The Prospective Evaluation of the Net Effect of Red Blood Cell Transfusions in Routine Provision of Palliative Care.

"Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/jpm.2017.0072” This author accepted manuscript is made available following 12 month embargo from date of publication (June 2017) in accordance with the publisher’s archiving policyBackground Red Blood Cell (RBC) transfusions are commonly used in palliative care. RBCs are a finite resource, transfusions carry risks, and the net effect (benefits and harms) is poorly defined for people with life-limiting illnesses. Aim The aim of this study was to examine the indications and the effects of RBC transfusion in palliative care patients. Design This international, multisite, prospective consecutive cohort study assessed target symptoms (fatigue, breathlessness, generalised weakness, or dizziness) prior to transfusion and at day 7 by treating clinicians, using National Cancer Institute Common Terminology Criteria for Adverse Events. Assessment of harms was made at day 2. Setting/participants One-hundred and one transfusions with day 7 followup were collected. Median age was 72·0 (IQR 61·5-83·0) years, 58% male, and mean Australian-modified Karnofsky Performance Status of 48 (SD 17). Results A mean 2·1 (SD 0·6) units was transfused. The target symptom was fatigue (61%), breathlessness (16%), generalized weakness (12%), dizziness (6%) or other (5%). Forty-nine percent of transfusions improved the primary target symptom, and 78% of transfusions improved at least one of the target symptoms. Harms were infrequent and mild. An AKPS of 40-50% was associated with higher chances of symptomatic benefit in the target symptom, however no other predictors of response were identified. Conclusions In the largest prospective consecutive case series to date, clinicians generally reported benefit, with minimal harms. Ongoing work is required to define the optimal patient- and clinician-reported haematological and functional outcome measures to optimise the use of donor blood and minimise transfusion-associated risk

A study of the circulating myeloid progenitor cell in man / Luen Bik To

Thesis (M.D.) -- University of Adelaide, Dept. of Haematology, 198

Parent education: a case of a secondary school in Hong Kong

published_or_final_versionEducationMasterMaster of Educatio

A cohort study assessing the impact of small volume blood tubes on diagnostic test quality and iatrogenic blood loss in a cohort of adult haematology patients

to estimate the reduction in blood volume loss and diagnostic test quality associated with introduction of small volume blood tubes in a cohort of haematology inpatients compared to a historical comparator group.prospective cohort study.haematology unit of a tertiary referral hospital in Adelaide.haematology inpatients.small volume blood tubes were used in an intervention cohort admitted between 2012-2013 and compared to a control cohort admitted between 2009-2010 where standard volume tubes had been used.the diagnostic test quality, specimen integrity and total reduction in blood loss associated with small volume tubes were estimated.small volume tubes demonstrated acceptable collinearity on commonly assay haematological and biochemical parameters. Small volume tubes were associated with a 42% reduction in blood volume loss equating to 8.5ml per patient per day or 180ml of blood over a three-week admission. Small volume tubes were associated with a slight but significantly increased rate of fibrin contamination of EDTA samples (0.2 to 0.5% of specimens).small volume tubes are associated with a substantial reduction in total blood volume collected per day in haematology inpatients. They have similar diagnostic validity and sample integrity to that of standard volume containers