국내 적십자혈액원 혈액성분제제의 품질관리 현황

김종암,서동희,황병갑,김상인 대한임상검사정도관리학회 2001 臨床檢査와 精度管理 Vol.23 No.2

原著(원저) : 수혈용 혈액의 취소 및 폐기를 줄이기 위한 방안

박성화 ( Sung Hwa Park ),김영태 ( Young Tae Kim ),서장수 ( Jang Soo Suh ),김영권 ( Young Kwon Kim ) 대한임상병리사협회 2001 임상수혈검사학회 발표자료집 Vol.6 No.1

In order to reduce return and disuse of blood components the authors scrutinized the rate of canceled blood components by each department from January to December in 1998 and also estimated the wasted cost for cancelling a unit of blood component. The returned packed red cell was 2,199 units (11.4%) of the released 19,234 units, the returned platelet concentration was 310 units (1.4%) of the released 21,950 units, and returned whole blood were 77 unit (9.4%) of the released 822 units. The returned rate of the packed red cell by the department of chest surgery is 448 units (20.44%) which is the highest, and that by the department of pediatric is 4 units (0.2%) which is the lowest. The returned rate of the platelet concentration by the department of internal medicine is 150 units (48.4%) which is the highest and that by the department of plastic surgery is 23 units (7.4%) which is the lowest. The returned rate of the whole blood was 32 units (48.4%) which is the highest by the department of chest surgery and department of obstetric and gynecology is 3 units (3.9%) which is the lowest. The reason for cancelling blood component is a follow; the patient`s recovery is 2,206 unit (85.3%), the patient`s death is 266 unit (10.3%) and the transfusion reaction is 12 units (0.5%). For the efficient management of insufficient blood resources the doctor should ordered the accurate volume of blood component, and to reduce the rate of return and disuse of blood component the following measures are necessary ; 1) to review and control blood component by the physician in charge along with the clinical pathologist, 2) the more active participation of the transfusion committee 3) to acknowledge of the type & screening test in the medical insurance is needed for the scheduled patient`s transfusion 4) to return of the blood component after release 30 minute is to be inhibited 5) the authors think the continous informing and serious review is very important.

단국대학교병원에서의 국제질병사인분류에 의한 질환군별 혈액사용량 분석

임인수,이길호 대한혈액학회 2004 Blood Research Vol.39 No.4

Background:A few recent studies have been conducted to analyzing the blood usage with regard to diagnosis of Korean recipients. We performed a study to analyze the usage of blood components. Methods:Transfused components such as packed red blood cells (RBC), whole blood (WB), fresh frozen plasma (FFP), and platelet components (PLT) were estimated by the principal diagnoses of the patients, who were discharged from February 1998 to January 1999, according to the International Statistical Classification of Diseases (ICD)-10. Results:Eleven percentage (2,227/20,650) of inpatients were transfused. The transfusion rate of hospitalized patients for RBCs, WBs, FFPs, and PLTs was 10.1%, 0.4%, 4.0% and 16.2 %, respectively. There was a difference in the sex ratio (1.6 male/female) in all blood components transfused. Of all investigated blood components (22,523 units), 10,729 units (47.6%) of RBCs, 240 units (1.1%) of WBs, 5,355 units (23.8%) of FFPs, and 6,199 units (27.5%) of PLTs were transfused. The hospitalized patients who received 1 unit of RBCs was 12.9%, and 2 units were most frequent transfused units (25.6%). Seventy-four percent of all 22,523 units were used in four diagnostic categories of highest blood usage; injury and poisoning (29.2%), nonhematologic neoplasms (16.3%), digestive system disease (16.1%) and circulatory system disease (12.5%). Conclusion:We performed usage analysis of blood components with regard to diagnosis, comparing the previous studies in other hospitals. This study could provide baseline transfusion information in relation to diagnosis, and help improve the quality control of blood utilization and transfusion practice.

