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

Background. Trauma is the leading cause of mortality and morbidity worldwide. Blood transfusions play an incremental role in the acute phase, yet practice varies owing to variations in transfusion thresholds and concerns about potential complications, especially in children.Objectives. To evaluate protocol adherence to blood transfusion thresholds in paediatric trauma patients and determine the degree of blood product wastage, as defined by discarded units.Methods. A retrospective, descriptive study of trauma patients (age 0 - 13 years) who received a blood transfusion in the trauma unit at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa, over a 5.5-year period (1 January 2009 - 1 July 2014). Haemoglobin (Hb) transfusion thresholds were defined as 10 g/dL for neurotrauma patients and patients requiring skin grafting or a musculocutaneous flap (group 1). All other trauma patients had an Hb transfusion threshold of 7 g/dL (group 2).Results. A total of 144 patients were included (mean age 5.2 years (standard deviation (SD) 3.3), 68.1% male). The mean Hb increase after transfusion was 3.5 g/dL (SD 1.7). Adherence to the transfusion Hb threshold protocol was 96.7% for group 1 v. 34.0% for group 2. No complications were reported. Average blood wastage was 3.5 units per year during the study period.Conclusions. Adherence to paediatric blood transfusion protocol was low in the Hb threshold group <7 g/dL. However, transfusion-related complications and wastage were minimal. Further prospective research is required to determine optimal blood transfusion guidelines for paediatric trauma patients

Les obstacles au développement du commerce extérieur entre les pays du CAEM et les pays capitalistes développés

The Obstacles Faced In Developing Foreign Trade between CEMA and Advanced Capitalist Countries. The CEMA countries esteem they are discriminated against by the capitalist countries, namely by those belonging to the Common Market in the following ways : customs' duty exemptions for certain products which are not accorded to CEMA countries, protectionism and a unified agricultural policy within the EEC, the formation of a new zone of free exchange in Western Europe centered around the EEC, préférentiel cooperation agreements with North African and Mediterranean countries, restrictions on the sale of certain so-called strategic materials, etc. In turn, the Western countries observe the existence of obstacles created by the CEMA, insufficient adaption to the Western market, a certain rigidity due to central planning procedures and the monopoly of foreign trade, the non-convertibility of socialist moneys and a lack of reciprocity in making concessions. The final part of the analysis is devoted to monetary and financial problems affecting East-West exchanges.Les pays du CAEM estiment qu'une discrimination est faite à leur égard par les pays capitalistes et notamment par ceux du Marché commun : réduction des droits de douane sur certains biens qui ne correspondent pas à la liste d'exportation des pays du CAEM, politique agricole unifiée et protectionnisme au sein de la CEE, formation d'une nouvelle zone de libre échange en Europe occidentale autour de la CEE, accords préférentiels d'association avec les pays africains et méditerranéens, interdiction de vente pour certains produits dits stratégiques, etc. Les pays occidentaux, eux-aussi, soulignent l'existence d'une série d'obstacles créés par les membres du CAEM : faible adaptation aux besoins du marché occidental, une certaine rigidité due à la planification et au monopole du commerce extérieur, non-convertibilité des monnaies socialistes, manque de réciprocité des concessions... Pour finir, les auteurs analysent les problèmes monétaires et financiers qui affectent les échanges Est-Ouest.Dimova B., Beltchev M. Les obstacles au développement du commerce extérieur entre les pays du CAEM et les pays capitalistes développés. In: Revue de l'Est, vol. 5, 1974, n°2. pp. 51-57