A hemotransfusÃo à uma necessidade que acompanha a humanidade desde seus primÃrdios. A partir do sÃculo XV vÃrios estudiosos tentaram utilizar o sangue atravÃs da transfusÃo. Somente no sÃculo XX com a descoberta dos grupos sangÃÃneos e a descriÃÃo da prova cruzada, tornaram a transfusÃo como um mÃtodo cientÃfico. Os institutos de transfusÃo de sangue foram criados na Europa a partir do ano de 1920. No Brasil somente na dÃcada de 1940 surgiram as primeiras organizaÃÃes hemoterÃpicas. Em 1949 surgiu a Sociedade Brasileira de Hematologia e Hemoterapia. A primeira Lei incentivando a doaÃÃo voluntÃria de sangue no Brasil data de 1950. Com o surgimento do movimento militar em 1964 e a constataÃÃo de que numa eventual catÃstrofe nÃo haveria sangue suficiente para atender a demanda nacional, à recomendada uma definiÃÃo na PolÃtica Nacional de Sangue. Em 1965 à editado pelo Governo Federal a Lei n 4.071 disciplinando a atividade hemoterÃpica no paÃs. E este foi o primeiro passo para regulamentar estes serviÃos. Somente em 1980 à criado o Programa Nacional de Sangue e Hemoderivados â Pro-Sangue tendo com meta a implantaÃÃo dos Hemocentros no Brasil. Comparando-se o ano de 1999 quando 2.096.190 coletas de sangue foram realizadas pela Hemorrede Nacional em relaÃÃo ao ano de 2000 quando 2.329.937 pessoas doaram sangue, notamos um aumento significativo no nÃmero de doadores em todo o Brasil. A GerÃncia Nacional de Sangue e Hemoderivados responsÃvel pelo setor de sangue no Brasil estima o percentual das doaÃÃes espontÃneas em torno de 41,74% sendo que 54,99% representam os doadores de reposiÃÃo. Em 1971 surgem os primeiros bancos de sangue privados no CearÃ. Em 1983 HEMOCE inicia suas atividades. ApÃs dez anos os Hemocentros Regionais sÃo implantados no interior do Estado. Hoje a cobertura hemoterÃpica no Cearà se aproxima dos 100% atendendo a todos os hospitais pÃblicos e privados. / The hemotransfusion is a need which has accompanied the humanity since its origins. Starting from the 15th century, several specialists tried to use the blood trough transfusion, however, only in the 20th century, with the discovery of blood groups and description of the crossed proof, transfusion was recognized as a scientific method. Blood Tranfusion Institutes were created in 1920, but in Brazil, only in the decade of 1940 apperead the first hemotherapics organizations. In this period, the Brazilian Society of Hematology and Hemotherapy was founded (in 1949) and the first law motivating the voluntary donation of blood in Brazil was written (which dates from 1950). In 1964, with the appereance of the military movement and the verification that in an eventual catastrophe there would not be enough blood to assist the national demand, was recommended a definition in the National Politics of Blood. In 1965 was edited by the Federal Government the law number 4.071 which has established rules to hemotherapic activity in the country and this was the first step to regulate this kind of service. But only in 1980 the National Program of Blood and Stems â Pro-Sangue was created tends with main goal the implantation of Hemocenters in Brazil. Comparing the year 1999, when 2.096.190 blood collections were accomplished by National Hematology Network, with the year 2000, when 2.329.937 people donated blood, we noticed a significant increase in the number of donors throughout Brazil. The National Management of Blood and Stems, responsible for the blood section in Brazil, steems the percentage of spontaneous donations around 41,74% and in this estimate 54,99% represent replacement donors. In 1971, the first private blood banks showed up in CearÃ, and in 1983, HEMOCE, started to operate. Ten years later, Regional Hemocenters was implanted in the country side of the state. Nowadays, the hemotherapic coverage in Cearà approaches 100%, assisting all of the public and private hospitals.