2008년 국내 의료기관의 혈액사용 및 폐기량 분석

권정란,이상원,이현주,김창훈,조영희,권윤형,김혜정,정성훈,신영학 대한수혈학회 2009 大韓輸血學會誌 Vol.20 No.3

Background: Investigating the blood usage and blood wastage in Korea hospitals national wide, and including all types of medical institutes, has not been sufficient with the only study having been carried out by the KCDC thorough an Academic Research Contract in 2007. Yet that study was limited due to lack of participation from hospitals. Our study tried to establish a fundamental database for blood transfusion management by investigating the current status of blood products usage, under the KCDC's supervision, to improve participation from medical institutes. Methods: From January to December in 2008, the Blood Bank, Red Cross of the Republic of Korea looked into the blood product supply of all the medical institutes and we conducted a national survey using questionnaires distributed via the local public health centers on the blood use, blood waste, the reasons for waste and the inventory of the remaining blood. The supply, as compared to the actual use of blood products in the same period, was analyzed by the Korean Red Cross. Results: The total amount of blood products distributed by the Korean Red Cross to medical institutes in 2008 increased by 13.8% for platelets, 11.5% for RBC products, 8.4% for apheresis products and 2% for FFPs, as compared with that of 2006. A total of 2,500 institutions participated in the questionnaire and 60.7% (1,517 out of 2,500 institutes) of the institutes sent feed-back. The total amount of blood use was 3,483,636 units and 52% of the consumption was focused in metropolitan areas like Seoul, Geong-Ki and Busan. The total wastage rate for blood was 1.2% and it was 4.8% for institutes with admitting capacities of 100 beds or less, with expiration of the storage date being the main reason for wastage, while the wastage rate was 1.1% for general hospitals with admitting capacities of 500 beds or more, with an improving patient status or death being the main reason. Conclusion: The results of this study were similar to those of 2007, but the participation rate from medical institutes was much increased. Establishment of an investigational system for the use of blood products in medical institutes on a national level is needed to secure data for dealing with the increased projected demand of blood/blood products in the future. 배경: 그동안 국내의 전 의료기관을 대상으로 하는 전국적인 조사는 미비하여 2007년 질병관리본부의 학술연구용역을 통한 연구가 유일하였으나, 의료기관의 참여가 미흡한 제한점이 있었다. 본 연구는 국내 의료기관들의 참여율을 높이기 위해 질병관리본부가 주관하여 전체적인 혈액사용현황을 파악하여 수혈관리를 위한 기초자료를 마련하고자 하였다. 방법: 2008년 1년동안 대한적십자사 혈액원이 한단위 이상 혈액을 공급한 전국 의료기관을 대상으로 혈액공급량을 조사하였으며, 혈액사용량 및 폐기량, 폐기사유, 재고량은 전국 시도 및 보건소를 통해 수혈을 실시한 의료기관을 대상으로 설문조사를 수행하였다. 그리고 동기간 대한적십자사의 혈액공급량 대비 의료기관의 실제 혈액사용량을 비교분석하였다. 결과: 2008년 대한적십자사가 의료기관에 공급한 혈액량은 2006년에 비해 혈소판제제 13.8%, 적혈구제제 11.5%, 성분채혈제제 8.4%, 신선동결혈장제제가 2% 순으로 증가하였다. 조사대상 의료기관의 설문회신률은 60.7% (1,517/2,500기관)으로 이들 기관의 2008년 혈액 총 사용량은 3,483,636단위였으며 서울, 경기, 부산 등의 대도시 지역이 전체 혈액의 52.3%를 사용하였다. 혈액 총 폐기율은 1.2%를 차지하였는데, 이중 100병상 미만 중소병의원의 폐기율은 4.8%로 보존기간 경과로 인한 폐기가 가장 높은 반면 500병상 이상 종합병원의 폐기율은 1.1%로 환자증상 호전 및 사망이 가장 높았다. 결론: 국내 의료기관의 혈액사용량 및 폐기량은 2007년 국내 조사와 유사한 양상을 보였으며, 혈액사용 현황조사에 대한 의료기관들의 참여율은 상당히 증가하였다. 따라서 향후 국내 혈액수급예측자료 확보를 위해 국가 차원의 의료기관 혈액제제 사용량 조사체계 확립이 필요할 것으로 여겨졌다.

