Sainte-Foy-lès-Lyon, France
Sainte-Foy-lès-Lyon, France

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Dubost C.,hopital Bicetre | Ausset S.,hopital dinstruction des Armees Percy | Vincent C.,hopital Bicetre | Gozlan C.,hopital Bicetre | And 4 more authors.
Anaesthesia Critical Care and Pain Medicine | Year: 2015

Background and objectives To understand the mechanisms related to both the onset and correction of severe anaemia after orthopaedic surgery, we analysed all the full blood counts (FBCs) for patients on one orthopaedic ward during a one-year period in an academic hospital. Methods FBCs were screened and the medical records of those patients for whom a postoperative haemoglobin (Hb) concentration below 8 g/dL was recorded at least once were reviewed. The onset of postoperative anaemia was determined by calculating the various time intervals delineated by surgery, the time at which the transfusion threshold was reached and the time at which the lowest Hb level (nadir) and transfusion (if any) occurred. Results A total of 6573 FBCs drawn from 1255 patients were screened. The medical records of 74 consecutive patients with at least one Hb value < 8 g/dL were analysed. The postoperative Hb nadir was 7.4 (± 0.6) g/dL (mean – SD). The medians (IQR 25–75) of the calculated intervals were: (surgery – nadir): 72 (48–144) h, (nadir – transfusion): 7 (5–21) h and (transfusion threshold – transfusion): 26 (11–51) h. Conclusions Delayed transfusion (defined as > 12 hours between the time at which the transfusion threshold was reached and actual transfusion) was observed in 57% of severely anaemic patients after orthopaedic surgery. © 2015 Société française d'anesthésie et de réanimation (Sfar)


PubMed | hopital Bicetre, hopital dinstruction des Armees du Val de Grace, Service dhemovigilance, hopital dinstruction des Armees Percy and hopital Saint Antoine
Type: Journal Article | Journal: Anaesthesia, critical care & pain medicine | Year: 2015

To understand the mechanisms related to both the onset and correction of severe anaemia after orthopaedic surgery, we analysed all the full blood counts (FBCs) for patients on one orthopaedic ward during a one-year period in an academic hospital.FBCs were screened and the medical records of those patients for whom a postoperative haemoglobin (Hb) concentration below 8 g/dL was recorded at least once were reviewed. The onset of postoperative anaemia was determined by calculating the various time intervals delineated by surgery, the time at which the transfusion threshold was reached and the time at which the lowest Hb level (nadir) and transfusion (if any) occurred.A total of 6573 FBCs drawn from 1255 patients were screened. The medical records of 74 consecutive patients with at least one Hb value < 8 g/dL were analysed. The postoperative Hb nadir was 7.4 ( 0.6) g/dL (mean - SD). The medians (IQR 25-75) of the calculated intervals were: (surgery - nadir): 72 (48-144) h, (nadir - transfusion): 7 (5-21) h and (transfusion threshold - transfusion): 26 (11-51) h.Delayed transfusion (defined as > 12 hours between the time at which the transfusion threshold was reached and actual transfusion) was observed in 57% of severely anaemic patients after orthopaedic surgery.


Moncharmont P.,Service dhemovigilance | Meyer F.,Service dhemovigilance
Transfusion Clinique et Biologique | Year: 2015

Purpose of the study: Vitamin K antagonist treated patients are exposed to a risk of haemorrhage in case of overdose leading to a need for transfusion. In order to determine the incidence of adverse transfusion reactions in these patients, the reports indicating a vitamin K antagonist treatment were analyzed. Patients and methods: In the treated and transfused patient population, the diagnosis following the adverse transfusion reactions, the incidence, the degree of severity, the blood component involved and its imputability were evaluated. Results: From January 1st 2000 to December 31st 2014, 142 reports were notified in 141 patients. Haemorrhage was observed in 102 cases (71.8%). Overdose of anti-vitamin K was reported in 43 cases only (30.3%). The most frequent adverse transfusion reaction was the anti-erythrocyte alloimmunization (66 cases, 46.5%) followed by the febrile non-haemolytic reaction (37 cases, 26.1%). Most adverse reactions were non-severe (131 cases, 92.3%). The most involved blood component was the red blood cells concentrate (139 cases, 97.9%). The imputability of the blood product was certain in 39 cases only (27.5%). Conclusion: In patients treated with vitamin K antagonists and transfused, the anti-erythrocyte alloimmunization was the most frequent adverse transfusion reaction. Overdose of the vitamin K antagonists was notified in approximately a third of cases. © 2015 Elsevier Masson SAS.


