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北卡纳塔克邦一家三级护理医院血库中废弃血液及其成分的基本原理。

The Rationale for Discarding Blood and Its Components in a Tertiary Care Hospital Blood Bank in North Karnataka.

作者信息

Kulkarni Keshav R, Kulkarni Pavan, Jamkhandi Uma

机构信息

Department of Pathology, S Nijalingappa Medical College and HSK (Hanagal Shree Kumareshwar) Hospital and Research Centre, Bagalkote, IND.

出版信息

Cureus. 2022 Nov 4;14(11):e31112. doi: 10.7759/cureus.31112. eCollection 2022 Nov.

Abstract

Background Human blood is an essential human element for which no substitute has yet been discovered. This study aims to determine the causes of discarding blood and its components. Material and methods A retrospective study of three years (January 1, 2018, to December 31, 2020) was performed in a tertiary care hospital blood bank. Data were retrieved from the various registers and analysed. Results During this study, a total of 3280 units, 1868 units, and 486 units of whole blood were collected in 2018, 2019, and 2020, respectively. It was observed that the discard rate of whole blood was 9.48%, 17.23%, and 43% in 2018, 2019, and 2020, respectively. The discard rate for components varied, such as for packed red blood cells (PRBC), it was 1.76% in 2018, 1.73% in 2019, and 3.03% in 2020, for fresh frozen plasma (FFP), it was 4.08% in 2018, 4.36% in 2019, and 2.20% in 2020, and for platelets, it was 43.08% in 2018, 31.56% in 2019, and 45.03% in 2020. A total of 311, 322, and 209 units of whole blood were discarded in 2018, 2019, and 2020, respectively. The total whole blood and blood components were discarded for various reasons such as undiagnosed sterility (HIV, hepatitis B surface antigen, hepatitis C virus, Venereal Disease Research Laboratory), quality control, underweight, hemolysis unit, expiry, and polycythemia. Conclusion The wastage of stored blood and its components is inevitable. Still, it can be minimised by optimum utilisation and implementation of blood transfusion services (BTS) along with the education and training of blood bank staff. There are various reasons for the wastage of blood and its components, such as unscreened transfusion-transmitted diseases, sterility, storage, less bleeding, expiry, hemolysis samples and polycythemia. Self-regular audits, coordination between hospital and blood bank staff, proper storage and handling of blood units, strict donor selection and deferral criteria, along with appropriate history taking, will help minimise the wastage of blood or its components.

摘要

背景 人类血液是一种至关重要的人体元素,目前尚未发现其替代品。本研究旨在确定血液及其成分被丢弃的原因。

材料与方法 对一家三级护理医院血库进行了为期三年(2018年1月1日至2020年12月31日)的回顾性研究。从各种登记簿中检索数据并进行分析。

结果 在本研究期间,2018年、2019年和2020年分别采集了3280单位、1868单位和486单位的全血。观察到2018年、2019年和2020年全血的丢弃率分别为9.48%、17.23%和43%。成分的丢弃率各不相同,例如,浓缩红细胞(PRBC)在2018年为1.76%,2019年为1.73%,2020年为3.03%;新鲜冰冻血浆(FFP)在2018年为4.08%,2019年为4.36%,2020年为2.20%;血小板在2018年为43.08%,2019年为31.56%,2020年为45.03%。2018年、2019年和2020年分别有311单位、322单位和209单位的全血被丢弃。全血和血液成分因各种原因被丢弃,如未确诊的无菌状态(艾滋病毒、乙型肝炎表面抗原、丙型肝炎病毒、性病研究实验室检查)、质量控制、重量不足、溶血单位、过期和红细胞增多症。

结论 储存血液及其成分的浪费是不可避免的。不过,通过优化利用和实施输血服务(BTS)以及对血库工作人员进行教育和培训,可以将其降至最低。血液及其成分浪费的原因有多种,如未筛查的输血传播疾病、无菌状态、储存、出血少、过期、溶血样本和红细胞增多症。自我定期审核、医院与血库工作人员之间的协调、对血液单位的妥善储存和处理、严格的献血者选择和延期标准以及适当的病史采集,将有助于减少血液或其成分的浪费。

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