实时血液监测显示,与储存后全血随机血小板相比,使用储存前白细胞还原血小板和集合全血血小板有减少输血反应和节约成本的趋势。

Nick Park, Mayrin Correa Medina, Fernando Martinez, Marla Throssel, Amitava Dasgupta, Adriana Knopfelmacher, Colleen Villamin, Sandra Rivas, Nancy Tomczak, Saahith Garg, Lorraine Layton, Kimberly Klein
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引用次数: 0

摘要

背景:由于化疗引起的中性粒细胞减少症或血液系统恶性肿瘤,免疫功能低下的癌症患者发生发热性非溶血性输血反应的几率可能高于普通人群,因此经常需要输注血小板。该质量改进项目使用一个主动血液监测系统,比较了使用储存前白细胞还原和集合全血血小板(Acrodose/WBD)与传统的储存后全血血小板(RDP)的输血安全性:方法:在医院接受血液制品的每位患者都会受到来自远程血液监测单位的训练有素的护士的实时虚拟监测。这些护士监控着一个数字仪表盘,从开始使用血液制品到输血后 12 小时,该仪表盘会生成一份患者观察名单。在 6 个月的时间里,共对 371 名接受 792 次 RDP 输血的患者和 423 名接受 780 次 Acrodose/WBD 输血小板的患者进行了输血反应监测:结果:我们在 RDP 组中发现了 26 例输血反应,而在 Acrodose/WBD 血小板组中仅发现了 12 例输血反应:结论:Acrodose 输注血小板可减少输血反应,从而显著节约成本。
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Trend towards reduction of transfusion reactions using prestorage leukocyte-reduced and pooled whole blood-derived platelets and cost savings compared with poststorage whole blood-derived random platelets as evidenced by real-time hemovigilance.

Background: Due to chemotherapy-induced neutropenia or hematologic malignancies, immunocompromised cancer patients may have higher incidence of febrile nonhemolytic transfusion reactions compared with the general population and frequently require platelet transfusions. This quality improvement project compared the safety of transfusion using prestorage leukocyte-reduced and pooled whole blood-derived platelets (Acrodose/WBD) with conventionally produced poststorage WBD platelets (RDP) using an active hemovigilance system.

Methods: Every patient receiving a blood product at the hospital was virtually monitored in real time by trained nurses from a remote hemovigilance unit. These nurses monitor a digital dashboard, which populates a watch list of patients from the time blood product administration is initiated until 12 hours posttransfusion. Over the course of 6 months, 371 patients receiving 792 RDP transfusions and 423 patients receiving 780 Acrodose/WBD platelets transfusions were monitored for transfusion reactions.

Results: We identified 26 transfusion reactions in RDP but only 12 transfusion reactions in the Acrodose/WBD platelet group.

Conclusion: Acrodose platelet transfusion was associated with fewer transfusion reactions, which resulted in significant cost savings.

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