gedoen is om die vermoëns vas te stel van professionele verpleegkundiges wat in die neonatale intensiewe sorgeenheid werk met betrekking tot kliniese besluitneming wat die aanwending van bloedprodukfilters tydens neonatale transfusie betref. Aanvullend het die oorsig onthul dat daar geen volledige riglyne bestaan, of voorsien word, vir professionele verpleegkundiges in gevalle waar hul met so ’n besluit gekonfronteer word. Die studie is in twee fases gedoen. In Fase een is ’n vraelys ontwerp gebaseer op konsepte en temas uit die literatuur geїdentifiseer, waarna dit gevalideer is deur kundiges. Die vraelyste is uitgegee aan 10 genomineerde privaat- en publieke hospitale met neonatale inesiewe sorgeenhede in Gauteng vir voltooiing. Die voltooide vraelyste is gesorteer en geanaliseer. Deelnemers is self-genomineerd; die navorser het hulle toegelaat om self te besluit of hulle wou deelneem aan die studie of nie. Deelnemers en hospitale se name is op geen stadium bekend gemaak nie. Nommers is gebruik om die vraelyste te identifiseer. In Fase twee is die uitslae van die vraelyste gebruik om riglyne te ontwerp om gebruik te word in neonatale intensiewe sorgeenhede deur professionele verpleegkundiges vir neonatale transfusie. Riglyne vir neonatale transfusie is geformuleer volgens die uitkoms van die vraelyste in kombinasie sowel as die oorsig van die reeds bestaande literatuur deur middel van induktiewe en deduktiewe beredenering. Aangesien professionele verpleegkundiges kennis moet dra van algemene riglyne om spesifieke riglyne te kan toepas, is die riglyne in twee kategorieë verdeel: Algemene riglyne en Spesifieke bloedprodukte riglyne. Deur hierdie studie in twee verskillende omgewings, naamlik privaat- en publieke instansies te doen, en 10 eenhede van een area (Gauteng) in Suid- Afrika daarby te betrek, sowel as om ’n relatief groot steekproef te gebruik, is die oordraagbaarheid van die uitkoms van die studie na ander streke verhoog. Die navorser het aanbeveel dat verdere studies oor dieselfde onderwerp gedoen word, en die uitkomste daarvan vergelyk word met die resultaat van hierdie studie. Die uitkoms die studie sal dan meer oordraagbaar wees na ander streke in Suid-Afrika. Die uitgebreide literatuuroorsig, die betrokkenheid van kundiges en die navorser se eie ondervinding en kennis in die neonatale intensiewe sorgverpleegkunde, het bygedra tot die vertrouenswaardigheid van die studie. Kundiges op die gebied van neonatale verpleegkunde en bloedtransfusie was betrokke, sowel as ’n biostatistikus verbonde aan die Universiteit van Pretoria. Etiese beginsels is gevolg. Die navorser was nie bewus van, en is ook nie gekonfronteer met enige etiese dilemmas of probleme tydens die studie nie. Konfidensialiteit is deurgaans gehandhaaf in die studie deurdat geen name van die deelnemers of hospitale genoem is nie. Alle inligting met betrekking tot die studie is aan die relevante partye verstrek en die deelnemers het almal uit eie vrye wil ’n ingeligte toestemmingsvorm onderteken. Toestemming om die studie te doen is ook verkry van die genomineerde hospitale se bestuur. Toestemming om die studie te doen is verkry van die Etiese Komittee van die Fakulteit van Gesondheidswetenskappe, Universiteit van Pretoria. Daar was geen risiko’s betrokke aan die studie nie, slegs voordele, aangesien die doel van die studie was om die professionele verpleegkundiges in die neonatale intensiewe sorgeenhede behulpsaam te wees met besluitneming rakende die gebruik van bloedprodukfilters tydens transfusie van bloed of bloedprodukte aan ’n neonaat. Die bevindings van die studie is bedoel om die kliniese praktyk van verpleging in neonatale intensiewe sorgeenhede te verbeter. Gevolglik word ’n aanbeveling gemaak dat hierdie riglyne geïmplimenteer word in neonatale intensiewe sorgeenhede, opleidingsinstansies sowel as die Suid-Afrikaanse Bloedoortappingsdiens. / Dissertation (MCur)--University of Pretoria, 2011. / Nursing Science / unrestricted