Serious hazards of transfusion in children (SHOT)

Harrison, E. A.; Bolton, Philip

doi:10.1111/j.1460-9592.2010.03474.x

Cited by 47 publications

(18 citation statements)

References 4 publications

(4 reference statements)

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“…The SHOT scheme [27] showed the estimation of the incidence of an adverse outcome to be 18:100,000 transfusions for children less than 18 years and 37:100,000 for infants less than 12 months, compared to 13:100,000 for adults. The SHOT classifies incidents reported into 12 different categories [28]; of these, IBCT event errors were the most common category in both adults and children, but they were particularly common in children, making up more than 80% of reports [26]. These findings suggest that pediatric patients are more vulnerable to transfusion-associated complications than adults.…”

Section: Preoperative Autologous Blood Donation and Transfusionmentioning

confidence: 81%

Electronic Pre-Transfusion Check at the Bedside: Experience in a University Hospital

Ohsaka¹

2017

HTIJ

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Although the current risks of viral transmission through blood components are very small, mistransfusion in which the wrong blood is transfused to the wrong patient remains the most common type of error in transfusion practice. Many studies have revealed that transfusion errors occur frequently in clinical areas, with the most common error being failure to perform the final patient identification check at the bedside. Thus, pre-transfusion check at the bedside is the most critical step for the prevention of mistransfusion. Machine-readable identification technology, especially an electronic identification system (EIS), is ideally suited to pre-transfusion check requirements. An experience at the Juntendo University Hospital (JUH) showed that the bar code-based EIS works well on a hospital-wide basis in the setting of regular allogeneic blood transfusion, preoperative autologous blood donation (PAD) and transfusion, pediatric transfusion and hematopoietic progenitor cell (HPC) infusion at the bedside. Approximately 110,000 blood components have been transfused over a 10.5-year period without a single mistransfusion. The overall compliance rate with electronic pre-transfusion check at the bedside was 98.2%. Human error was the most frequent cause of errors leading to failure of the 'second' electronic pre-transfusion check. If we want to reduce the risk of mistransfusion to improve transfusion safety, we have to address the issue at the hospital level, with a system-based approach.

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Section: Preoperative Autologous Blood Donation and Transfusionmentioning

confidence: 81%

Electronic Pre-Transfusion Check at the Bedside: Experience in a University Hospital

Ohsaka¹

2017

HTIJ

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“…32,33 More worryingly, the rate of complications, due to RBC transfusion, is higher in children than in adults and reported among infants to be up to three times as high. 34,35 Another study found an overall complication rate of 10.7 per 1000 units transfused in children compared to a rate of 2.5 in adults. 36 Plasma transfusion in critically ill children was in a recent prospective study independently associated with an increased occurrence of new or progressive multiple organ dysfunction syndrome, nosocomial infections, and prolonged length of stay in ICU.…”

Section: Paediatric Transfusionmentioning

confidence: 97%

“…* However, evolving challenges such as prion diseases (vCJD), malaria, dengue, babesia, and West Nile Virus are testing this notion. 4,34 Non-infectious risks Non-infectious serious hazard of transfusion (NISHOT) include human errors, accounting for the vast majority of these complications in children as well as in adults. 38 Alarmingly up to 82% of cases in infants and 58% in small children (less than 1 year old) appear to be due to human-related errors such as identification errors, laboratory errors, accidental over-transfusion, and lack of knowledge of special requirements.…”

Section: Infectious Risksmentioning

confidence: 99%

Transfusion in critically ill children: an ongoing dilemma

Secher

Stensballe

Afshari

2013

Acta Anaesthesiol Scand

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Transfusion of blood products is a cornerstone in managing many critically ill children. Major improvements in blood product safety have not diminished the need for caution in transfusion practice. In this review, we aim to discuss the interplay between benefits and potential adverse effects of transfusion in critically ill children by including 65 papers, which were evaluated based on previously agreed selection criteria. Current practice on transfusing critically ill children is mainly founded on the basis of adult studies, common practices with cut-off values, and expert opinions, rather than evidence-based medicine. Paediatric patients have explicit physiological challenges and requirements to be addressed. Critically ill children often suffer from anaemia, have substantial iatrogenic blood loss with subsequent transfusions, and are at a higher risk of complications, often due to human errors. Transfusion in children is associated with increased morbidity. A restrictive transfusion strategy is not associated with increased morbidity. Thus, transfusion in paediatrics should be considered a high-risk treatment and requires individual clinical assessment. Current level of evidence support the notion that in most stable cases, despite high severity of illness (cyanotic children and neonates excluded), a restrictive haemoglobin threshold of 70 g/l (4.3 mmol/l) is no more harmful than to transfuse at a liberal trigger, e.g. haemoglobin 95 g/l (5.9 mmol/l). Thus, balanced against potential benefits and often its necessity, a restrictive approach may be appropriate due to the associated risks of transfusion.

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“…4 Allogenic transfusion is associated with potentially serious complications such as; incorrect blood component transfused (CMV+ blood to a CMV-patient), acute transfusion reactions, as well as transfusion-related acute lung injury. 19 Allogenic transfusion also increase the risk of infectious disease such as hepatitis B and C, HIV and nvCJD. 19 Predonation has several limitation in major spinal surgery such as difficulty of predicting which patients require blood tranfusion, 20,21 the high potential for wastage (up to 40% discarded autologous blood products), 20 a high level of communication across a variety of specialties necessary for successful implementation, and its inavailability in emergency surgeries.…”

Section: Estimated Blood Volumementioning

confidence: 99%

“…19 Allogenic transfusion also increase the risk of infectious disease such as hepatitis B and C, HIV and nvCJD. 19 Predonation has several limitation in major spinal surgery such as difficulty of predicting which patients require blood tranfusion, 20,21 the high potential for wastage (up to 40% discarded autologous blood products), 20 a high level of communication across a variety of specialties necessary for successful implementation, and its inavailability in emergency surgeries. 4 With the exception of the estimated blood volume, the baseline demographic variables between the PD and non-PD groups were similar.…”

Section: Estimated Blood Volumementioning

confidence: 99%

Pre-Operative Autologous Blood Donation Does Not Affect Pre-Incision Hematocrit in Adolescent Idiopathic Scoliosis Patients. A Retrospective Cohort of a Prospective Randomized Trial

et al. 2016

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Background Pre-donation of autologous blood prior to spine fusion for adolescent idiopathic scoliosis (AIS) has been used in deformity surgery. The effect of pre-donation on pre-operative hematocrit (Hct) remains debated. Multiple factors may influence pre-operative Hct including intravascular volume status, patient factors, and timing of pre-operative blood donation. The purpose of this study was to determine if pre-donation significantly lowers pre-incision Hct in AIS patients.

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Serious hazards of transfusion in children (SHOT)

Cited by 47 publications

References 4 publications

Electronic Pre-Transfusion Check at the Bedside: Experience in a University Hospital

Electronic Pre-Transfusion Check at the Bedside: Experience in a University Hospital

Transfusion in critically ill children: an ongoing dilemma

Pre-Operative Autologous Blood Donation Does Not Affect Pre-Incision Hematocrit in Adolescent Idiopathic Scoliosis Patients. A Retrospective Cohort of a Prospective Randomized Trial

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