Objective: Pretransfusion ABO compatibility testing is a
simple and required precaution against ABO-incompatible
transfusion, which is one of the greatest threats in transfusion
medicine. While distinct agglutination is most important
for correct test interpretation, protection against infectious
diseases and ease of handling are crucial for accurate
test performance. Therefore, the aim of this study
was to evaluate differences in test card design, handling,
and user safety. Design: Four different bedside test cards
with pre-applied antibodies were evaluated by 100 medical
students using packed red blood cells of different ABO
blood groups. Criteria of evaluation were: agglutination,
labelling, handling, and safety regarding possible user injuries.
Criteria were rated subjectively according to German
school notes ranging from 1 = very good to 6 = very
bad/insufficient. Results: Overall, all cards received very
good/good marks. The ABO blood group was identified
correctly in all cases. Three cards (no. 1, no. 3, no. 4) received
statistically significant (p < 0.008) prominence
(mean values shown) concerning clearness of agglutination
(1.7-1.9 vs. 2.4 for no. 2). Systems with dried antibodies
(no. 2, no. 4) outmatched the other systems with respect
to overall test system performance (2.0 vs. 2.8-2.9),
labelling (1.5 vs. 2.2-2.4), handling (1.9-2.0 vs. 2.5), and
user safety (2.5 vs. 3.4). Analysis of card self-explanation
revealed no remarkable differences. Conclusion: Despite
good performance of all card systems tested, the best results
when including all criteria evaluated were obtained
with card no. 4 (particularly concerning clear agglutination),
followed by cards no. 2, no. 1, and no. 3.
Giant pulmonary bullae are rare and surgical management of patients with severe emphysema and advanced chronic obstructive lung disease (COPD) presenting with giant bullae can be very challenging. Previously, perioperative, two-site, high-flow, veno-venous extracorporeal membrane oxygenation (ECMO) was successfully utilized during giant bulla resection. Here we report the perioperative application of single-site, low-flow extracorporeal CO removal (ECCOR) for minimally invasive thoracoscopic giant bulla resection. This approach of low-flow, veno-venous ECCOR, which is less invasive than conventional ECLS approaches, has enabled the safe performance of surgery and facilitated protective intraoperative single-lung ventilation while avoiding possible complications of aggressive mechanical ventilation.
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