Nearly half of red blood cell (RBC) transfusions are not given based on suggested guidelines, according to results of a cross-sectional survey conducted at three Jerusalem hospitals and presented at the ASH Annual Meeting and Exposition. The findings highlight the need for clearer guidelines and better understanding of clinical decision-making, researchers wrote.
Revel-Vilk and colleagues evaluated data from 584 RBC transfusions given to 302 patients. The mean number of transfusions per patient was 1.9 (± 1.3); 52.6% of patients received one transfusion. Two patients received eight transfusions. Nearly all patients (n = 291) had at least one underlying medical condition and nearly half (n = 142) of patients took antithrombotic therapy. The prevalence of off-protocol RBC transfusion was 48.1%, occurred more in surgical departments than nonsurgical departments, and was performed on patients with a higher mean age than on-protocol patients. Off-protocol RBC transfusion was not related to presence of underlying malignancy, heart disease, nephrology conditions or pulmonary disease. However, it was more common among patients who took antithrombotic therapy. Pretransfusion recording of patients’ blood pressure, pulse rate and saturation were not associated with off-protocol RBC transfusion. “Although clinical considerations, such as underlying disease or patients’ pretransfusion signs, may explain nonadherence to guidelines, no clear pattern was observed in the current study to support this explanation,” Revel-Vilk and colleagues wrote.
A blood bank in Amsterdam is using public drinking water to flash-cool its drug production line - reducing the city's water-heating needs in the process. Working with Dutch water company Waternet, Sanquin Blood Supply Foundation has found a way to draw water from Amsterdam's two main public drinking-water lines, both of which pass near its campus on the west side of the city. Then, using a heat exchanger, Sanquin extracts the cold from the water, leaving the rest of Amsterdam's drinking water 0.5°C warmer in the winter months. A portion of this harvest cools the air in Sanquin's facilities, and the rest is stored underground.
"Sustainability is important, but we also need to efficiently meet our cooling needs," says Jordy Pedd, facilities project manager at Sanquin. "This turned out to be our best option." Sanquin says it could save about 1,900 tonnes of carbon dioxide a year, which, according to the city of Amsterdam, is the annual energy usage for up to 1,800 households.
Like many other blood banks, Sanquin recruits volunteer blood donors, collects blood and isolates the samples' red blood cells and platelets to send back to hospitals for clinical treatments. But Sanquin goes one step further: it keeps the blood's leftover plasma in order to manufacture plasma-based therapies on-site. This production process requires a year-round stream of sterile water to sanitize its lab tools. Sanquin heats the process water up to 80°C before using a quick burst of energy to cool it down rapidly to 20°C before use.