Moncharmont P.,Service dhemovigilance | Meyer F.,Service dhemovigilance
Transfusion Clinique et Biologique | Year: 2013

Purpose of the study: In the transfused patients, in France, in 2011, allergy ranked as the third adverse transfusion reaction. In order to evaluate the incidence and symptomatology of allergic adverse transfusion reactions in the paediatric people, a study was performed. Patients and methods: It was focused on patients under 18. years of age cared for in hospitals of the Rhone-Alpes area. The national haemovigilance database (e-FIT) reports of allergic transfusion reactions were reviewed. Results: From January 1st 2009 to December 31st 2011, among 2,165 reports, 141 (6.5%) adverse transfusion reaction reports were collected in paediatric patients. Sixty-eight (48.2%) indicated allergic reactions and corresponded to 64 recipients. As regards clinical manifestations, forty-eight (70.6%) indicated cutaneous signs only, 3 (4.4%) mentioned pulmonary signs only and 9 (13.2%) reported both. Urticaria was observed in 38 cases (55.9%). Bronchospasm was notified in 4 cases but there was no angioedema. As for the severity of reactions, one adverse transfusion reaction was severe (grade 2) and 2 were life-threatening (grade 3). The most involved blood component was the apheresis platelet concentrate (40 cases, 58.8%) followed by the red blood cell concentrate (17 cases, 25.0%) and the methylene blue-treated fresh-frozen plasma (11 cases, 16.2%). Conclusion: This study shows that among paediatric recipients, cutaneous signs are predominant in allergic adverse transfusion reactions and that the apheresis platelet concentrate is the most frequently involved blood component. © 2013 Elsevier Masson SAS.


Purpose: Today most transfusions are given to people over 70. In order to evaluate the production and the circumstances of the appearance of red blood cells (RBC) allo-antibodies (Ab), a three-year study was performed in transfused patients aged 80 and over. Material and methods: Based on the Adverse Event Reports (AER) on RBC Ab from 2007 to 2009 in the Rhône-Alpes area, the prevalence and specificity of the RBC Ab, the type of blood component involved, the imputability and the previous transfusion and obstetrical history were studied. Results: Of 2,169 AER, 240 (11.1%) related to the appearance of RBC Ab; they included 150 females (F) patients (62.5%) and 90 males (M) (37.5%). The Rhesus (RH) blood group was most involved (75 AER) and anti-E was the most frequent Ab (52 cases; 69.3%). Packed RBC were predominantly involved (233 cases; 97,1%). Absolute imputability could be established in 120 cases only (50.0%). Previous transfusion history was observed in 85 F patients (56.7%) and 52. M (57.8%). Pretransfusion Ab was noted in 18 F patients (12.0%) and five M (5.6%). Seventy-three F patients (48.7%) had had a pregnancy but the number of unknown data was high (71 F patients; 47.3%). Conclusion: In the transfused patient population aged 80 and over, RBC Ab are common and in most cases are due to RBC transfusions. On the contrary, pretransfusion RBC Ab are not frequent. © 2010 Elsevier Masson SAS.


PubMed | Service dhemovigilance
Type: Journal Article | Journal: Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine | Year: 2012

Transfusions are exceptional while patients are rushed to hospital for sanitary reasons. The quality of care requires the collaboration with different partners (samu, blood bank centre, haemovigilance correspondents). In response to dysfunctions that occurred during transports for sanitary reasons we have drawn up a regional procedure, which specifies how to get and use blood products. This procedure harmonizes our medical practice, states the role of the different participants (traceability of blood samples of immunohaematology tests, etc.), including a part dedicated to identity vigilance. The expected impacts of this procedure are: the decrease of dysfunctions and of destructions of red blood cells, the improvement of security while patients are transfused.