A novel approach to bedside pretransfusion identity check of blood and its components: the Sandesh Positive-Negative protocol

Udupi Sandesh,Puri Kriti 대한마취통증의학회 2020 Korean Journal of Anesthesiology Vol.73 No.3

Background: Blood component mistransfusion is generally due to preventable clerical errors, specifically pretransfusion misidentification of patient/blood unit at bedside. Hence, electronic devices such as barcode scanners are recommended as the standard instrument used to check the patient’s identity. However, several healthcare facilities in underdeveloped countries cannot afford this instrument; hence, they usually perform subjective visual assessment to check the patient’s identity. This type of assessment is prone to clinical errors, which precipitates significant level of anxiety in the healthcare personnel transfusing the blood unit. Hence, a novel objective method in performing pretransfusion identity check, the ‘Sandesh Positive-Negative (SPON) protocol,’ was developed. Methods: A nonrandomized study on bedside pretransfusion identity check was conducted, and 75 health care personnel performed transfusion. The intervention was performed by matching a custom-made negative label with blood component with the positive label of the same patient available at bedside who was about to receive transfusion. Results: In total, 85.3% of the subjects were anxious while performing pretransfusion identity check based on the existing standard practice. After the implementation of the SPON protocol, only 38.7% experienced either mild, moderate or severe anxiety. The overall level of satisfaction also increased from 8.0% to 38.7% and none were dissatisfied. Although only 9.3% were dissatisfied about the existing practice, approximately 70.7% felt the need for a better/additional protocol. Clerical error was not observed. Conclusions: The SPON protocol is a cost-effective objective method that reduces anxiety and increases satisfaction levels when performing final bedside identity check of blood components.

혈액성분제제 품질관리 자료의 통계학적인 비교

김종암 ( Chongahm Kim ),서동희 ( Dong Hee Seo ),권소영 ( So Yong Kwon ),오영철 ( Yuong Chul Oh ),임채승 ( Chae Seung Lim ),장충훈 ( Choong Hoon Jang ),김순덕 ( Soonduck Kim ) 대한임상검사과학회 2004 대한임상검사과학회지(KJCLS) Vol.36 No.1

According to increase of domestic blood components use, the quality control of blood components is necessary to support good products. The purpose of this study is used to provide the producing index of the good product as compared with the accuracy and validity for the distribution of the quality control data. The value of mean, standard deviation, 95% confidence interval and degree of normal distribution of data were calculated by univariate procedure, the value of monthly mean of each blood centers per items were compared by Analysis of Variance(ANOVA) test for the degree of distribution. When there was difference among the mean values, the Duncan``s multiple range test was done to confirm the difference. Finally, methods for accessing accuracy and validity of the quality data was done by the Contingency table test. The quality data of five blood centers was showed to the normal distribution and it was in a acceptable range. For each blood centers, the monthly means of Hematocrit(Hct), Platelet(PLT) and pH were not significantly different except Hct of C center, PLT of B, D center and pH of A center. The quality data per items was graded according to quality to six level. As a result of the comparative analysis, the monthly means of Hct of C and E center was significantly different higher than that of D, B and A center. The monthly means of PLT of A center and pH of C center was significantly different higher than that of the others. In the accuracy and validity of the quality control data, C center for Hct, A center for PLT and C center for pH were better than the other. The C blood center was most satisfiable and stable in the quality control for blood component. If the quality control method used in C blood center is adopted in other blood centers, the prepared level of the blood component of the center will be improved partly.

사육 엘크의 녹용혈과 체녹혈의 혈액성분

최석화,강성수,최향순,조성구 한국임상수의학회 1998 한국임상수의학회지 Vol.15 No.2

This study was performed to investigate the blood contents of velvet antler and femoral venous blood in farmed elk (Cervus canadensis). Blood samples were collected from 12 young adult elk (3.5-4.5 years old) with a mixture of fentanyl-azaperone-xylazine (Fentazine$^{(R)}$). Values for hematological and clinicochemical components of the clinical healthy elk were determined. The results were grouped for comparison according to velvet antler and femoral venous blood. Lower mean platelet counts and fibrinogen values were found in the velvet antler than femoral venous blood (p<0.01). White blood cell count of velvet antler was significantly higher than that of femoral venous blood 0<0.05). The clinicochemical parameters (total protein, albumin, globulin, alanine aminotransferase, aspartate aminotransferasei blood urea nitrogens calciums magnesium and phosphonls) obtained in this study far farmed elk are consistent with the values between velvet antler and femoral venous blood.

해양 V. vulnificus의 내독소가 rat의 혈액 성분에 미치는 독성 효과

이봉헌 한국환경과학회 1997 한국환경과학회지 Vol.6 No.1

Endotoxin from the cell wall of marine V. vulnificus was extracted using the hot phenol-water method, injected endotoxin into rat, and tested the toxic effect of endotoxin on the blood component in rat blood. The results showed that blood glucose, blood urea nitrogen, white blood cell, and reticulocyte were increased and red blood cell was the same as the number of control group(normal blood), but platelet was decreased. Above results suggested that endotoxin induced a malfunction of liver and that the increase of white blood cell was for the removal of foreign toxic substance.

Prevalence of extracorporeal blood purification techniques in critically ill patients before and during the COVID-19 pandemic in Egypt

Aya Osama Mohammed,Hanaa I. Rady 대한중환자의학회 2024 Acute and Critical Care Vol.39 No.1

Background: Extracorporeal blood-purification techniques are frequently needed in the pediatric intensive care unit (PICU), yet data on their clinical application are lacking. This study aims to review the indications, rate of application, clinical characteristics, complications, and outcomes of patients undergoing extracorporeal blood purification (i.e., by continuous renal replacement therapy [CRRT] or therapeutic plasma exchange [TPE]) in our PICU, including before the coronavirus disease 2019 (COVID-19) pandemic in 2019 and during the pandemic from 2020–2022. Methods: This study included children admitted for extracorporeal blood-purification therapy in the PICU. The indications for TPE were analyzed and compared to the American Society for Apheresis categories. Results: In 82 children, 380 TPE sessions and 37 CRRT sessions were carried out children, with 65 patients (79%) receiving TPE, 17 (20.7%) receiving CRRT, and four (4.8%) receiving both therapies. The most common indications for TPE were neurological diseases (39/82, 47.5%), followed by hematological diseases (18/82, 21.9%). CRRT was mainly performed for patients suffering from acute kidney injury. Patients with neurological diseases received the greatest number of TPE sessions (295, 77.6%). Also, the year 2022 contained the greatest number of patients receiving extracorporeal blood-purification therapy (either CRRT or TPE).Conclusions: The use of extracorporeal blood-purification techniques increased from 2019 through 2022 due to mainly autoimmune dysregulation among affected patients. TPE can be safely used in an experienced PICU. No serious adverse events were observed in the patients that received TPE, and overall survival over the 4 years was 86.5%.

발육발달 : 복합훈련이 장거리 육상선수의 심폐기능과 혈액성분에 미치는 영향

최재현(ChoeJaeHyeon),양점홍(YangJeomHong),남태호(NamTaeHo),홍순미(HongSunMi) 한국체육학회 2004 한국체육학회지 Vol.43 No.2

This study analyzed the change of cardiorespiratory function and blood component. The male long distance runners(n=14) in high school trained for 12 weeks dividing into 2 groups, which are CT group(n=7) and RT group(n=7) for studying effect on Combined training. The CT group was operated running for 3 days(Mon., Wed., Fri.) and circuit weight training for 3days(Tue., Thu., Sat.) with 6 times/week, and RT group was operated only running training with 6 times/week. Also, running training was operated in the same way with similar training condition between 2 group as possible. All data were expressed as mean and standard deviations by using SPSS window 10.0 package program, and were analyzed by using paired t-test toevaluate the difference ofwithin groups and were analyzed using t-test to evaluate the difference of between groups. These statistical processes were all performed at the signficance lavel is .05. The results are as follow.1. HRrest decreased within two groups, and was no difference between groups.2. O2max increased within two groups, and CT group increased more significant than RT group.3. Emax increased within two groups, and was no difference between groups.4. Exhaustion time increased within two groups, and CT group increased more significant than RT group.5. Red blood corpuscle increased within two groups, and CT group increased more significant than RT group.6. Hemoglobin increased within two groups, and no difference between groups.7. Hematocrit was no difference within groups and between groups.Accordingly to this result,, CT group in cardiorespiratory function and blood component shows more profitable change than RT group does. Combined training which is Combined CWT(circuit weight training)+running training is more useful training method for improving long distance runners performance.