RESUMEN
Cystatin C has recently been proposed as an alternative marker of glomerular filtration rate. The study compares cystatin C and creatinine concentrations during cardiopulmonary bypass and the first 72 hours postoperatively in patients undergoing coronary artery bypass graft. Forty-nine patients with normal preoperative renal and cardiac function were scheduled for coronary artery bypass graft. Blood was sampled for creatinine and cystatin C measurements at 7 time points till 72 hours postoperatively. Glomerular filtration rate was estimated from calculated clearance using the Cockroft and Gault formula for creatinine and Larsson equation for cystatin C. The baseline values of both markers were within the normal range. Their concentrations were comparable during the whole study period. This was also the case for the calculated creatinine and cystatin C clearance. In patients with normal preoperative renal function undergoing coronary artery bypass graft, measured creatinine concentration remains a cheap and easy way of estimating renal function.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Cistatinas/sangre , Pruebas de Función Renal , Anciano , Anestesia , Biomarcadores , Puente de Arteria Coronaria/efectos adversos , Creatinina/sangre , Cistatina C , Circulación Extracorporea , Femenino , Tasa de Filtración Glomerular/fisiología , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
In April 1995 the Ministry of Public Health invited all Belgian hospitals to participate to a survey on the use of blood transfusion. The questionnaire presented two parts, the first one devoted to products transfused and the second one to the transfusion organisation in the hospital. 71 hospitals answered: 7 university and 64 general hospitals. All hospitals reported the use of red cells, 31 of them still used whole blood. Surgical departments transfused the greatest absolute amount of units, but the highest intensity (units/bed/year) was observed in intensive care units. 52 hospitals mentioned the use of autologous predeposit. The highest consumption of platelets occurred in medicine but intensive care showed the highest intensity of platelet transfusion. In 41 hospitals platelets were obtained by cytapheresis. The number of plasma units transfused was highly correlated with the quantities of packed red cells and whole blood transfused. Ten hospitals didn't report the use of any blood conservation technique. Returning unused units to the blood bank was allowed in 80% of the hospitals, their return to the transfusion center was permitted in 65% of the hospitals. A transfusion committee existed in only 11 hospitals. Transfusion should be improved by a better education of all physicians and nurses involved with transfusion and by improving standardisation, by better documentation, better reporting and information of all health care workers involved.
Asunto(s)
Transfusión Sanguínea/estadística & datos numéricos , Bélgica/epidemiología , Transfusión Sanguínea/normas , Transfusión de Sangre Autóloga/estadística & datos numéricos , Documentación , Transfusión de Eritrocitos/estadística & datos numéricos , Control de Formularios y Registros , Departamentos de Hospitales/organización & administración , Departamentos de Hospitales/estadística & datos numéricos , Registros de Hospitales , Hospitales Generales/organización & administración , Hospitales Generales/estadística & datos numéricos , Hospitales Universitarios/organización & administración , Hospitales Universitarios/estadística & datos numéricos , Humanos , Capacitación en Servicio , Unidades de Cuidados Intensivos/estadística & datos numéricos , Cuerpo Médico de Hospitales/educación , Personal de Enfermería en Hospital/educación , Plasma , Transfusión de Plaquetas/estadística & datos numéricos , Plaquetoferesis/estadística & datos numéricos , Administración en Salud Pública , Servicio de Cirugía en Hospital/estadística & datos numéricos , Encuestas y CuestionariosAsunto(s)
Transfusión Sanguínea/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Artroplastia de Reemplazo de Cadera/estadística & datos numéricos , Bélgica/epidemiología , Transfusión de Componentes Sanguíneos/estadística & datos numéricos , Transfusión Sanguínea/clasificación , Transfusión de Sangre Autóloga/estadística & datos numéricos , Colecistectomía Laparoscópica/estadística & datos numéricos , Colectomía/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Europa (Continente)/epidemiología , Retroalimentación , Femenino , Fracturas del Cuello Femoral/cirugía , Hematócrito/estadística & datos numéricos , Hospitales Generales/estadística & datos numéricos , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Tasa de SupervivenciaRESUMEN
We investigated a group of Belgian HCV-100 Elisa positive volunteer blood donors for potential sources of contamination and the presence of liver biochemical abnormalities. In addition, results of serological testing and liver biochemistry of their related blood products recipients were also analysed. In blood donors, anti-HCV-100 repeat reactive rate was 0.77% with a 34% rate of abnormal liver function tests. A potential source of parenteral exposure was found in all donors with RIBA-confirmed HCV-100 positivity. Among recipients, anti-HCV-100 RIBA-2 positive blood product donations were associated with RIBA-2 seroconversion, a history of transfusion in donors being of high predictive value of infectivity.
Asunto(s)
Donantes de Sangre , Anticuerpos contra la Hepatitis C/aislamiento & purificación , Adolescente , Adulto , Anciano , Niño , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Immunoblotting , Hígado/enzimología , Pruebas de Función Hepática , Masculino , Persona de Mediana EdadRESUMEN
SANGUIS was multicentric European study involving more than 7,000 patients in 43 teaching hospitals during a one year period. The goal of the study was to describe current transfusion practice for elective surgery in adult. The present paper summarizes the data collected on the 1,193 patients enrolled in Belgium. It also introduces the final report of the SANGUIS study in Belgium, which will be published as a special issue of the Acta Chirurgica Belgica.
Asunto(s)
Transfusión Sanguínea/normas , Adulto , Transfusión de Componentes Sanguíneos , Sustitutos Sanguíneos , Transfusión Sanguínea/métodos , Transfusión de Eritrocitos , Femenino , Hematócrito , Humanos , Masculino , Procedimientos Quirúrgicos OperativosAsunto(s)
Transfusión Sanguínea , Procedimientos Quirúrgicos Operativos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Aorta Abdominal/cirugía , Bélgica , Transfusión de Componentes Sanguíneos , Sustitutos Sanguíneos/uso terapéutico , Transfusión Sanguínea/estadística & datos numéricos , Transfusión de Sangre Autóloga , Colecistectomía , Colectomía , Puente de Arteria Coronaria , Transfusión de Eritrocitos , Femenino , Hematócrito , Prótesis de Cadera , Humanos , Masculino , Persona de Mediana Edad , Sustitutos del Plasma/uso terapéutico , Transfusión de Plaquetas , ProstatectomíaRESUMEN
The true incidence of bedside transfusion errors, i.e. those happening when blood products have left the blood bank, is underestimated because published figures rely on reporting of clinically relevant events or on indirect methods. The SAnGUIS project assessing blood practice in a prospective and randomized fashion for 6 elective surgical procedures gave the opportunity to trace all transfused units and to identify steps at risk during blood delivery in surgery. We considered transfusion of a wrong unit as a major error and poor execution or documentation as a recording error. Over 15 months, 808 patients out of 1,448 were transfused with 3,485 units. A total of 165 errors were found after blood products had left the blood banks. Seven were misidentifications (0.74% of patients, 0.2% of units). Eight other major errors occurred in 4 (0.5%) patients. Major errors occurred during nonemergency situations, in wards or intensive care units. The remaining ('recording') 150 errors consisted of misrecordings (61), mislabellings (6), or failures to document transfusions in the medical records (83). All errors were uneventful except one misidentification which induced a transient, yet unreported, reaction. The 'descending' inquiry method used for this study showed that most errors pass unnoticed and are therefore not reported. Measurement of error rates may constitute an important quality indicator. Retrospective information of this survey to the concerned staff people provided an impetus to take adequate measures to reduce these bedside errors.