Patient blood management: The best approach to transfusion medicine risk management

Bolcato, Matteo; Russo, Marianna; Trentino, Kevin M.; Isbister, James P.; Rodriguez, Daniele; Aprile, Anna

doi:10.1016/j.transci.2020.102779

Cited by 40 publications

(30 citation statements)

References 56 publications

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“…In these cases, the autopsy tool represents the gold standard method to gain all information about death [38]. The same approach could be useful in order to diagnose other morbid conditions in other disciplinary contexts (i.e., blood transfusion) [42]. Two kinds of diseases were reported: a rare form of cerebral venous sinus thrombosis (CVST) and cases of pulmonary embolism and splanchnic vein thrombosis associated with thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis

et al. 2021

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The current challenge worldwide is the administration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Even if rarely, severe vascular adverse reactions temporally related to vaccine administration have induced diffidence in the population at large. In particular, researchers worldwide are focusing on the so-called “thrombosis and thrombocytopenia after COVID-19 vaccination”. This study aims to establish a practical workflow to define the relationship between adverse events following immunization (AEFI) and COVID-19 vaccination, following the basic framework of the World Health Organization (WHO). Post-mortem investigation plays a pivotal role to support this causality relationship when death occurs. To demonstrate the usefulness and feasibility of the proposed workflow, we applied it to two exemplificative cases of suspected AEFI following COVID-19 vaccination. Based on the proposed model, we took into consideration any possible causality relationship between COVID-19 vaccine administration and AEFI. This led us to conclude that vaccination with ChAdOx1 nCov-19 may cause the rare development of immune thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4), which clinically mimics heparin-induced autoimmune thrombocytopenia. We suggest the adoption of the proposed methodology in order to confirm or rule out a causal relationship between vaccination and the occurrence of AEFI.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis

et al. 2021

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“…This approach comprises over 100 methods and activities with the aim of optimizing the use of the patient’s blood instead of resorting to allogenic blood transfusions [ 57 , 58 ]. In addition to reducing transfusion risks [ 59 ], PBM is also proving instrumental in applying the law on patient safety in Italy [ 60 , 61 ]. It does, however, necessitate consistent and systemic planning and management if it is to be a dependable resource in times of severe crisis [ 62 , 63 , 64 , 65 ].…”

Section: Resultsmentioning

confidence: 99%

Take-Home Messages from the COVID-19 Pandemic: Strengths and Pitfalls of the Italian National Health Service from a Medico-Legal Point of View

et al. 2020

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The World Health Organization (WHO) declared the outbreak of the Coronavirus disease-2019 (COVID-19) infection a pandemic on 11 March 2020. As of the end of October 2020, there were 50 million cases of infection and over one million deaths recorded worldwide, over 45,000 of which occurred in Italy. In Italy, the demand for intensive care over the course of this pandemic crisis has been exceptionally high, resulting in a severe imbalance between the demand for and availability of the necessary resources. This paper focuses on elements of preventive medicine and medical treatments in emergency and non-emergency situations which, based on the international scientific literature, may prove to be useful to physicians on a behavioral level and avert professional liability problems. In order to achieve this objective, we have performed a search on MEDLINE to find published articles related to the risks associated with the pandemic that contain useful suggestions and strategies for mitigating risks and protecting the safety of the population. The results have been collocated in line with these specific study areas.

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“…This law, no. 24/2017 [ 70 , 71 ], set forth the need to implement clinical risk management programs in all hospital settings to prevent the occurrence of such infections [ 72 , 73 ].…”

Section: Discussionmentioning

confidence: 99%

Risk Management in the New Frontier of Professional Liability for Nosocomial Infection: Review of the Literature on Mycobacterium Chimaera

Bolcato

Rodriguez

Aprile

2020

IJERPH

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Background: Mycobacterium chimaera (MC) is of recent origin and belongs to the large family of non-tuberculous mycobacteria. In recent years, it has shown a high infectious capacity via the aerosol produced by operating room equipment, such as heater–cooler units (HCU). The infection has a long latent period and high mortality rate. Genetic and epidemiological studies have shown that there is a clear link between the infection and a specific HCU model manufactured by LivaNova/Sorin. There is, therefore, a strong possibility that contamination occurs during device construction. The objective of this article is to describe the characteristics of this particular infection in view of the medico–legal implications on professional liability, specifically focusing on current evidence regarding contamination prevention. Methods: we have analyzed the clinical characteristics and data from the autopsic investigations performed on a patient who died as a result of MC infection, in addition to analyzing all pertinent recommendation documents available internationally. We searched for all articles in the literature available on MEDLINE between 1995 and 30 July 2020, using the search words “Mycobacterium chimaera”. We then analyzed those articles and reported only those that provide useful information regarding prevention techniques for containing dissemination and contamination. Results: the literature review produced 169 results that highlight the need to develop systems to mitigate and eliminate the risk of MC infection in operating rooms such as physical containment measures, e.g. device replacement, use of safe water, providing patients with information, and training healthcare professionals. Conclusions: from a medico–legal viewpoint, this particular situation represents a new frontier of professional liability, which includes manufacturers of electromedical equipment. In order to comprehend the true extent of this silent global epidemic, the development of an organic, preventative monitoring system is essential.

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Patient blood management: The best approach to transfusion medicine risk management

Cited by 40 publications

References 56 publications

COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis

COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis

Take-Home Messages from the COVID-19 Pandemic: Strengths and Pitfalls of the Italian National Health Service from a Medico-Legal Point of View

Risk Management in the New Frontier of Professional Liability for Nosocomial Infection: Review of the Literature on Mycobacterium Chimaera

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