Hospitals around the country launch major research to determine shelf life
Article Source: msnbc.com
from:msnbc.comIs fresher blood better for surgery? Tests aim to find out
Seeded on Mon Jul 26, 2010 4:55 PM EDT (msnbc.com)
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This is a great research question. The results of these studies may improve the practice of medicine and the human condition. Money well spent by the NIH.
Of course it it...you right!!
Ahh, like the old blood...it's bettah for ya...ya know, like religion! Just gimme that old time religion..yeee-haaah!!
of course fresh blood is better than stored blood. even in food you'll tell the difference. we know that substances has what we called a shelf life. the longer it was stored the sooner it degrades ;-)
What you are saying is true. Blood is certainly not fine wine that gets better with age. However, establishing that "fresher" blood significantly improves outcomes will provide the basis for future research. For example, investigators will be interested in determining what they must put into (or take out of) fresh blood to give it a longer shelf-life, as donations are generally in short supply relative to need.
This news is somewhat old to the medical field. One solution is to encourage all those who qualify to donate blood. Self-directed pre-op blood donation often is impractical or not medically appropriate.
While fresh blood may provide better health outcomes, it seems that the studies neglect how this would affect trauma centers, which depend on blood with the 42-day expiration. Changing the expiration to 2 weeks would significantly reduce the inventory. People can suggest conserving blood and transfusing less. However, when trauma patients potentially use 50-90 units while in the operating room, and more during recovery, conservation is not much of an option. Also, donors can only give once every 56 days, so the replacement is slower than consumption or disposal.
Any facility that has had this experience needs to do two things stat: 1) Educate themselves about blood recovery methods, and 2) Find a surgeon that doesn't use a chain saw. The first step to any successful trama surgery is to stabilize the patient. That means stopping or at least minimizing the blood loss. Any surgeon who's patient requires 50-90 units of blood during surgery of any kind is a hack that needs to be removed by the medical board.
I give blood as a part of my care for patients in surgery and I understand the need and the consequences of blood transfusions all too well. Transfusions can be reduced in most surgeries by a coordinated plan involving all of the medical specialists that come into contact with the patient, to preserve the patient's own blood, limit dilution by administered fluids and decrease bleeding and blood loss. There has to be education on the part of medical specialists and with the patients we serve to know that there are transfusion alternatives and methods to reduce the factors that lead to transfusions. There are numerous web sites devoted to the practices of blood management that help everyone know and understand the alternatives to transfusion and the methods to reduce the factors that lead to a transfusion. Here are a few to get you started: www.sabm.org, www.nataonline.com/, www.mybloodfirst.com, www.noblood.org
More and more the medical community is realizing that blood transfusions are often unnecessarily used in hospitals. To say that one in 7 hospital patients 'require' a blood transfusion is misleading at best. Most of these patients would recover just fine, sometimes even faster, without their body having to deal with rejecting a foreign substance that has been transfused into them. Study after study has shown this to be true. Hospitals that have policies limiting the use of blood are the ones with better outcomes for patients.
Why cant these overpaid doctors and nurses be made to donate blood to patients. The government should make it a part of the Hippocratic oath to donate blood in an emergency. These people are readily available and healthy. They should realize their duty to serve their patients.
What!? It's not enough physicians go to school for 12+ years to assist complete strangers in one of the most pivotal moments in their life, but now you want to legislate and REQUIRE me to give my own blood? Who the hell do you think you are?
Clearly Perry, their blood is too good for you and the rest of the underpaid and underprivileged population who are subjected to their haughty, good-blood-hoarding snobbery. You don't mix a Barolo with White Zin, that's all I'm saying.....
I was one of those over-paid nurses about whom you are ranting, and I have only one question; Are you on some kind of drug!? Many times patients are given the option to donate their own blood during the weeks leading up to their surgery or procedure, and that is to help lower the risk of complications. Your suggestion is ridiculous, and you are assuming we are healthy and that our blood is readily available. Ha! Nurses and doctors are the second and third highest in likelihood to use drugs and alcohol. Policemen are the highest, so you might want their blood instead of ours, as it would be a cheap, quick high. Get a grip, fool!
I don't believe anyone can REQUIRE me to give my own blood! I believe nurses and doctors deserve the amount of money they are paid...how much would you pay to have YOUR life saved??
