A review of blood transfusions in a trauma unit  for young children

Salverda, M; Ketharanathan, Naomi; Dijk, Monique van; Beltchev, E; Buys, Heloise; Numanoglu, Alp; As, A B van

doi:10.7196/samj.2017.v107i3.11307

Cited by 5 publications

(11 citation statements)

References 10 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that more than two thirds of all children tested in our ED have anaemia as compared to the estimated prevalence of anaemia globally (24.8%) [ 2 ], and that of developed countries [ 15 , 16 , 23 , 24 ]. However, these findings were very similar to other low resource countries in South and Southeast Asia, and South and West Africa [ 3 , 4 , 16 , 18 ]. The prevalence of anaemia in this study was lower compared to the study done in Ghana where more than a quarter of children admitted had anaemia, with as 71% of these children having severe anaemia which is higher compared to our study where children with severe anaemia comprised 42% of children with anaemia [ 4 ].…”

Section: Discussionsupporting

confidence: 85%

“…The availability of blood in emergencies is still a challenge in many developing countries [ 14 ]. The blood supply is not adequate to meet population demands in most of the low income countries such as Bangladesh, South East Asia, South and West Africa [ 3 , 4 , 15 – 18 ]. This lack of blood has been attributed to limited emergency and critical care services in these areas [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Emergency blood transfusion practices among anaemic children presenting to an urban emergency department of a tertiary hospital in Tanzania

et al. 2017

View full text Add to dashboard Cite

BackgroundSevere anaemia contributes significantly to mortality, especially in children under 5 years of age. Timely blood transfusion is known to improve outcomes. We investigated the magnitude of anaemia and emergency blood transfusion practices amongst children under 5 years presenting to the Emergency Department (ED) of Muhimbili National Hospital (MNH) in Tanzania.MethodsThis prospective observational study enrolled children under 5 years old with anaemia, over a 7-week period in August and September of 2015. Anaemia was defined as haemoglobin of <11 g/dL. Demographics, anaemia severity, indications for transfusion, receipt of blood, and door to transfusion time were abstracted from the charts using a standardized data entry form. Anaemia was categorized as severe (Hb <7 g/dL), moderate (Hb 7–9.9 g/dL) or mild (Hb 10–10.9 g/dL).ResultsWe screened 777 children, of whom 426 (55%) had haemoglobin testing. Test results were available for 388/426 (91%), 266 (69%) of whom had anaemia. Complete data were available for 257 anaemic children, including 42% (n = 108) with severe anaemia, 40% (n = 102) with moderate anaemia and 18% (n = 47) with mild anaemia. Forty-nine percent of children with anaemia (n = 125) had indications for blood transfusion, but only 23% (29/125) were transfused in the ED. Among the non-transfused, the provider did not identify anaemia in 42% (n = 40), blood was not ordered in 28% (n = 27), and blood was ordered, but not available in 30% (n = 29). The median time to transfusion was 7.8 (interquartile range: 1.9) hours. Mortality was higher for the children with severe anemia who were not transfused as compared with those with severe anaemia who were transfused (29% vs 10%, p = 0.03).ConclusionThe burden of anaemia is high among children under 5 presenting to EMD-MNH. Less than a quarter of children with indications for transfusion receive it in the EMD, the median time to transfusion is nearly 8 h, and those not transfused have nearly a 3-fold higher mortality. Future quality improvement and research efforts should focus on eliminating barriers to timely blood transfusion.Electronic supplementary materialThe online version of this article (10.1186/s12878-017-0091-y) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Emergency blood transfusion practices among anaemic children presenting to an urban emergency department of a tertiary hospital in Tanzania

et al. 2017

View full text Add to dashboard Cite

show abstract

“…We found parallel patterns both for the individual hospital wards, with most products being given to the pediatric ward, and for subgroup patient populations. In the pooled analysis of the nine studies that included only children, it was found that 64% of blood products were used for children with severe malaria. Similarly, from the five pooled studies in obstetrics and gynecology, over one‐half (54%) of blood products were used for obstetric hemorrhage (represented here by the diagnostic categories of PPH, antepartum hemorrhage, and cesarean deliveries).…”

Section: Discussionsupporting

confidence: 85%

“…Blood use among the other patient populations of pediatrics, obstetrics and gynecology, cesarean section births, and newborns are shown in Appendices S3.3 through S3.7. The studies among pediatric patients showed that 64% (2810 of 4387) of blood products were transfused for malaria. Postpartum hemorrhage (PPH) at 24% (524 of 2228) and cesarean sections at 22% (485 of 2228) were the most transfused diagnostic categories among the obstetrics and gynecology patients, with abortions and cancer accounting for only 10% and 8% of transfusions, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…These 10 studies were used for the primary outcome calculation. The rest of the studies evaluated blood use among specific patient groups: nine studies among pediatric patients only; five on obstetrics and gynecology patients; three among cesarean section deliveries; three among newborn babies; two among elective surgical operations; two exclusively on the use of platelets; two on the use of autologous blood; and one among hepatogastroenterology patients . Most studies made a clear distinction between the number of patients transfused and the number of blood products used for transfusion.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Blood use in sub‐Saharan Africa: a systematic review of current data

et al. 2019

View full text Add to dashboard Cite

Clinicians’ Perceptions of an Artificial Intelligence–Based Blood Utilization Calculator: Qualitative Exploratory Study

Choudhury¹,

Asan²,

Medow³

2022

JMIR Hum Factors

View full text Add to dashboard Cite

Background According to the US Food and Drug Administration Center for Biologics Evaluation and Research, health care systems have been experiencing blood transfusion overuse. To minimize the overuse of blood product transfusions, a proprietary artificial intelligence (AI)–based blood utilization calculator (BUC) was developed and integrated into a US hospital’s electronic health record. Despite the promising performance of the BUC, this technology remains underused in the clinical setting. Objective This study aims to explore how clinicians perceived this AI-based decision support system and, consequently, understand the factors hindering BUC use. Methods We interviewed 10 clinicians (BUC users) until the data saturation point was reached. The interviews were conducted over a web-based platform and were recorded. The audiovisual recordings were then anonymously transcribed verbatim. We used an inductive-deductive thematic analysis to analyze the transcripts, which involved applying predetermined themes to the data (deductive) and consecutively identifying new themes as they emerged in the data (inductive). Results We identified the following two themes: (1) workload and usability and (2) clinical decision-making. Clinicians acknowledged the ease of use and usefulness of the BUC for the general inpatient population. The clinicians also found the BUC to be useful in making decisions related to blood transfusion. However, some clinicians found the technology to be confusing due to inconsistent automation across different blood work processes. Conclusions This study highlights that analytical efficacy alone does not ensure technology use or acceptance. The overall system’s design, user perception, and users’ knowledge of the technology are equally important and necessary (limitations, functionality, purpose, and scope). Therefore, the effective integration of AI-based decision support systems, such as the BUC, mandates multidisciplinary engagement, ensuring the adequate initial and recurrent training of AI users while maintaining high analytical efficacy and validity. As a final takeaway, the design of AI systems that are made to perform specific tasks must be self-explanatory, so that the users can easily understand how and when to use the technology. Using any technology on a population for whom it was not initially designed will hinder user perception and the technology’s use.

show abstract

A review of blood transfusions in a trauma unit for young children

Cited by 5 publications

References 10 publications

Emergency blood transfusion practices among anaemic children presenting to an urban emergency department of a tertiary hospital in Tanzania

Emergency blood transfusion practices among anaemic children presenting to an urban emergency department of a tertiary hospital in Tanzania

Blood use in sub‐Saharan Africa: a systematic review of current data

Clinicians’ Perceptions of an Artificial Intelligence–Based Blood Utilization Calculator: Qualitative Exploratory Study

Contact Info

Product

Resources

About