Development and implementation of a hemovigilance program at a university veterinary teaching hospital.

Jillian M Haines, Thandeka R Ngwenyama, Linda G Martin, K Jane Wardrop
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引用次数: 1

Abstract

Objective: To describe the development and implementation of a small animal hemovigilance program at a university veterinary teaching hospital.

Design: Retrospective observational descriptive study performed between October 2014 and March 2019.

Setting: University teaching hospital.

Animals: Dogs and cats receiving blood product transfusions .

Interventions: None.

Measurements and main results:  A hemovigilance working group composed of veterinary specialists in clinical pathology, internal medicine, and emergency and critical care was established. This group developed evidence-based definitions of transfusion reactions, reaction classification systems, and a transfusion reaction reporting form. The reporting form contained sections for patient information, transfusion information, administration details, and reaction details. Reaction events were classified by reaction type, severity grade, and imputability to the transfusion. Following implementation of the hemovigilance program, transfusion reaction data were collected and examined for the period spanning October 2014 and March 2019. During the study period, 718 canine transfusions (4 whole blood, 400 packed RBC [pRBC], 300 fresh frozen plasma [FFP], 7 platelet rich plasma, and 7 cryoprecipitate) and 124 feline transfusions (5 whole blood, 95 pRBC, and 24 FFP) were administered. There were 32 total reactions (27 canine and 5 feline), with the most common reaction being febrile nonhemolytic transfusion reactions (19/32; 59%). The incidence rate of transfusion reactions was found to be 3.8% in dogs and 4.0% in cats. For the confirmed reactions, classification criteria for case definition, reaction severity grade, and imputability were able to be determined and recorded. This allowed targeted interventions to be implemented in order to potentially reduce future reactions.

Conclusions: A hemovigilance program can be instituted successfully in a veterinary hospital setting and once developed, standardized reporting tools could be utilized by multiple hospitals and provide the basis for more widespread reaction reporting in veterinary medicine.

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一所大学兽医教学医院血液警戒计划的制定和实施。
目的:介绍某大学兽医教学医院小动物血液警戒方案的制定和实施情况。设计:2014年10月至2019年3月进行回顾性观察性描述性研究。单位:大学教学医院。动物:接受输血的狗和猫。干预措施:无。测量结果和主要结果:成立了一个由临床病理学、内科、急诊和重症护理兽医专家组成的血液警戒工作组。该小组制定了以证据为基础的输血反应定义、反应分类系统和输血反应报告表。报告表包含患者信息、输血信息、给药细节和反应细节部分。反应事件按反应类型、严重程度和输血的可归责性进行分类。在实施血液警戒计划后,收集并检查了2014年10月至2019年3月期间的输血反应数据。在研究期间,共输718次犬血(4次全血、400次填充红细胞(pRBC)、300次新鲜冷冻血浆(FFP)、7次富血小板血浆和7次冷冻沉淀)和124次猫血(5次全血、95次pRBC和24次FFP)。共有32例反应(犬27例,猫5例),最常见的反应是发热性非溶血性输血反应(19/32;59%)。输血反应的发生率在狗和猫中分别为3.8%和4.0%。对于确诊的反应,可以确定并记录病例定义、反应严重程度等级和归责性的分类标准。这使得有针对性的干预措施得以实施,以潜在地减少未来的反应。结论:血警程序可以在兽医院成功建立,一旦开发,标准化的报告工具可以被多家医院使用,并为兽医学中更广泛的反应报告提供基础。
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