L’objectif de notre travail est de contribuer à l’amélioration de la sécurité transfusionnelle. Pour ce faire, nous sommes partis de notre expérience personnelle en banque de sang hospitalière. Le risque infectieux lié aux transfusions, inscrit dans l’esprit de chacun depuis l’affaire du « scandale du SIDA » en France, est aujourd’hui un des risques les mieux maîtrisés. Actuellement, les risques transfusionnels les plus importants sont essentiellement de type immunologique ou liés à des erreurs humaines. Nous avons donc mis en évidence trois axes de travail correspondant chacun à un type de réaction transfusionnelle spécifique choisis parmi ces deux derniers risques. Les données d’hémovigilance internationales publiées nous ont confortés dans l’idée que ces trois sujets représentent une part importante des réactions transfusionnelles notifiées ces dix dernières années. Nous avons choisi de travailler sur la prévention des réactions transfusionnelles hémolytiques de type ABO, des réactions transfusionnelles hémolytiques chez les patients atteints d’anémie hémolytique auto-immune et des réactions d’hyperkaliémie post-transfusionnelle.<p>Notre premier travail a consisté en la démonstration de la faisabilité d’une automatisation complète du contrôle ultime au lit du malade par vérification de la compatibilité entre le groupe ABO du patient et celui de la poche de sang à transfuser. Cet appareil utilise une nouvelle technique de détection d’hémagglutination entièrement conçue et validée au sein de notre laboratoire de recherche et brevetée par l’ULB.<p>La seconde partie du travail consiste en l’évaluation d’un nouvel algorithme de prise en charge transfusionnelle des patients atteints d’anémie hémolytique autoimmune en incluant la réalisation d’un génotypage érythrocytaire permettant ainsi, d’une part, d’éviter les réactions hémolytiques transfusionnelles et, d’autre part, d’éviter de nouvelles alloimmunisations chez ces patients.<p>Dans la dernière partie du travail, nous nous sommes intéressés aux effets des liquides de conservation des poches de sang sur le relargage de potassium à partir d’unités de globules rouges irradiées destinées aux patients immunodéprimés. Nous avons pu observer des différences entre les deux solutions de conservation que nous utilisons et nous avons pu ainsi émettre de nouvelles recommandations visant à prévenir ces hyperkaliémies transfusionnelles.<p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Blood transfusion forms a mainstay of the treatment of a variety of illnesses, and is lifesaving. Nonetheless, it is not without its risks and drawbacks. Blood transfusion is a cornerstone in the treatment of canine babesiosis. The development of blood alternatives has received attention in recent times. Blood alternatives offer much of what natural blood does but without many of the associated drawbacks. These include disease transmission, transfusion reactions, poor in vitro and in vivo shelf-life and special storage and administration requirements. One product, Oxyglobin®, is the first commercially available, veterinary-licensed, haemoglobin-based oxygen carrying solution (HBOCS). Although licenced for use in canine babesiosis, this colloidal “Oxygen Bridge” has never been evaluated against the gold standard of therapy, isovolumic packed red blood cell transfusion (pRBCT). This investigation was conducted to evaluate important aspects the equivalence of these two treatments in a field situation of naturally-infected dogs. Given the cost of HBOCS, they are unlikely to be commonly used by the practicing veterinarian in the treatment of canine babesiosis. Nonetheless, similarities in efficacy would bolster the case for and further research into blood substitutes of this and other classes, and may open the way to evaluation of HBOCS for falciparum malarial anaemia, a disease similar in many respects to canine babesiosis. / Dissertation (MMedVet)--University of Pretoria, 2007. / Companion Animal Clinical Studies / unrestricted

No description available.

Red blood cells are commonly administered during the perioperative period, however our understanding of available guidance informing transfusion decisions as well as appropriateness of current practice is not well understood. Blood transfusions are associated with post-operative morbidity and possibly worse long-term outcomes. Furthermore, they are a costly and limited resource. They should therefore be used sparingly. The objective of this thesis was to further our understanding of guidance available for administration of intraoperative red blood blood cell transfusion, as well as conduct an audit of the appropriateness of transfusions administered during the perioperative period. This thesis is composed of both a systematic review as well as a retrospective review of a prospectively maintained database. The systematic review of identified 10 guidelines published between 1992-2018 that included indications for intraoperative transfusions. Six provided objective clearly defined criteria for transfusion based on hemoglobin triggers (range 60-100g/L) or hematocrit (<30%); one stated a specific clinical situation for which transfusion would be appropriate (ST changes). The evidence supporting intraoperative recommendations was extrapolated primarily from the non-operative setting. Retrospective review of a single centre revealed 19% of patients underging liver resection were transfused a mean of 2.6 units during the perioperative period. A total of 22% to 63% of transfusions administered during the intraoperative period were considered inappropriate based on the application of three different instruments. In contrast, 38% to 67% of transfusions administered during the postoperative period were considered inappropriate. Patients considered to have been inappropriately transfused during the intraoperative period were at increased risk of developing a major postoperative adverse event (Clavien-Dindograde 3) compared to those who did not receive a transfusion (OR 4.2; 95% CI 1.1-15.6). In conclusion, this thesis demonstrates evidence-based, practitioner oriented, intraoperative transfusion guidance for clinicians is lacking. Furthermore, a significant proportion of patients continue to be exposed to unnecessary transfusion. Further work in this area is warranted to clarify indications for intraoperative transfusion and subsequently minimize the administration of unnecessary transfusion.

No description available.

In humans, washing stored blood products prior to transfusion reduces storage lesions and the potential for transfusion reaction, but the effectiveness of washing units of canine whole blood is unknown. The objective of this study was to determine if a manual method of washing of stored whole blood units reduced storage lesions without adversely affecting erythrocytes. Units of canine whole blood were stored for 28 days and manually washed three times with sterile .9% NaCl. Following the first wash, there was a decrease in serum potassium (P<.0001), lactate (P<.0001), pH (P=.0110), pCO2 (P<.0001), TCO2 (P<.0001), arachidonic acid (P<.0001), and thromboxane B2 (P=.0417), and increases in iCa (P=.0494), iMg (P=.0024), MCV (P<.0001), MCHC (P=.0093), RDW (P=.0009), hemoglobin (P=.0011), and MCF (P=.0006). No bacterial growth was identified on the post-transfusion samples. Manual washing of stored blood significantly reduces storage lesions after a single wash and additional washing may cause in vitro hemolysis.

An association between compatible but ABO non-identical red blood cell (RBC) transfusions and increased in-hospital mortality was identified in an observational study. A review of the literature was performed to explore plausible biological mechanisms and inflammation was chosen. This thesis describes a body of work that was performed to develop a PICOT research question and design a pilot feasibility randomized crossover trial in patients with myelodysplastic syndrome (MDS) to determine whether there is evidence of an inflammatory response resulting from transfusion of ABO non-identical RBCs compared with the transfusion of ABO identical RBCs. The work undertaken as part of this thesis included: identifying a theoretical framework to guide the selection of outcome measures that would detect inflammation; identifying an appropriate and feasible population to study; designing the feasibility pilot study to answer the research question that was developed; and a discussion of ethical issues that were considered as the design of the pilot study was developed. The work that was done to develop the elements of PICOT resulted in the following research question: Is it feasible to perform a randomized crossover trial in chronically transfused blood group A patients with myelodysplastic syndrome (MDS), that looks for laboratory evidence of inflammation (in vitro biomarkers measured at baseline and pre-specified times between 1 and 96 hours post transfusion), following the transfusion of group O RBCs (ABO non-identical) compared to transfusion of group A (ABO identical) RBCs? / Thesis / Master of Science (MSc)

