Browsing by Author "Moura, H"
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- Casuistic of related blood donations incidents in HPFF Blood DepartmentPublication . Barra, A; Barradas, A; Gil, A; Costa, C; Silva, I; Rebelo, S; Simões, A; Rodrigues, T; Moura, H; Santos, L; Soares, FBackground Related blood donations incidents (RBDI) have to be reported to the Portuguese Haemovigilance Blood Group since de last year. In our department we have a manual system of incidents registration since 2006. We understand how is important the analysis of this data to prevent future incidents. Aims We want in some way to share our results aimed a better prevention of this incidents. Methods Data of RBDI between March of 2006 and December of 2009. This register include date, ID, age, sex, weight, time of incidents in relation to donation, donation status (first-time vs. repeat), type of incidents, the time window between last meal and donation. Measures to ease RBDI, past donor history and haemoglobin value before donation (g/dl). Results Between March of 2006 and December of 2009 we have registered 122 (0.60%) RDBI, in a total of 20067 allogeneic donations, 68.58% donations from men and 31.42% from women. RBDI were 70 in men (0.50% of male donations) and 52 in women (0.82% of female donations). The age of studied donors ranged between 19 and 62 ears old with an average of 32.21 ears (19-30 - 34.43%; 31-40 - 25,4%; 41-50 - 16,4%; 50-62 - 13,1%) . The average of weight was 70.1 Kilos. We found 96.2% of early RBDI (< 1h) and 3.8% were late (> 1h). RBDI was verified in 20 first time donors, 61 in donors who have donated less than 5 times and 41 in donors with more than 5 donations. What concern to past donor history 18 (14.75%) of blood donors that had RBDI tell us that they already have at least one BDI in past blood donations. We had to interrupted blood donation in 4 (3.27%) occasions. Hb average was 14.29 g/dl. In the first 6 months of the year RBDI are about half of those in the second semester. In most cases the RBDI happened within 10 minutes after initiation of blood donation and the last food intake occurred on average 1.5 hours prior to donation. Signs and symptoms. Most RBDI reversed with simple procedures (Trendelemburg donor position, drinking a sweet juice or water and heating of some biscuits). We didn’t find severe RDBI. Summary/conclusions In conclusion we can say that in our study most frequent RBDI were non-severe (vasovagal reaction), RBDI are few (~1/200 donations). RBDI were more frequent in young people. Early RBDI are more frequent than late. It seems that women are more likely to have BDI. We have not found a direct relationship between the level of Hb and RBDI. We found a relationship between the donations and the seasons, and in the warmer seasons there is a greater tendency to be RDBI. Probably in future we have to take steps to prevent RDBI.
- Teste à cabeceira no HFF: a última oportunidade para evitar transfusões ABO incompatíveisPublication . Costa, C; Cardoso, E; Barradas, A; Barra, A; Nunes, C; Plácido, C; Moura, H; Silva, I; Santos, L; Ferreira, MB; Pereira, MF; Ferreira, MRIntrodução: O teste à cabeceira é utilizado desde há cerca de 12 anos no Hospital Fernando Fonseca (HFF). Este teste é um teste realizado imediatamente antes da transfusão para a determinação do grupo ABO do doente à cabeceira do doente a transfundir. Este teste (cartão Medtro NK4®Medtro GmbH) permite, de uma maneira rápida e fácil (aproximadamente 2 minutos) confrontar o resultado obtido com o resultado do grupo obtido na amostra estudada pelo Serviço de Sangue e Medicina Transfusional. Este resultado deverá ser o mesmo. O resultado do teste é ainda comparado com o grupo da unidade de concentrado eritrocitário (CE) a transfundir, determinan-do assim a sua compatibilidade com o grupo do receptor. O teste é constituído por um soro anti-A (clone Birma-1) e outro anti-B (clone-LB2), sendo de execução fácil e o seu preço é convidativo (1,57€/teste). Os enfermeiros que realizam o teste devem registar na ficha de confirmação positiva da transfusão (CPT) que o efectuaram e se está ou não conforme. A ficha de CPT faz também, como