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Le Havre, France

Royon V.,CHU Charles Nicolle | Lardennois C.,Service de Pediatrie Neonatale et Reanimation | Marechal I.,Unite dhemovigilance | Dureuil B.,CHU Charles Nicolle | And 4 more authors.
Annales Francaises d'Anesthesie et de Reanimation | Year: 2012

Objective: To assess the concordance rate between the prescriptions of blood products and Afssaps guidelines for transfusion practices in neonatology. Study design: Retrospective monocentric study. Patients and methods: Children transfused in the neonatology intensive care units in the Universitary Hospital of Rouen were included. Concordance rates between transfusion prescriptions, delivered and transfused products and the Afssaps guidelines were assessed. Any additional costs resulting from a theoretical discordance was also assessed. Results: In 2006, 380 PSL were administered to 168 newborn children (NBC). Packed red blood cells (PRBC) represented the most often transfused products (. n=. 290, 76%). Fifty packed platelets (PP) were transfused (13% of the blood products) and 41 fresh frozen plasmas (11%). Overall concordance rate between the Afssaps guidelines and the prescriptions was 64.9%. In 35.1% of cases, the prescription was excessive, compared to the recommendations. Excessive transfusion represented a total of 27,307 euros. Conclusion: Global concordance's rate between the guidelines and the prescriptions is fairly well. PRBC are the most blood product transfused. Excessive transfusions related to this concordance rate are leading to important theoretical costs. New informations to the guidelines are warranted to improve transfusional practices in this institution. © 2012 Société française d'anesthésie et de réanimation (Sfar).

Leo-Kodeli S.,Center hospitalier regional dOrleans | Renaudier P.,Agence regionale de sante Lorraine | Lassale B.,Unite dhemovigilance
Transfusion Clinique et Biologique | Year: 2014

Although notification of post-transfusion hemosiderosis is mandatory since 1994 among the French hemovigilance network, it is so far largely under reported. Patients and methods: We screened 42,443 patients hospitalized for blood diseases in France in 2009 and 2010 and determined which patients had received more than 20 PRC. Among them, we selected those having at least one measure of serum ferritin, and subsequently those which ferritin was greater than or equal to 1000. ng/mL. Results: Three thousand eight hundred and twelve patients (9%) received more than 20 PRC, 1935 (4.5%) had a ferritin assay, which was increased in 1216 patients (2.9%). Eight hundred and eighty-one patients underwent an hemovigilance report form. Forty-nine percent had low-risk myelodysplasia or acute leukemia, 7% hemoglobinopathies. Hemosiderosis was asymptomatic for 680 patients (77%), serious 188 (88%) and life-threatening for 11 (1%). Two patients died of terminal heart failure. The most severe hemosiderosis (≥ grade 2) were low-risk myelodysplasia and idiopathic aplastic anemia. Ninety-two percent of thalassemia patients and 46% of sickle cell anemia patients received an iron chelator. For low-risk myelodysplastic syndromes and idiopathic aplastic anemia, 228 of the 317 patients whose treatment is known and who could benefit from iron chelation (72%) have not received it. Conclusion: These results encourage seeking optimal transmission of information (over 20 CGR) to the clinician, and prolonging hemovigilance action towards a more comprehensive statement of post-transfusion hemochromatosis. © 2014 Elsevier Masson SAS.

Le Niger C.,Unite dhemovigilance | Dalbies F.,Institute Of Cancerologie Et Dhematologie | Narbonne V.,Brest University Hospital Center | Hery-Arnaud G.,Brest University Hospital Center | And 4 more authors.
Transfusion Clinique et Biologique | Year: 2014

Bacterial infections are uncommon complications of the blood products transfusion but they are potentially serious. Many advances have been done over the past few years to guarantee the microbiological security of blood products as the donors selection with a medical talk, the derivation of the first 30 millilitres blood during the donation, the deleucocytation of blood products. But in spite of these advances, cases of bacterial infection always remain. The purpose of this study was to point out the platelet concentrate's transfusion-transmitted bacterial infection with Streptococcus gallolyticus and the unusual consequence for the donor by uncovering an asymptomatic rectal neoplastic tumor. This study as raised as to whether the usefulness of systematic bacterial inactivation in the platelets concentrates. © 2014 Elsevier Masson SAS.

Damais-Cepitelli A.,British Petroleum | Lassale B.,Unite dhemovigilance
Transfusion Clinique et Biologique | Year: 2014

Blood transfusion is currently a delegated medical act in patient care services. Blood transfusion safety depends onthe strict respect ofprocesses from the prescription of blood products and required patient immuno-hematologyexamsto the administration of blood products and follow-up of the patient. We conducted a survey among haemovigilance correspondents to establish the documents needed to practice blood transfusion. Blood products delivery depends on the hospitals local organizations and blood products traceability relies on hospitals levels of computerization. We notice heterogeneous practices. Consequently, an updating of the December 15th 2003 circular relative to the transfusion act seems necessary and could thus lead to blood transfusions homogenous practices. © 2014 Elsevier Masson SAS.

Bernasinski M.,Pole anesthesie reanimation medecine durgence | Mertes P.-M.,Hopitaux Universitaires Of Strasbourg | Carlier M.,Unite dhemovigilance | Dupont H.,Pole anesthesie reanimation medecine durgence | And 4 more authors.
Transfusion Clinique et Biologique | Year: 2014

Respiratory complications of blood transfusion have several possible causes. Transfusion-Associated Circulatory Overload (TACO) is often the first mentioned. Transfusion-Related Acute Lung Injury (TRALI), better defined since the consensus conference of Toronto in 2004, is rarely mentioned. French incidence is low. Non-hemolytic febrile reactions, allergies, infections and pulmonary embolism are also reported. The objective of this work was to determine the statistical importance of the different respiratory complications of blood transfusion. This work was conducted retrospectively on transfusion accidents in six health centers in Champagne-Ardenne, reported to Hemovigilance between 2000 and 2009 and having respiratory symptoms. The analysis of data was conducted by an expert committee. Eighty-three cases of respiratory complications are found (316,864 blood products). We have counted 26 TACO, 12 TRALI (only 6 cases were identified in the original investigation of Hemovigilance), 18 non-hemolytic febrile reactions, 16 cases of allergies, 5 transfusions transmitted bacterial infections and 2 pulmonary embolisms. Six new TRALI were diagnosed previously labeled TACO for 2 of them, allergy and infection in 2 other cases and diagnosis considered unknown for the last 2. Our study found an incidence of TRALI 2 times higher than that reported previously. Interpretation of the data by a multidisciplinary committee amended 20 % of diagnoses. This study shows the imperfections of our system for reporting accidents of blood transfusion when a single observer analyses the medical records. © 2014 Elsevier Masson SAS.

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