A transfusão de hemocomponentes, apesar de segura, expõe o paciente a riscos de reações adversas, as reações transfusionais. No Brasil a ocorrência dessas reações é de notificação obrigatória à Agência Nacional de Vigilância Sanitária (ANVISA). As reações notificadas tornam-se fontes de informação para ações de avaliação, controle, prevenção, melhoria da qualidade e segurança do processo transfusional. Objetivos: Identificar, descrever e analisar as reações transfusionais imediatas ocorridas num hospital da Rede Sentinela do interior do estado de São Paulo e propor medidas para ajustar a Hemovigilância no hospital. Casuística e Métodos: Realizado estudo prospectivo, descritivo, quantitativo e exploratório, por meio de ações de Hemovigilância: visita pós transfusional para busca ativa de reações transfusionais imediatas e investigação junto à equipe de trabalho, identificando motivos para subnotificação de reações. Resultados: Em 1230 hemocomponentes transfundidos, incluídos no estudo, de março a junho de 2016 e junho de 2017, foram encontradas 167 reações transfusionais imediatas, que deveriam ter sido notificadas. Porém, no período, foram notificadas apenas 22 com uma subnotificação de 145 reações (11,8% ou 117,9 reações por 1000 hemocomponentes transfundidos). A maioria das reações subnotificadas foram Reações Febris Não Hemolíticas (RFNH) e Reações Alérgicas (ALG), de gravidade leve, com imputabilidade possível, mas também foram subnotificadas reações de gravidade moderada e grave: Sobrecarga circulatória associada à transfusão (SC/TACO). As causas identificadas para subnotificação foram: desinformação do paciente, falha na monitorização de sinais vitais póstransfusionais, excesso de transfusão no período noturno com equipe de trabalho reduzida, dificuldade de identificar a reação transfusional pela equipe de trabalho, sinalizando a necessidade de capacitação periódica. Conclusões: Este estudo contribuiu para reflexão, identificação de necessidades de educação continuada em serviço e, principalmente, para conscientização da importância de uma equipe de trabalho destinada a realizar ações de Hemovigilância por meio da busca ativa de reações transfusionais. / Although the transfusion of blood components is safe, it exposes the patient to risks of adverse transfusion reactions. In Brazil, the occurrence of these reactions has to be mandatorily notified to the Brazilian Health Regulatory Agency (ANVISA). The reactions notified become a source of information for actions of assessment, control, prevention, quality improvement and safety of the transfusion process. Objectives: To identify, describe, and analyze the immediate transfusion reactions at a hospital of the Sentinela Network in the countryside of the state of São Paulo and then to propose measures to adjust hemovigilance at the hospital. Casuistic and Methods: We carried out a prospective descriptive quantitative exploratory study by the hemovigilance actions: visit after transfusion for the active search of immediate transfusion reactions and investigation with the work team, identifying the reasons for the subnotification of reactions. Results: In 1230 blood components transfused included in this study, from March 2016 to June 2017, we found 167 immediate transfusion reactions which should have been notified; however, in this period, only 22 were notified with a subnotification of 145 reactions (11.8% or 117.9 reactions per 1000 blood components transfused). Most reactions subnotified were Febrile Non-Hemolytic Reactions (FNHTR) and Alergic Reactions (ALG), with mild severity and possible imputability, but moderate and severe reactions were also subnotified; such as Transfusion-associated circulatory overload (TACO). The causes identified for subnotification were: patient misinformation, fail in monitoring vital signs after transfusion, excess of transfusions in the night shift with a reduce work team, and difficulty of the team in identifying the transfusion reaction, highlighting the need for continuous training in Hemovigilance. Conclusions: This study contributed to reflect on and identify the needs for continuing education in the service mainly to make the health team aware of the importance to take hemovigilance actions by the active search of transfusion reactions.

