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在输血时降低红细胞成分保存时间的库存管理策略。

Inventory management strategies that reduce the age of red blood cell components at the time of transfusion.

作者信息

Poisson Jessica L, Tuma Christopher W, Shulman Ira A

机构信息

Department of Pathology, Keck School of Medicine, University of Southern California; and the Transfusion Service, LAC+USC Medical Center, Los Angeles, California.

出版信息

Transfusion. 2016 Jul;56(7):1758-62. doi: 10.1111/trf.13639. Epub 2016 May 17.

Abstract

BACKGROUND

There has been interest concerning patient outcomes when older red blood cell (RBC) components are utilized. Inventory management is key to maintaining a stock of fresher RBCs for general transfusion needs. We have altered our practice for RBC management to reduce RBC age at the time of transfusion.

STUDY DESIGN AND METHODS

Retrospective review of RBC age at time of transfusion at a tertiary care hospital with active trauma service was performed. The baseline nonirradiated RBC inventory was decreased from 12 to 15 days of stock to 7 to 10 days of stock, with request made to the blood supplier for fresher RBCs, specified at 75% of RBCs less than 14 days old. The age of RBCs at time of receipt and at time of transfusion was tracked on a monthly basis for the next 12 months.

RESULTS

The mean age of RBCs at transfusion was decreased by 9 days on average for the year. Significant decreases in the mean age of RBCs at transfusion were seen in the second half of the year, with 4 of 6 months seeing a mean age of less than 20 days. There were no documented incidences of hospital blood shortages after the reduction in inventory; no surgery was canceled or delayed because of inventory.

CONCLUSION

Inventory age depends on active management, combined with vendor cooperation to receive fresher components. Reducing the age of RBC components transfused is possible without experiencing blood component shortages. Longer periods of observation may allow for further adjustment of stocking levels on a seasonal basis.

摘要

背景

使用较陈旧的红细胞(RBC)成分时,人们一直关注患者的治疗效果。库存管理是维持库存新鲜红细胞以满足一般输血需求的关键。我们改变了红细胞管理做法,以降低输血时红细胞的老化程度。

研究设计与方法

对一家设有活跃创伤服务的三级护理医院输血时红细胞的老化情况进行回顾性研究。将基线未辐照红细胞库存从12至15天的储备量减少至7至10天的储备量,并要求血液供应商提供更新鲜的红细胞,规定75%的红细胞年龄小于14天。在接下来的12个月里,每月跟踪红细胞接收时和输血时的年龄。

结果

这一年输血时红细胞的平均年龄平均降低了9天。下半年输血时红细胞的平均年龄显著降低,6个月中有4个月的平均年龄小于20天。库存减少后,没有记录在案的医院血液短缺事件;没有手术因库存问题而取消或推迟。

结论

库存年龄取决于积极管理以及供应商配合以接收更新鲜的成分。在不出现血液成分短缺的情况下,降低输注红细胞成分的年龄是可行的。更长时间的观察可能有助于根据季节进一步调整库存水平。

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