Overpaid doctors and nurses??? You have no idea what you are talking about. I do not see people that complain such as yourself, going to school for 19+ years to in preparation for a profession, having 100000+ in student loans, and working 36+ hour shifts, to save people that are ungrateful, ignorant, and litigious. Nurses are the workers in healthcare, yet they make about 60000+ a year to deal with people like you. My auto mechanic who smoked dope in high school, did not go to junior college, and got his girlfriend pregnant on the government dime, is allowed to make 55/hr, and work 8/hr days. Get your facts straight.
I am highly offended by your post. I am an OR nurse, and I work at a level II trauma center. I have been helping save lives for 10+ years now. I would love to donate blood- but I have one of the LEAST used blood types- my blood type is only found in 4% of the population, and our blood bank never has had a shortage on my blood type. And by the way, I am not overpaid- if anything, I am underpaid! I do not pass judgement on anyone who needs my help, ever. I see critically injured people who need to be rushed to the OR on a daily basis, mostly from motor vehicle accidents- and sometimes WE WORK ALL NIGHT. I have had several days where I have been up for 24 hours straight, just to help save the life of a complete stanger to me- because that person has a family who loves them, just as I love my family. Do not pass judgement on the health care workers who may help save your life someday. Consider yourself lucky to live in a country where educated and skilled individuals care enough to help complete strangers. So don't start shooting your mouth off about something you know nothing about. I chose my career path, and you are free to chose yours.
I wouldn't donate 1cc to save your sorry life. And you're even more of a jackass to think that just because someone works in healthcare that they are healthy. And we nurses are UNDERPAID. We get a base rate. We work a minimum of 40 regular hours a week and have to take call on top of that. We have to work double shifts, nights and weekends when someone calls in sick. We are asked to work late, and pick up the other nurses call/shifts when they quit. And while you're at home with your friends/family on weekends and holidays, we're at the hospital waiting to take care of your sorry ass for doing something stupid. Do you even have insurance? As far as I'm concerned, $65k isn't enough to deal with ungrateful people like yourself. Now, go and donate some blood.
JVAVNVAV and ORRN...you go, ladies, you rock! Thank you, thank you, thank you! Just home from my 51st surgical procedure in the last 7 years, and all I have to say is God bless my doctors and my nurses...they are the best, and I wouldn't be here without them. And you are right, you have an incredibly difficult job, and, in truth, most all of you are amazing. People are people, and there are the good and not so good in every group. And then there are those who expose their ignorance every time they open their post. Ignore them, and keep doing what you do...those of us lucky enough to have someone like you there to care for us when we need you most appreciate you and the care you give to us...and NOT because you have to, but because you choose to. Kudos and blessings to you all!
Perry is and idiot. He needs a brain transplant. Hope you have to wait one day on some overworked,underpaid medical personel who has been exposed to Hepatitis B or C or HIV to donate blood in their spare time you egocentric lump of carbon based junk. You are the reason people bleed to death. You want someone else to give while you do nothing but take.
You sir, are an ignorant moron. Not just ignorant. Not just a moron, but both.
I was a RN for 25 years, I started at $7.31/hr in 1982. By the time I quit disabled (cardiac, lung disease, home oxygen 24 hours-a-day), I was making slightly over $25.00/hr in 2006.
Overpaid my ass. You are a pompous ignoramus.
I busted my tail taking care of people just like you, catering to your whims, listening to you bellyache and whine, never complaining, always smiling back.
And you think that I ought to have been MADE to donate my OWN blood?
First of all, you lunatic, I am A+. People are A+, A-, AB+, AB- B+, B-, O+, or O-. So my blood would only be good for a select group, as anyone's is.
Furthermore, there's a whole slew of things they test for beyond blood type, to try to minimize reaction.
Why the hell should I be busting my tail 12-hour shifts to take care of and save jerks like you only to be forced to donate my blood for you?
You are either drunk, on drugs, or very stupid. In either case, I wouldn't want your Karma for anything.
I donate 6 units of blood per year. I am a primary care physician. I struggle to make 6 figures before taxes. I pay $32K/yr malpractice insurance despite having no prior lawsuit. I am not paid for the hours of on-call duty after hours - nights and weekends.
Besides, it takes a few days to process donated blood, test to make sure it is free of infection (e.g. HIV, hepatitis B & C, West Nile virus, etc.), before it is available to transfuse. So, in an emergency, it is not like we'll hook up an IV from the donor to the patient.
And nurses are underpaid and underappreciated, hence the nationwide shortage of nurses.
Perry, with all due respect, your comments are idiotic.