Made available in DSpace on 2016-08-10T10:54:40Z (GMT). No. of bitstreams: 1 VIVIANNE TEIXEIRA DUARTE VALERIO.pdf: 673884 bytes, checksum: e2b380f28837d9659beb99ebb03ec6eb (MD5) Previous issue date: 2015-03-11 / Blood transfusion is a well-established and an essential therapy in clinical settings. In practical terms, blood transfusion presents risks to the receptor even when it is properly administered and when it follows transfusion rules; This adverse events may occur, they so-called transfusion reaction. The present study evaluate acute transfusion reaction in the Clinical Hospital of Goiás between January to June 2014. This is a prospective epidemiological study based on a quantitative approach. We performed data collection through two different ways. Firstly by an active search for evidence of acute transfusion reaction in transfusion and medical records and secondly by spontaneous reporting. Data collection started after the Research Ethics Committee approval report number 490,699. After the data collection, they were recorded and analyzed using the statistical software Bioestat 5.0. We adopted a significance level of 5% (p &#8804; 0.05) or all the analyzes. The rate of acute transfusion reactions analyzed by active search was 10.6 in 852 transfusions and 1.8 of spontaneous reports in 5440 transfusions, covering an underreporting rate of 47.4%. The packed red blood cells prevailed as the most common blood component in transfusion related to reactions (61.3%). Age and gender distribution were not statistically significant (p = 0.0912 and 0.9982 respectively). Allergic reaction was the most common event (n = 13, 68.4%). Interestingly the rate of febrile non-hemolytic transfusion reaction was small (n=2, 10.5%), the volume overload represented (n=2, 10.5%) of the reactions and the hypotensive response rate was (n = 1, 5.3%). The results show an improvement of the reports in the Clinical Hospital of Goiás compared to the reports described in the national Haemovigilance in 2014. It is less than ideal and it reflects the situation of the hemotherapy in country, with few reports and a small production of national knowledge on the subject. / A transfusão de sangue é uma terapêutica consagrada e essencial em situações clínicas. Na prática, apesar de corretamente administrada e obedecendo às normas vigentes, a transfusão apresenta riscos ao receptor, podendo ocorrer eventos adversos chamados de reações transfusionais. Este trabalho teve como objetivo avaliar as reações transfusionais agudas ocorridas no Hospital das Clínicas de Goiás, no período de janeiro a junho de 2014. Trata-se de um estudo epidemiológico prospectivo com abordagem quantitativa. A coleta de dados foi guiada por dois caminhos, a busca ativa por evidências de reações transfusionais agudas nos registros transfusionais e prontuários, e pelas notificações espontâneas. A coleta de dados iniciou-se após aprovação pelo Comitê de Ética em Pesquisa da PUC-GO sob parecer nº. 490.699. Após a coleta dos dados, os mesmos foram registrados e analisados no pacote estatístico Bioestat, 5.0. Em todas as análises adotou-se um nível de significância de 5% (p &#8804; 0,05). A incidência de reações transfusionais agudas encontrada nas transfusões estudadas por busca ativa foi de 10,6 em 852 hemocomponentes transfundidos, já a notificada espontaneamente foi 1,8 em 5440 transfusões, perfazendo uma taxa de subnotificação de 47,4%. O concentrado de hemácias prevaleceu como o hemocomponente mais associado às reações transfusionais (61,3%), a distribuição por gênero não foi estatisticamente significativa (p=0,9982) e nem por idade (p= 0,0912). A reação alérgica foi a reação mais comum (n=13, 68,4%), fato interessante é a pequena ocorrência de reação febril não hemolítica (n=2, 10,5%), a sobrecarga volêmica representou (n=2, 10,5%) das reações encontrados, reação hipotensiva (n=1, 5,3%). Os resultados encontrados demonstram um avanço das notificações no Hospital das Cínicas de Goiás em relação às notificações do estado de Goiás descritas no relatório de hemovigilância nacional 2014, mas aquém do ideal e reflete a situação da hemoterapia do país, com poucas notificações e pequena produção de conhecimento nacional acerca do assunto.