o teste à cabeceira, parte integrante do sistema de hemovigilância implementado no Hospital. Objetivo Analisar a efectiva implementação do teste à cabeceira e da confirmação positiva da transfusão no nosso hospital e a sua contribuição para o aumento da segurança transfusional. Material e métodos: Analisámos as fichas de confirmação positiva da transfusão que foram entregues no nosso serviço entre 21 de Novembro de 2012 e 20 de Setembro de 2014, num total de 17284 e que incluem o registo dos testes à cabeceira efetuados antes da transfusão de CEs. Resultados: Durante o período analisado, foram transfundidas 23954 unidades de CE correspondentes a 17284 pedidos. Foram registados 16195 testes à cabeceira, ficando por registar 1089 (6,3%), ficando por se saber se estes não foram efectuados ou simplesmente não registada a sua execução. Todas as fichas de confirmação positiva da transfusão, relativas aos pedidos efectuados, foram devolvidas ao serviço (100%). Conclusão: A confirmação positiva da transfusão está, na nossa opinião, totalmente implementada no HFF, permitindo o registo, rastreabilidade e arquivo dos dados relativos à transfusão de todos os componentes eritrocitários transfundidos aos doentes. A fácil execução e a rapidez na obtenção de resultados do teste à cabeceira permitiu uma grande adesão à sua execução pelos enfermeiros responsáveis pela transfusão (93,7%). É, por isso, imprescindível continuar o reforço da formação em Segurança Transfusional, já em curso no Hospital, para que o risco de transfusão de componentes ABO incompatíveis se aproxime do zero, tendo o Hospital classificado esta possibilidade como "Não Evento".
- Transfusion therapy and sickle cell diseasePublication . Barra, A; Barradas, A; Cardoso, E; Costa, C; Ferreira, R; Fontes, A; Mota, M; Moura, H; Oliveira, C; Pereira, F; Rebelo, S; Rodrigues, T; Santos, L; Silva, A; Silva, I; Simões, A; Soares, F; Venâncio, BBackground: Sickle cell disease is a very common hemoglobinopathy. The main goal of transfusion therapy in sickle cell disease is to prevent thrombotic events, improve tissue oxygenation and treat anaemia complications. However the risk of all immunization is well known. Since 2001 our service has been doing a tight surveillance work in sickle cell patients, creating a database of about 15,000 studied blood donors. Aims: We want to share our experience in transfusion of sickle cell patients and highlight the importance to have a computer database with compatible donors in order to reduce all immunization in these patients. Methods: We have studied the above described donors for the following blood group systems ABO, Rh, Kell, Duffy, Kidd, MNSs, Lutheran, P (P1) and haemoglobin S. For each transfusion demand for these patients we research in our computer data base the more likely compatible donor. From January 2007 to January 2011 we studied 64 patients. To transfuse these patients we followed the protocol described above. We transfused these patients with red cells of compatible donors pre investigated. We perform pre transfusion tests in all patients. Results : Have been studied 64 patients who needed red cells transfusion, 30 were females and 34 were males. The range of ages was from 1 to 46 years old. 55 patients were black (85.9%). We have been able to transfuse these patients with red cells of 135 compatible donors from database. We performed 439 red cell concentrate (RCC) transfusions (average per patient 6.85). The patient with the biggest supply was transfused with 22 RCC and we didn’t find in this case any clinically significant red cell alloantibody. We had 7 positive antibody screenings, 2 were anti-Lea, 2 anti-E and 3 were inconclusive. Summary/Conclusions: In our study all patients with clinically significant alloantibody were previously transfused in other institution. We didn’t find any alloantibody in patients exclusively transfused in our department. Our experience transfusing sickle cell disease patients reveals that RCC compatible to antigens of the groups mentioned above greatly reduce all immunization. Hence the importance of the existence in urgency blood department of extended phenotype donors files.