In a trauma setting, when several units are needed, some units are bled out simultaneously. Blood provides need Rbc's to carry oxygen at the moment of low H&H or during a surgery. While for infants tranfusions using fresh blood up to seven days is preferred sometimes there isn't a choice. To even suggest that fresher blood is better suggests all exisiting research by those in the business to make blood product preservative missed something. Is this just a sales ploy for patients to ask for fresh blood only? The average cost of a unit of blood is about $200 will it now cost more for the freshest blood.
I can't believe money is still being wasted on a study like this. Progressive hospitals and the most skilled surgeons know that there are many blood transfusion-alternative strategies. Use of whole blood is not necessary for surgery. Use of blood in surgery is most often because the surgeon and the surgical staff fails to a) minimize blood loss b) conserve red blood cells c) stimulate blood production and d) recover lost blood during surgery. It is also because the hospital refuses to acquire equipment and training health care staff to use a) hemodilution b) cell salvage. If your hospital is still decades behind these medical procedures... studying the shelf life of whole blood for surgical use, you need to find a more progressive hospital before letting them perform surgery. Even in trauma cases blood is mainly used to expand volume which can be done with non-blood substitutes that carry no risk of infection or complications associated with rejection.
So, we should not fund studies to assess the safety of blood transfusions? Please! The issues you discuss are mostly valid, yet independent of the need to understand the clinical sequelae of transfusing older blood.
Force health care workers to give their blood to patients? My choice of occupation should not require me to do any more in my job than to do my job. The idea of forcing someone to donate is bizarre. I do not expect the workers of an oil company to "donate" gas for my car. I do not expect the banker to "donate" his/her money to me. Nor do I expect anyone to force you to "donate" anything from your chosen profession. Additionally, one can donate blood once in any given period. Hospitals would have to hire more staff to have enough people to forcefully "donate" to keep up with the demand. Next you would have them force me to donate a kidney, lung, skin, and eyes. After I had done this and have run out of organs would I then be fired for not being able to keep up with the demands of my job?
Everyone knows that giving blood is not like giving a kidney. The body makes up the blood again. And it is not like a oil company worker being force to give free gas, coz gas costs money. You doctors make 10 times as much as the average americans and seem 10 times more selfish. You are granted your medical license to serve people. You are the readily available healthy persons in an emergency. The govenment can and should ask you to step up to your duty. Just like it can force a draft for the army.
Even if you forced all hospital staff to give blood you are only supposed to give every 56 days to be safe. Plus, you would not want the staff to feel faint because they gave blood during an emergency.
I would favor freezing more blood to extend the shelf life.
The blood supply comes from VOLUNTEER DONORS. Not from anyone forced to donate.
This has been studied intensively for years. Blood bankers have had incentives to maintain and extend the viability of RBC's for years. Blood banking is one of the most highly standardized and regulated fields you will ever find. Current standards are not adopted without stringent research.
So, does that mean fresher blood isn't "better?" No. It just means that IF more research shows a STATISTICAL difference in patient outcome by using fresher blood, the CLINICAL significance will likely be minimal if at all. It might be there, but the incremental difference will likely be practically nil. And although it's always tough to pit cost against human suffering, the truth is, that you CAN create slightly better outcomes at a tremendously higher cost. But, really, it's not worth it. Clinically, barely detectable improvement, if at all, by doubling the cost.
Don't be misled, we're not talking life vs. death over an already thoroughly research shelf-life issue.
Why don't more blood banks freeze blood to make it last longer? It might cost more but it would help with shortages. I know they freeze rare blood types maybe it can be done with the common kinds. Also aren't there methods, such as used on Jehovah's witnesses, where the blood can be recovered back into the patient during surgery?
I can see a lot of blood being used at once in a trauma case but 50-90 units on one person? How can that happen? A person has maybe 6-7 units in them.
Oh, and by the way, health care professionals already give their own blood. I worked in a medical records department once and have donated in several blood drives. I would feel faint afterward, so I got out of working the rest of the day as my bonus for giving.
Sometimes patients bleed out as fast or faster than we can pump it in....
What i still dont understand is: There ARE blood substitutes that are used all over the world. Why, why, why, do american doctors/hospitals still act as vampires to justify unnecessary surgeries????? Donating your own blood is the only good answer of late.
