Optimizing O red blood cell concentrate usage in the emergency department in the era of patient blood management.

Autor:	Courcelles L; Blood Transfusion Service, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Woluwe Saint-Lambert, 1200 Brussels, Belgium., Pouplard M; Blood Transfusion Service, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Woluwe Saint-Lambert, 1200 Brussels, Belgium., Braun O; Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Woluwe Saint-Lambert, 1200 Brussels, Belgium., Streel C; Blood Transfusion Service, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Woluwe Saint-Lambert, 1200 Brussels, Belgium., Deneys V; Blood Transfusion Service, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Woluwe Saint-Lambert, 1200 Brussels, Belgium. Electronic address: veronique.deneys@saintluc.uclouvain.be.
Jazyk:	angličtina
Zdroj:	Hematology, transfusion and cell therapy [Hematol Transfus Cell Ther] 2024 Nov; Vol. 46 Suppl 5, pp. S90-S96. Date of Electronic Publication: 2024 Aug 21.
DOI:	10.1016/j.htct.2024.05.008
Abstrakt:	Background: Emergency transfusion may require the availability of O-negative red blood cell concentrates without pre-transfusion testing. At the Cliniques Universitaires Saint-Luc, the emergency department was used to having access to two decentralized O-negative red blood cell concentrates. This study aims to analyze the consumption of O-negative red blood cell concentrates in emergency situations both before and after the implementation of a novel strategy aiming at optimizing stocks. This strategy provides a combined allocation of one unit of O-positive red blood cell concentrate and one unit of O-negative red blood cell concentrate decentralized in the emergency department and reserve the transfusion of the negative unit only to under 45-year-old women and under 20-year-old men. Materials and Methods: A retrospective study was conducted of the transfusion and medical records of all patients who received immediate transfusions in the emergency department without pre-transfusion testing between 2008 and 2022. Results: A total of 193 patients received O red blood cell concentrates without pre-transfusion testing in emergency situations between 2008 and 2022. During the first 24 h of hospitalization, 354 O-negative units were transfused. Mean ratios of number of O-negative bags between 2008 and 2020 was 1.98 unit/patient. After implementation of the new strategy, the ratio in 2021 was 1.46 unit/patient and drastically decreased in 2022 to 0.79 unit/patient. Conclusion: In situations of emergency, allocating O-negative units only for women younger than 45 years and men younger than 20 years could have saved 85% of O-negative red blood cell concentrates transfused (303/354) yet balancing the immunological risk. Limiting the number of delocalized units of O-negative red blood cell concentrates in the emergency department seems to lower O-negative consumption. With this strategy, the units spared could have been transfused to patients with greater needs (e.g., sickle cell patients or chronically transfused patients). Competing Interests: Conflicts of interest The authors affirm that they have no conflicts of interest to declare. (Copyright © 2024 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu