MEDICAL AND ECONOMIC ANALYSIS OF THE CHOICE OF THERAPEUTIC PLASMAPHERESIS METHOD TO OPTIMIZE THE TRANSFUSION CARE QUALITY.

OBJECTIVE: The aim: To analyze the medical and economic aspects of the manual and different types of automatic plasmapheresis (manual, automatic centrifugal, automatic membrane, plasmapheresis with plasma therapy and mixed) used for therapeutic purposes. PATIENTS AND METHODS: Materials and methods: The Baxter Auto-C, Haemonetics PCS2, Haemophenics, Baxter CPDA anticoagulant and saline, Baxter 16GA needles were used. Total protein was examined by the biuret method, hemoglobin by the Sally method, total bilirubin by the colorimetric photometric method, cell fragments by the Goryaev camera microscopy method; patient comfort - with a 10-point scale. Healthy blood donors participated in the study. Manual plasmapheresis was performed in 31 people, automatic plasmapheresis with centrifugal technology - 36 people, with membrane technology - 21 people, mixed technology - 36 people. RESULTS: Results: An analysis of the different technologies impact on hematological, psychological and medical and economic indicators was performed. Native hemoglobin was absent in the bloodstream and in the final plasma with all technologies. Bilirubin index was within normal limits. There were no cell fragments. It was proved the absence of significant differences in various technologies on hematological parameters. The lower level of patient comfort by manual plasmapheresis was established. CONCLUSION: Conclusion: All therapeutic plasmapheresis technologies have the same effect on the patient's blood hematological parameters and did not have a negative impact on the body by the indicators: hemolysis, the presence of cell fragments, patient discomfort and citrate reactions during the standard procedure of sampling 800 ml of plasma. The most effective are plasmapheresis machines with centrifugal technology by medical and economic parametres.

NEW MARKETING TOOLS IN THE BLOOD SERVICE TO OPTIMIZE QUALITY MANAGEMENT.

OBJECTIVE: The aim: To identify the main fears of donation among young people in the city and ways to eliminate these phobias with the help of modern marketing tools. PATIENTS AND METHODS: Materials and methods: It was conducted the questionnaire among Sumy State University students on donation fears. The questionnaire included questions about experience of donation, reason for non donation and age. After that a focus group among students who feared donation was organized. Participants were shown a 360 degree video recorded in the blood center and discussed how to donate blood after watching the video. RESULTS: Results: The main phobias were fear of becoming infected during the procedure (37.7%), fear of the procedure itself due to ignorance and misunderstanding of what to expect (14.0%), and fear of the needle, blood, and the discomfort possibility during the procedure (10.0%); 26.7% indicated that they could not be donors due to poor health, and 11.6% due to personal laziness. It was developed a 360o video, which demonstrates the blood donation process, showing the next steps with the selected blood in facilities. Its continues for 20 minutes. This video was shown in the focus group for ten non-donors with some donation fear. 60% of them reported a change from blood to a positive, which may indicate this tool's effectiveness. CONCLUSION: Conclusions: Due a 360o video some non-donor people can ensure safety, sterility of the process, reduce the fear of donation and further increase the likelihood of becoming regular donors.

Therapeutic plasmapheresis in a complex treatment of patients with chronic hepatitis.

OBJECTIVE: The aim: To determine the pathogenetic expediency, efficiency and the place of therapeutic plasmapheresis in a complex treatment of patients with chronic hepatitis. PATIENTS AND METHODS: Materials and methods: It was carried out the analysis of case histories of 77 patients. In the course of treatment, the patients were diagnosed with chronic toxic hepatitis (K.71). Diagnosis was exposed in accordance with the official documentation introduced by the Gastroenterological department of Sumy Regional Clinical Hospital CH"SRCH", Sumy Regional Infectious Diseases Clinical Hospital named after Krasovytsky ZY and Sumy Regional Center of Blood Service. RESULTS: Results: It was found that total protein indicator is the normal range and albumin after plasmapheresis and during conservative treatment. Markers of cytolysis and cholestasis are have great value may. The most significant changes were observed in rates indicating lesion of the hepatic parenchyma, including ALT, AsAT and alkaline phosphatase. In conservative treatment, the percentageof the alkaline phosphatase level improved by 31%, after the course of plasmapheresis - by 58%. The obtained figures of cholestasis indexes indicate the effectiveness of both methods of treatment, but treatment with plasmapheresis has a more expressed effect on the decrease of alkaline phosphatase level. The level of bilirubin improve on 38,8% after plasmapheresis and 65% in the comparison group. CONCLUSION: Conclusion: Inclusion in the complex therapy of chronic hepatitis plasmapheresis reduces the severity of cytolysis and cholestasis, increases remission and significantly improves clinical manifestations.