Kok Jian Hao Jaryl, Lam Choong Weng Leslie, Lee Mee Yin Joanne
Department of Laboratory Medicine, Ng Teng Fong General Hospital, Singapore.
Asian J Transfus Sci. 2019 Jan-Jun;13(1):3-9. doi: 10.4103/ajts.AJTS_52_18.
Recent advances in damage control resuscitation have advocated a push for early transfusion to maintain circulating volume and minimization of crystalloid use. While measures such as using rapid-matched group specific blood or uncrossmatched blood have been implemented to shorten this wait, delivery times can still be improved. We explored reducing delivery times by use of a pneumatic tube delivery system already built in our hospital. Few studies have evaluated this using fresh blood samples for one-way transport. We modified and evaluated our pneumatic tube delivery system for delivery timings and quality parameters; designing a robust protocol that also tested aged blood for simulated returns unlike other previous studies.
Delivery timings of emergency blood products by our present portering system were collected and compared against that of products sent through the pneumatic tube system (PTS). The samples sent through the PTS were also tested and analyzed for temperature, quality, and hemolysis in accordance with established blood banking quality guidelines.
Blood products delivered by our PTS showed satisfactory conformance with all parameters of temperature, timing, and hemolysis. We showed a significant reduction in transport delivery times from mean of 8 min 43 s to 2 min 23 s.
Delivery of blood products by our modified PTS is safe and significantly reduces delivery time. This time savings could be clinically significant in resuscitation. Usage of the PTS could also cut down on workforce utilization of porters, freeing them up for other tasks in the hospital.
损伤控制复苏的最新进展主张尽早输血以维持循环血容量，并尽量减少晶体液的使用。虽然已经采取了如使用快速配型的特定血型血液或未交叉配血等措施来缩短等待时间，但输送时间仍有改进空间。我们探索了利用我院已有的气动管道输送系统来缩短输送时间。很少有研究使用新鲜血液样本进行单向输送来评估这一系统。我们对气动管道输送系统的输送时间和质量参数进行了改进和评估；设计了一个稳健的方案，与以往其他研究不同的是，该方案还对老化血液进行了模拟回输测试。
收集了我院当前搬运系统运送急诊血液制品的时间，并与通过气动管道系统（PTS）运送的制品的时间进行比较。通过PTS运送的样本还按照既定的血库质量指南进行了温度、质量和溶血方面的测试与分析。
通过我们的PTS运送的血液制品在温度、时间和溶血的所有参数方面均显示出令人满意的一致性。我们发现输送时间从平均8分43秒显著减少至2分23秒。
通过我们改进后的PTS输送血液制品是安全的，并且显著缩短了输送时间。这一节省的时间在复苏过程中可能具有临床意义。使用PTS还可以减少搬运工的人力使用，使他们能够腾出精力去完成医院里的其他任务。
