Article ; Online: Measures to reduce red cell use in patients with sickle cell disease requiring red cell exchange during a blood shortage.
2021 Volume 5, Issue 12, Page(s) 2586–2592
Abstract: ... based on precise red cell volume required can optimize patient care and judicious use of blood resources. ... blood shortage. The inventory of Rh and K antigen-negative red cell units recommended for patients ... that implementation of 2 measures could reduce blood use. First, obtaining the pretransfusion hemoglobin S (HbS ...
Abstract | The COVID-19 pandemic has created major disruptions in health care delivery, including a severe blood shortage. The inventory of Rh and K antigen-negative red cell units recommended for patients with hemoglobinopathies became alarmingly low and continues to be strained. Because patients with sickle cell disease requiring chronic red cell exchange (RCE) incur a large demand for red cell units, we hypothesized that implementation of 2 measures could reduce blood use. First, obtaining the pretransfusion hemoglobin S (HbS) results by procedure start time would facilitate calculation of exact red cell volume needed to achieve the desired post-RCE HbS. Second, as a short-term conservation method, we identified patients for whom increasing the targeted end procedure hematocrit up to 5 percentage points higher than the pretransfusion level (no higher than 36%) was not medically contraindicated. The goal was to enhance suppression of endogenous erythropoiesis and thereby reduce the red cell unit number needed to maintain the same target HbS%. These 2 measures resulted in an 18% reduction of red cell units transfused to 50 patients undergoing chronic RCE during the first 6 months of the COVID-19 pandemic. Despite reduction of blood use, pretransfusion HbS% target goals were maintained and net iron accumulation was low. Both strategies can help alleviate a shortage of Rh and K antigen-negative red cells, and, more generally, transfusing red cell units based on precise red cell volume required can optimize patient care and judicious use of blood resources. |
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MeSH term(s) | Anemia, Sickle Cell/therapy ; COVID-19 ; Erythrocyte Transfusion ; Humans ; Pandemics ; SARS-CoV-2 | |||||
Language | English | |||||
Publishing date | 2021-06-21 | |||||
Publishing country | United States | |||||
Document type | Journal Article ; Research Support, N.I.H., Extramural | |||||
ZDB-ID | 2915908-8 | |||||
ISSN | 2473-9537 ; 2473-9529 | |||||
ISSN (online) | 2473-9537 | |||||
ISSN | 2473-9529 | |||||
DOI | 10.1182/bloodadvances.2021004395 | |||||
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Database | MEDical Literature Analysis and Retrieval System OnLINE |
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