PubMed | Service dhemovigilance
Type: Journal Article | Journal: Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine | Year: 2010

Today most transfusions are given to people over 70. In order to evaluate the production and the circumstances of the appearance of red blood cells (RBC) allo-antibodies (Ab), a three-year study was performed in transfused patients aged 80 and over.Based on the Adverse Event Reports (AER) on RBC Ab from 2007 to 2009 in the Rhne-Alpes area, the prevalence and specificity of the RBC Ab, the type of blood component involved, the imputability and the previous transfusion and obstetrical history were studied.Of 2,169 AER, 240 (11.1%) related to the appearance of RBC Ab; they included 150females (F) patients (62.5%) and 90males (M) (37.5%). The Rhesus (RH) blood group was most involved (75AER) and anti-E was the most frequent Ab (52cases; 69.3%). Packed RBC were predominantly involved (233cases; 97,1%). Absolute imputability could be established in 120 cases only (50.0%). Previous transfusion history was observed in 85 F patients (56.7%) and 52M (57.8%). Pretransfusion Ab was noted in 18F patients (12.0%) and five M (5.6%). Seventy-three F patients (48.7%) had had a pregnancy but the number of unknown data was high (71 F patients; 47.3%).In the transfused patient population aged 80 and over, RBC Ab are common and in most cases are due to RBC transfusions. On the contrary, pretransfusion RBC Ab are not frequent.


PubMed | Service dhemovigilance
Type: Journal Article | Journal: Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine | Year: 2013

In the transfused patients, in France, in 2011, allergy ranked as the third adverse transfusion reaction. In order to evaluate the incidence and symptomatology of allergic adverse transfusion reactions in the paediatric people, a study was performed.It was focused on patients under 18years of age cared for in hospitals of the Rhone-Alpes area. The national haemovigilance database (e-FIT) reports of allergic transfusion reactions were reviewed.From January 1st 2009 to December 31st 2011, among 2,165 reports, 141 (6.5%) adverse transfusion reaction reports were collected in paediatric patients. Sixty-eight (48.2%) indicated allergic reactions and corresponded to 64 recipients. As regards clinical manifestations, forty-eight (70.6%) indicated cutaneous signs only, 3 (4.4%) mentioned pulmonary signs only and 9 (13.2%) reported both. Urticaria was observed in 38 cases (55.9%). Bronchospasm was notified in 4 cases but there was no angioedema. As for the severity of reactions, one adverse transfusion reaction was severe (grade 2) and 2 were life-threatening (grade 3). The most involved blood component was the apheresis platelet concentrate (40 cases, 58.8%) followed by the red blood cell concentrate (17 cases, 25.0%) and the methylene blue-treated fresh-frozen plasma (11 cases, 16.2%).This study shows that among paediatric recipients, cutaneous signs are predominant in allergic adverse transfusion reactions and that the apheresis platelet concentrate is the most frequently involved blood component.


PubMed | Service dhemovigilance
Type: Journal Article | Journal: Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine | Year: 2015

Vitamin K antagonist treated patients are exposed to a risk of haemorrhage in case of overdose leading to a need for transfusion. In order to determine the incidence of adverse transfusion reactions in these patients, the reports indicating a vitamin K antagonist treatment were analyzed.In the treated and transfused patient population, the diagnosis following the adverse transfusion reactions, the incidence, the degree of severity, the blood component involved and its imputability were evaluated.From January 1st 2000 to December 31st 2014, 142 reports were notified in 141 patients. Haemorrhage was observed in 102 cases (71.8%). Overdose of anti-vitamin K was reported in 43 cases only (30.3%). The most frequent adverse transfusion reaction was the anti-erythrocyte alloimmunization (66 cases, 46.5%) followed by the febrile non-haemolytic reaction (37 cases, 26.1%). Most adverse reactions were non-severe (131 cases, 92.3%). The most involved blood component was the red blood cells concentrate (139 cases, 97.9%). The imputability of the blood product was certain in 39 cases only (27.5%).In patients treated with vitamin K antagonists and transfused, the anti-erythrocyte alloimmunization was the most frequent adverse transfusion reaction. Overdose of the vitamin K antagonists was notified in approximately a third of cases.


PubMed | Service dhemovigilance
Type: Journal Article | Journal: Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine | Year: 2012

One of the main goals of haemovigilance is to gather and analyze adverse events in recipients of blood products in order to improve blood safety. The French National Blood Service has a specific role in the management of immediate adverse events: to alert to quarantine the potentially dangerous blood products from the same donation(s), to provide blood testing for the etiologic assessment and to give transfusion advice to patients. The updating of the recipients computer file allows a better monitoring for both immediate and delayed adverse events. Finally, the French National Blood Services correspondent of haemovigilance is responsible for donors inquiries, especially in cases of transfusion related to bacterial contamination, severe allergy, suspicion of transfusion acute related lung injury and viral seroconversion. The management effectiveness for adverse events requires a strong collaboration between all members of the haemovigilance network.

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