Courcelles Louisiane, Pouplard Marie, Braun Orla, Streel Corentin, Deneys Véronique
Blood Transfusion Service, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Woluwe Saint-Lambert, 1200 Brussels, Belgium.
Emergency Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Woluwe Saint-Lambert, 1200 Brussels, Belgium.
Hematol Transfus Cell Ther. 2024 Nov;46 Suppl 5(Suppl 5):S90-S96. doi: 10.1016/j.htct.2024.05.008. Epub 2024 Aug 21.
Emergency transfusion may require the availability of O-negative red blood cell concentrates without pre-transfusion testing. At the Cliniques Universitaires Saint-Luc, the emergency department was used to having access to two decentralized O-negative red blood cell concentrates. This study aims to analyze the consumption of O-negative red blood cell concentrates in emergency situations both before and after the implementation of a novel strategy aiming at optimizing stocks. This strategy provides a combined allocation of one unit of O-positive red blood cell concentrate and one unit of O-negative red blood cell concentrate decentralized in the emergency department and reserve the transfusion of the negative unit only to under 45-year-old women and under 20-year-old men.
A retrospective study was conducted of the transfusion and medical records of all patients who received immediate transfusions in the emergency department without pre-transfusion testing between 2008 and 2022.
A total of 193 patients received O red blood cell concentrates without pre-transfusion testing in emergency situations between 2008 and 2022. During the first 24 h of hospitalization, 354 O-negative units were transfused. Mean ratios of number of O-negative bags between 2008 and 2020 was 1.98 unit/patient. After implementation of the new strategy, the ratio in 2021 was 1.46 unit/patient and drastically decreased in 2022 to 0.79 unit/patient.
In situations of emergency, allocating O-negative units only for women younger than 45 years and men younger than 20 years could have saved 85% of O-negative red blood cell concentrates transfused (303/354) yet balancing the immunological risk. Limiting the number of delocalized units of O-negative red blood cell concentrates in the emergency department seems to lower O-negative consumption. With this strategy, the units spared could have been transfused to patients with greater needs (e.g., sickle cell patients or chronically transfused patients).
紧急输血可能需要在不进行输血前检测的情况下提供O型阴性红细胞浓缩液。在圣卢大学医院，急诊科过去可以获取两份分散存放的O型阴性红细胞浓缩液。本研究旨在分析在实施旨在优化库存的新策略前后，紧急情况下O型阴性红细胞浓缩液的使用情况。该策略将一份O型阳性红细胞浓缩液和一份O型阴性红细胞浓缩液组合分配到急诊科，并仅将阴性单位的输血保留给45岁以下女性和20岁以下男性。
对2008年至2022年间在急诊科接受即时输血且未进行输血前检测的所有患者的输血和医疗记录进行回顾性研究。
2008年至2022年间，共有193例患者在紧急情况下接受了未进行输血前检测的O型红细胞浓缩液。在住院的前24小时内，输注了354个O型阴性单位。2008年至2020年间，O型阴性袋数的平均比例为1.98单位/患者。新策略实施后，2021年的比例为1.46单位/患者，2022年急剧下降至0.79单位/患者。
在紧急情况下，仅为45岁以下女性和20岁以下男性分配O型阴性单位可节省85%输注的O型阴性红细胞浓缩液（303/354），同时平衡免疫风险。限制急诊科O型阴性红细胞浓缩液的分散存放单位数量似乎可以降低O型阴性的消耗量。通过这种策略，节省下来的单位可以输注给更有需求的患者（如镰状细胞病患者或长期输血患者）。
