RESUMEN
For the proper functioning of the Immunohematology Area, an External Quality Control was established since 1973 through a program that evaluates the performance of the laboratories of the Blood Bank and transfusion services that carry out immunohematology tests. This program consists of sending panel cells to participating blood banks or services, which are phenotyped erythrocyte samples previously studied as problem cases but whose results are unknown by the participating laboratories. The processes in which the program is of most importance are determination of the ABO group, determination of Rh, performance of the direct and indirect Coombs test, and pre-transfusion compatibility tests. It was carried out an observational and retrospective study of the results obtained in the 2020 period from 104 units participating in the Immunohematology Quality Control Program of the National Medical Center's Blood Bank. A panel of cells was sent for external quality control of immunohematology every 45 days, resulting in 9 panels for each unit in the studied period. Compliance with the program was observed in the general result (79.6%), i.e., there was a decrease in the participation of the registered units. Of a maximum score of 100% to be obtained, it was observed a general result of 95.3% compliance of the participating units. The results obtained confirm the good general training of the immunohematology laboratories of the participating units. Yet, as in any external control program, it becomes clear that obtaining an erroneous result is a risk that can occur in any laboratory.
Para el buen funcionamiento del Área de Inmunohematología, desde 1973 se instauró el Control de Calidad Externo con un programa que evalúa los laboratorios del Banco de Sangre y los servicios de transfusión que hacen pruebas de inmunohematología. El programa consiste en enviar a los bancos de sangre, o servicios participantes, células panel, que son muestras de eritrocitos fenotipados y previamente estudiados como casos problema, pero cuyos resultados son desconocidos por los laboratorios participantes. Los procesos en los que el programa es de suma importancia son determinación del grupo ABO, determinación del Rh, realización de la prueba de Coombs directa e indirecta y las pruebas de compatibilidad pretransfusionales. Se hizo un estudio observacional y retrospectivo de los resultados de 2020 de 104 unidades participantes en el Programa de Control de Calidad de Inmunohematología del Banco de Sangre del Centro Médico Nacional Siglo XXI. Se envió un panel de células para el control de calidad externo de inmunohematología cada 45 días y dio como resultado nueve paneles para cada unidad. El cumplimiento del programa se observó en el resultado general (79.6%), es decir, disminuyó la participación de las unidades inscritas. De una calificación máxima de 100%, hubo un resultado general de las unidades participantes del 95.3% de cumplimiento. Los resultados confirman la buena capacitación general de los laboratorios de inmunohematología de las unidades participantes. Aun así, como en cualquier programa de control externo, obtener un resultado erróneo es un riesgo que puede presentarse en cualquier laboratorio.
Asunto(s)
Bancos de Sangre , Laboratorios , Humanos , Estudios Retrospectivos , Control de CalidadRESUMEN
Acute kidney injury (AKI) is a frequent complication in critically ill patients and is associated with high morbidity and mortality; therefore, its prophylaxis, diagnosis and intervention positively impact patient evolution. Neutrophil gelatinase-associated lipocalin (NGAL) or lipocalin, a protein synthesized by renal tubular cells, has the property to transport lipophilic molecules such as vitamins, hormones and antigenic agents. It is a novel biomarker of AKI of several etiologies and is increased in both serum and urine 48 h before the increase of creatinine. It has a strong correlation with early diagnosis of AKI. NGAL is of the most investigated and promising biomarkers for early diagnosis of AKI in different clinical scenarios, most notably in sepsis, cardiorenal syndrome, cardiac surgery, kidney transplant, contrast nephropathy and hemolytic uremic syndrome. Lipocalin guides the early institution of therapeutic interventions to improve prognosis in AKI of several etiologies.