I am a Nurse and I have worked for the American Red Cross. My daughter has Truncus Arteriosus and has had 3 repairs over her 15 years of life. I requested to have directed donor blood and my daughter was fortunate enough to have 'fresh' blood for all 3 surgeries. I selected my donors and it only took 10 days to process. It takes that long to get pre-approval from insurance companies and make arrangments needed. Fresh direct donor blood was the best for her.Thanks to all the organ and tissue donors. Lives are saved and quality of life is improved from all things donated.
Over paid Doctors what is he takling about in his on words 19 years of school and he thinks it should be free. Just wate till Obama care kicks in you want have to think about price it will cost so much you cant have it or there want be a High priced Doctor to find because thay want be any
These articles are not helpful. People get these ideas in their head that they *deserve* fresh blood.
The simple fact of the matter is that there is not enough blood available to give everyone "fresh" blood. I work in a hospital blood bank. There are times when there is not enough blood and we have to notify doctors that they can not have the blood they want. Sometimes elective surgeries have to be canceled or postponed. Drs do not ask what how the blood supply is when they schedule surgery. They assume that it will always be available if needed.
If/when people start caring about the blood they get when they need it, they need to start thinking about providing the blood through family transfusions.
Until everyone who is eligible gives blood every time they can, people should be glad to have blood available to save their lives!
I read this article once in an American Red Cross journal. In Africa, where sickle cell anemia is much more common and thus the blood demand is greater and the supply is less (because of HIV, malaria and sickle cell) there was this little girl who died waiting for blood. They also do not discharge people from the hospital when they have gotten blood without replacement from the family/friends. This little girl had a hemoglobin of about 3. In this country, we have enough blood available that doctors transfuse at about 8 (sometimes higher). See the difference there? And our blood supply is much much greater. But, of most types other than "O", part of this supply is due to blood that has been stored a bit. Sometimes, we give out blood that expires the same day.
People are often too quick to point out associations. People who die after surgery have other factors. How many of these people are ones that have taken Plavix? Plavix makes your platelets not work at all-for days! They bleed! How many of these deaths have diabetes or other things that affect their rate of survival?
The hospital I work does heart surgeries. Most of these surgeries require no blood at all! The ones that do, are emergency surgeries and often have taken Plavix. See the difference?
If you get the idea that you need fresh blood, make sure everyone you know is giving blood whenever they are able! Then you can direct how the blood supply is used!
Blood bank worker. Thanks for the facts. But I still have concerns as my post indicates. Thank you for taking the time to set it all straight.
This is one of those idiotic web "discussions" that's just TOO 'good' to pass up so here goes...
1) I'm no expert, but the article doesn't seem to specify any particular type of blood product and as I understand things, just because hospitals and surgeons shouldn't NEED a "whole lot" of blood per particular procedure doesn't mean that they don't type/cross/pull it "just in case" (which means it goes down the toilet after it's not used anyway)
2) I'll tell ya what perry...when you come in after a car accident we'll poll the trauma staff to type and cross everyone who matches YOUR blood type (minus anyone with positive needle stick exposure within the past 12 months, on medication, etc. of course - because we CARE). And because you'll likely need 8+ units we'll just tape 2 from 4 us - don't worry, I know it LOOKS like the guy wearing a mask seems like he's falling down, but trust us - it's the happy gas...just go to sleep.
Oh, wait - we won't take it from the surgery team - instead, we'll take the blood from the staff manning the floor in ICU, the ER, SICU, PICU, or maybe from OB/GYN where someone you know is about to have a baby - it'll be MUCH safer if their doctor/nurse collapses from lack of blood of course!
How dumb can YOU be?!?!? lol
When blood is type/screened and placed on hold for possible transfusion it is not then "down the toilet" if not used. It is simply returned to stock. It is only placed on hold because it takes 45min to 1 hour to perform a full crossmatch procedure and you don't want a patient that is bleeding to wait that long for their blood product. Also for those who want the blood to be frozen--red blood cells are very fragile and freezing causes them to rupture and then are of no use, the plasma and cryoprecipitate are frozen. Dr's often over use blood and should treat symptomatic patients with transfusion and simply give non-symptomatic patients that have a hemoglobin over 8 some iron and let their body do it's job. when a patient dies after having a transfusion it's not usually about the age of the red cells but what they were having the surgery for in the first place or what their injuries were. Healthy people are not transfused with blood so they need to look further into what really caused the death. As for the aggregates that can develop in the older units of blood--that's why they use a filter when infusing the unit. Most of the time a patient that dies would have died even if they hadn't received a transfusion.
