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BACKGROUND AND OBJECTIVES: The present study was conducted to evaluate the etiology of altered color of plasma component of blood in transfusion practice. MATERIALS AND METHODS: The study was conducted at the blood center of a tertiary care teaching hospital in western India for a period of 6 months. After component separation, all the plasma units with altered color were segregated and samples were taken for further evaluation. Altered colored plasma units were divided into three - green discoloration, yellow discoloration, and lipemic plasma. Donors were called, their detailed history was taken, and necessary investigations were done accordingly. RESULTS: Forty plasma units out of 20,658 (0.19%) donations showed discoloration. Out of which, 3 plasma units showed green discoloration, 9 plasma units showed yellow discoloration, and the remaining 28 plasma units were lipemic. Among three donors whose plasma showed green discoloration, one female donor had a history of oral contraceptive pill usage and had higher values of copper and ceruloplasmin. All donors with yellow plasma had a higher value of unconjugated bilirubin. All the donors with lipemic plasma gave a history of intake of fatty meal prior to donating blood and showed higher values of triglyceride, cholesterol, and very-low-density lipoprotein. CONCLUSION: Plasma component with altered color restricts its issue to the patient and also for use in fractionation. In our study, many of the altered color plasma units were safe to transfuse, but the decision regarding transfusion was debatable on consultation with the treating doctor. Further studies with a large sample size are recommended for the use of these plasma components.
RESUMO
BACKGROUND: Performance monitoring is an important tool which can be used for setting priorities for process improvement. At our centre, we have been monitoring every step in the processes, right from inventory of consumables (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI). MATERIALS AND METHODS: The present study was a retrospective study where the performance indicator (PI) data of blood bank was analyzed for over four years. For certain parameters, benchmarks or thresholds were set that represented warning limits or action limits. The yearly data were collated from monthly data. Shifts or Trends, if any, were identified and Corrective and Preventive Action (CAPA) taken accordingly. At the end, outcomes of the analysis were charted. RESULTS: After the yearly data evaluation, outcomes obtained were used to plan, correct and amend processes and systems in the blood center. It was observed that the workload of the center showed an upward trend. This helped us to plan for the purchase of consumables and management of manpower. The monitoring of usage and discard of blood helped in the efficient management of blood stocks. The need for any new equipment could also be judged by the trends in workload. CONCLUSION: Performance indicators are indispensible tools which various stakeholders in the Blood Transfusion centres should implement to improve on quality performance.
RESUMO
BACKGROUND AND OBJECTIVE: Therapeutic Plasma Exchange (TPE) is performed effectively and safely in adult patients, but the use of TPE is limited in paediatric patients due to lack of universally accepted indications and technical challenges like establishment of adequate vascular access, low blood volume, increased incidence of adverse events during procedure and poor co-operation of patients during procedure. We present our experience of TPE in paediatric patients to assess the effectiveness and safety of TPE in paediatric patients. MATERIALS AND METHODS: A total 122 TPE procedures were performed in 40 paediatric patients between 3 to 15 years of age group with Guillain Barre Syndrome (GBS). TPE procedures were performed on alternate days depending on the clinical condition of the patient. Patient's total blood volume was calculated as per Nadler's formula and processed through central double lumen catheter. 1-1.5 plasma volume was exchanged with normal saline and fresh frozen plasma. RESULTS: A total of 122 TPE procedures (with an average of three procedures per patient) were performed on 40 paediatric patients. More than three TPE procedures were performed in 29 patients, of which 27 patients showed improvement from grade-0 and grade-I to grade-III. One did not show any response and succumbed to the disease. Complications were observed in 14 patients which were well managed. Inadequate vascular access was most common complication observed in 11 patients. CONCLUSION: TPE in paediatric patients has been increasing and has been shown to be effective as first line or adjunctive therapy in selected diseases. It is safe procedure when volume shifts, calcium supplementation and venous access are taken care.
