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加拿大不列颠哥伦比亚省应对 COVID-19 大流行的输血系统调整:一家大型三级保健中心的早期经验和对省级活动的调查。

Adaptations of transfusion systems to the COVID-19 pandemic in British Columbia, Canada: Early experiences of a large tertiary care center and survey of provincial activities.

机构信息

Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada.

出版信息

Transfusion. 2021 Apr;61(4):1102-1111. doi: 10.1111/trf.16265. Epub 2021 Jan 16.

Abstract

BACKGROUND

In March 2020, a state of emergency was declared to facilitate organized responses to the coronavirus disease 2019 (COVID-19) pandemic in British Columbia, Canada. Emergency blood management committees (EBMCs) were formed regionally and provincially to coordinate transfusion service activities and responses to possible national blood shortages.

STUDY DESIGN AND METHODS

We describe the responses of transfusion services to COVID-19 in regional health authorities in British Columbia through a collaborative survey, contingency planning meeting minutes, and policy documents, including early trends observed in blood product usage.

RESULTS

Early strategic response policies were developed locally in collaboration with members of the provincial EBMC and focused on three key areas: utilization management strategies, stakeholder engagement (collaboration with frequent users of the transfusion service, advance notification of potential inventory shortage plans, and development of blood triage guidance documents), and laboratory staffing and infection control procedures. Reductions in transfusion volumes were observed beginning in mid-March 2020 for red blood cells and platelets relative to the prepandemic baseline (27% and 26% from the preceding year, respectively). There was a slow gradual return toward baseline beginning one month later; no product shortage issues were experienced.

CONCLUSION

Provincial collaborative efforts facilitated the development of initiatives focused on minimizing potential COVID-19-related disruptions in transfusion services in British Columbia. While there have been no supply issues to date, the framework developed early in the pandemic should facilitate timely responses to possible disruptions in future waves of infection.

摘要

背景

2020 年 3 月,加拿大不列颠哥伦比亚省宣布进入紧急状态,以促进对 2019 年冠状病毒病(COVID-19)大流行的有组织应对。紧急血液管理委员会(EBMC)在区域和省级成立,以协调输血服务活动和应对可能出现的全国性血液短缺。

研究设计和方法

我们通过协作调查、应急计划会议记录和政策文件描述不列颠哥伦比亚省各地区卫生当局对 COVID-19 的输血服务应对情况,包括早期观察到的血液制品使用趋势。

结果

早期的战略应对政策是在与省级 EBMC 成员合作的基础上在当地制定的,重点关注三个关键领域:利用管理策略、利益相关者参与(与输血服务的频繁使用者合作、提前通知潜在的库存短缺计划以及制定血液分类指导文件)以及实验室人员配备和感染控制程序。自 2020 年 3 月中旬以来,与大流行前基线相比,红细胞和血小板的输血量开始减少(分别减少 27%和 26%)。一个月后,开始缓慢恢复到基线水平;没有出现产品短缺问题。

结论

省级合作努力促成了各项倡议的制定,这些倡议侧重于最大限度地减少不列颠哥伦比亚省输血服务中与 COVID-19 相关的潜在中断。尽管迄今为止没有供应问题,但在大流行早期制定的框架应有助于及时应对未来感染浪潮中可能出现的中断。

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