I would just settle for blood that doesn't have HIV, Hep c, harmful drugs, or something else wrong with it. It's a risk every day that some untested "unknown" is in the blood the "good citizens" give. Much of the plasma is paid for and the folks who sell it are not exactly at the top of society. Although it's important stuff, I don't think anyone knows the full risk. It's too expensive to do all the work needed to examine every drop. Thank goodness I have family members who would line up in case I needed blood. I honestly shutter to think about what would happen if that option wasn't available. If they can make blood products safer, that would be good. I hate it when they said "The surgery was successful, the patient died." It happened to my Aunt.
"It's a risk every day that some untested "unknown" is in the blood the "good citizens" give. Much of the plasma is paid for and the folks who sell it are not exactly at the top of society."
The plasma that the "good citizens" get paid to donate is not given to people. It is against the FDA to sell body parts. The plasma that people get paid for goes to research.
I donate O- blood 6 times a year, like clockwork, to the American Red Cross. At my last whole-blood donation, I asked about donating my plasma. The phlebotomist filled out some extra papers and was able to get enough blood to test and send out to see if I was eliglble to donate plasma. I was called the following week and was told I was and scheduled an appointment. I gave plasma this week. After I was finished, I asked if it was going to go straight to a patient. I was told no, that it was going to be tested again.
Just because your family is willing to donate blood or plasma, doesn't mean that they will carry your type or even be eligible. There are a ton of questions that the Red Cross asks before they will even think about putting a donor in the chair. Has the donor had any piercings or tattoos in the last year? Has the donor ever traveled outside of the United States? Has the donor had sexual relations with a male that has had relations with another male? Etc. I would say that as long as people answer pre-donation questions honestly, that yes the Red Cross DOES know that the blood is deemed to be safe.
If you're going to share your thoughts with the world, it would help to know what you're talking about first.
I'm sorry about your aunt, but there must have been additional unknown factors that contributed to her passing.
Never mind all this" fresh" and "stale" blood talk! There are no guarantees! Jehovah's Witnesses have been proponents of bloodless surgery for a long time and have been immensely successful! It should behoove everyone out there considering surgery, where blood seems to be a requirement, to at least investigate "an educated alternative"!
Perry. Wow. You have reaffirmed my hunch that the world really is full of stupid people. Why does everyone cry that doctors are overpaid. We should be. How much value do you put on your life and health? People have no problem shelling out 20k for a car or 5k for a nice vacation, but god-forbid I charge a few hundred bucks to put your ankle back together. It costs more to put tires on that car then what I get paid for fixing your wheel. I am "overpaid" (in your reality) because of the value of my work, the time, effort and money it took me to become efficient at it. So stop it. Believe it or not, most in healthcare got into this job because it feels good to help people. Oh, by the way, most hospitals have blood drives and many healthcare providers donate yearly. You are the ignorant one, dear socialist.
This is not new information. Studies have shown that blood transfusions are not innocuous. A patient undergoing open heart surgery and receiving just one unit of blood has a lower probability of good outcome over 5 years than a patient that didn't receive any blood. Many of the issues related to blood do not have any association with its age. It is true that when it is needed it can help save a life. But, as the story states, it comes at a risk and cost. It is safer to donate your own blood but even that is not absolutely safe.
1st of all I believe it is unconstitutional to require Medical staff to donate blood. This is one of the toughest, yet most rewarding carriers in existence, and the amount of dedication, stress, and physical fatigue we endure, stems from our love of science, medicine, and humanity. SELFISH??? we dedicate our live to you! .... Targeting medical staff??? why stop there?, why not ask every Citizen of our nation to donate blood by law?; after all a country is only as strong as each individual constituent. Your rantings are ignorant and immoral! Medical staff are at the front lines of infectious diseases, requiring medical staff to donate blood is literally stupid, .. You must understand that even if a test says your healthy, one can never be 100% sure, as tests have flawed sensitivity and specificity.... I respect your statement because you have freedom of speech. However, it is people like you (ignorant, close minded splitters), that are the ones truly hurting humanity and civilization by saying ignorant comments. Please keep your thoughts to yourself!!!!!
One last comment. I am a nurse. I have donated over 20 gallons of blood in my life. I am doing my part. As for pay. A heart surgeon typically gets paid only about $2,500 to $3,000 for doing a heart surgery to save someone's life. Let's see, at $2.50/pack and 3 packs of cigarettes a day, a cost of $225/months and $2,700/year a 3 pack/day smoker spends more on cigarettes in a year than the surgeon gets paid to save his life. Interesting math, don't you think?