6 June 2024 (Thursday) - Transfusion Evidence Library Update

The nice people at Transfusion Evidence Library sent out a special update in honour of international Children’s Day.

Top article

Whole blood versus red cell concentrates for children with severe anaemia: a secondary analysis of the Transfusion and Treatment of African Children (TRACT) trial.
George, E.C., et al. (2022). Lancet Global Health.
PICO SUMMARY

 

Selected articles

Effects of delayed cord clamping at different time intervals in late preterm and term neonates: a randomized controlled trial.
Chaudahary, P., et al. (2023). European Journal of Pediatrics.

Tissue oxygenation changes after transfusion and outcomes in preterm infants: a secondary near-infrared spectroscopy study of the transfusion of prematures randomized clinical trial (TOP NIRS).
Chock, V.Y., et al. (2023). JAMA Network Open.

Comparative efficacy and safety of restrictive versus liberal transfusion thresholds in anemic preterm infants: a meta-analysis of 12 randomized controlled trials. 
Fu, X., et al. (2023). Annals of Hematology.

Two-year outcomes following a randomised platelet transfusion trial in preterm infants.
Moore, C.M., et al. (2023). Archives of Disease in Childhood - Fetal and Neonatal Edition.

Effective management of foetal anaemia in Rh(D) alloimmunised pregnant women with intrauterine transfusion: a Systematic review.
Prescott, B., and Jackson, D.E., (2023). Hematology, Transfusion and Cell Therapy.

Darbepoetin alfa to reduce transfusion episodes in infants with haemolytic disease of the fetus and newborn who are treated with intrauterine transfusions in the Netherlands: an open-label, single-centre, phase 2, randomised, controlled trial.
Ree, I.M.C., et al. (2023). Lancet Haematology.

Platelet transfusions in preterm infants: current concepts and controversies-a systematic review and meta-analysis.
Ribeiro, H.S., et al. (2023). European Journal of Pediatrics.

Effects of freshly irradiated vs irradiated and stored red blood cell transfusion on cerebral oxygenation in preterm infants: a randomized clinical trial.
Saito-Benz, M., et al. (2022). JAMA Pediatrics.

Transfusion-associated delirium in children: no difference between short storage versus standard issue RBCs.
Traube, C., et al. (2022). Critical Care Medicine.

 

 

4 June 2024 (Tuesday) - UKAS Update

The nice people at UKAS sent out some links to their free webinars today. You can sign up to them by clicking here. I didn’t. I’ll be honest – I didn’t see the point. Until such time as the standards are freely available and open to all (i.e you don’t have to pay to get a copy) it’s all just hot air, isn’t it?

4 June 2024 (Tuesday) - BTLP-TACT Exercise

Flushed with success at having got one right at the weekend, I thought I might have another go at the BTLP-TACT…
I was given two cases:
 

68116 – a forty-two year-old woman in A&E requiring group & save

She grouped as O Rh(D) Positive with a negative antibody screen.

 

53366 – a forty-seven year-old chap in theatre requiring group & save and four units of FFP for bleeding varices.

He also grouped as O Rh(D) Positive but with an antibody screen positive in cells 1 & 2.

I performed antibody panels. The IAT panel was positive in cells 2, 4, 5, 7,8 and 10 which corresponded with anti-Fy(b), and the enzyme panel was negative.

I didn’t issue FFP as according to the guidelines it isn’t recommended in this condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218432/ 

 
I got the green light… 

3 June 2024 (Monday) - Learning Monday

It’s Monday… it’s Learning Monday. I say “learning”… I suspect things in the European Hematology Association are rather different to how they are in my world. Again I’m doing CPD which isn’t so much brushing up what I know and updating it as remembering the good old days before the job was dumbed down and de-skilled.

The picture is of hairy cells. Back in the day we’d take a bit of the patient’s blood, and do an acid phos stain.

Science advanced, and we’d take a bit of blood to the flow cytometer and test for all sorts of CD markers.

Nowadays the lab assistant packs up the blood and sends it to London and we call it progress.

Such a shame…

 

I really should stop being so negative in what I post here. Wow – look! – a reflection!!

2 June 2024 (Sunday) - BTLP-TACT Exercise

Another BTLP-TACT exercise… I was presented with one case – a nineteen-year-old lady in the outpatient department needing two units of irradiated blood for the following morning.

 

Her ABO group was indeterminate. Does that invalidate the Rh(D) group? Her Rh(D) group was negative as the control was also negative. So I said it was negative. Because it was. If a new finding the whole lot would go off to NHSBT, and if a known patient we’d know what was going on. Wouldn’t we?

Anyway…

The antibody screen was positive in cells 1 & 2 so I performed antibody panels. The IAT and enzyme panels were positive in cells 1, 2 and 3 which corresponded with anti-D but didn’t rule out anti-Cw.

I selected two units of irradiated O Rh(D) Negative blood which were K-Negative

 

I got the green light…

 

28 May 2024 (Tuesday) - Healthcase Science Bulletin

The office of the chief scientific officer sent the Healthcare Science Bulletin today. You can read it by clicking here.

Please do.

This is clearly the sort of thing that the chief scientific officer thinks healthcare scientists should be up to. Personally I disagree, but what I think is irrelevant. And so I try to keep abreast of this sort of thing…

27 May 2024 (Monday) - Seriously?

Well… here’s a weird one. Leaving aside the fact that no one has performed an osmotic fragility in the last thirty years I’ve never seen a curve showing greater resistance to lysis. The curve is shifted to the right. Bearing in mind that HS, HE and AIHA would give lower resistance to lysis (curve shifted to the left) the correct answer must be sickle cell anaemia. Which thinking about it would seem to be right (which it was).

But who on earth would do an osmotic fragility when a simple blood film would point you in the right direction?