Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India.
Vox Sang. 2021 May;116(5):497-503. doi: 10.1111/vox.13019. Epub 2020 Oct 26.
Numerous concerns regarding maintenance of blood inventory have been raised after SARS-CoV-2 pandemic outbreak. These concerns were based on the experience of blood centres in previous pandemics where shortage of blood components was reported. The present study had tried to understand the impact of SARS-CoV-2 pandemic on blood collection and demand as well as the impact of disaster planning in maintaining an adequate inventory.
Data related to blood supply and demand were collected retrospectively using blood bank management software for pre-COVID-19 and COVID-19 time period and compared. Strategies adopted and effects of changes in existing disaster plans to maintain an adequate inventory were studied.
A drastic fall in the red cell inventory was observed as compared to pre-COVID-19 time period was observed due to disproportionate decrease in blood collection (1/6 to 1/9 of the previous collection) and demand (1/2 of the previous demand). The buffer stock fell gradually over a period of three weeks with cancellation of planned blood donation drives. A buffer stock equivalent to 2-week inventory led to adequate inventory in the initial lockdown periods. Similar fall was observed in the platelet inventory with reduction in the blood collection but almost a proportionate reduction in the platelet demand led to adequate inventory. No increase in wastage was observed for both red cells and platelets during this period.
A buffer stock of blood and blood components, strict adherence to the transfusion triggers, good coordination with the clinical staff and a prospective review of blood transfusion requests to ensure rational blood transfusion were some of the steps which helped us to successfully maintain transfusion requirements in the initial phases of the COVID-19 pandemic. Use of first-in-first-out policy prevented any wastage due to outdating of blood.
SARS-CoV-2 大流行爆发后,人们对血液库存的维护提出了诸多担忧。这些担忧基于血液中心在前几次大流行中的经验,当时曾报告过血液成分短缺的情况。本研究试图了解 SARS-CoV-2 大流行对血液采集和需求的影响,以及灾难计划在维持充足库存方面的影响。
使用血库管理软件回顾性地收集了与血液供应和需求相关的数据,比较了 COVID-19 大流行前和 COVID-19 大流行期间的数据。研究了所采用的策略以及对现有灾难计划的变更对维持充足库存的影响。
与 COVID-19 大流行前相比,观察到红细胞库存急剧下降,原因是血液采集(采集量为之前的 1/6 至 1/9)和需求(需求为之前的 1/2)不成比例下降。随着计划献血活动的取消,缓冲库存逐渐减少,在三周的时间内逐渐减少。缓冲库存相当于两周的库存,可确保在最初的封锁期间有充足的库存。血小板库存也出现了类似的下降,尽管血液采集量减少,但血小板需求几乎成比例减少,导致库存充足。在此期间,红细胞和血小板的浪费均无增加。
血液和血液成分的缓冲库存、严格遵守输血触发条件、与临床工作人员的良好协调以及对输血请求的前瞻性审查以确保合理输血,这些措施有助于我们在 COVID-19 大流行的初始阶段成功满足输血需求。使用先进先出政策可防止因血液过期而造成任何浪费。