The operational impact of introducing cold stored platelets.
blood supply chain
cold stored platelets
simulation
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
26
06
2023
received:
18
04
2023
accepted:
18
08
2023
medline:
7
12
2023
pubmed:
11
10
2023
entrez:
11
10
2023
Statut:
ppublish
Résumé
Cold stored platelets (CSP) undergo physical changes that make them better at initiating a clot. While cold stored platelets are superior for reducing bleeding in actively bleeding patients, room temperature platelets (RTP) are better for increasing platelet count in patients requiring a prophylactic transfusion. However, whether the overhead required to maintain a dual platelet inventory of both RTP and CSP could be compensated by reduced platelet wastage resulting from the longer shelf life of CSP has not been determined. A simulation model of a regional blood supply was built, with focus on the operations of a case hospital. Two scenarios were considered: "No-CSP," in which the hospital issues only RTP, and "CSP," in which the hospital issues both RTP and CSP Within the CSP scenario, conditions were tested under which the hospital receives only RTP and converts some to cold stored platelets and a second strategy where the hospital receives CSP from the regional supplier in addition to converting RTP. A centralized supply of CSP is necessary since on-site conversion is limited by platelet age. Product shortages decrease with increased CSP inventory, but CSP wastage increases. It was also determined that, because relatively few RTP units can be converted on-site, RTP wastage is not significantly decreased with the introduction of CSP. Given the clinical benefits for treatment of trauma, CSP is a desirable addition to a blood formulary. However, it is unlikely that significant reductions in RTP wastage will occur because of the introduction of CSP.
Sections du résumé
BACKGROUND
BACKGROUND
Cold stored platelets (CSP) undergo physical changes that make them better at initiating a clot. While cold stored platelets are superior for reducing bleeding in actively bleeding patients, room temperature platelets (RTP) are better for increasing platelet count in patients requiring a prophylactic transfusion. However, whether the overhead required to maintain a dual platelet inventory of both RTP and CSP could be compensated by reduced platelet wastage resulting from the longer shelf life of CSP has not been determined.
STUDY DESIGN AND METHODS
METHODS
A simulation model of a regional blood supply was built, with focus on the operations of a case hospital. Two scenarios were considered: "No-CSP," in which the hospital issues only RTP, and "CSP," in which the hospital issues both RTP and CSP Within the CSP scenario, conditions were tested under which the hospital receives only RTP and converts some to cold stored platelets and a second strategy where the hospital receives CSP from the regional supplier in addition to converting RTP.
RESULTS
RESULTS
A centralized supply of CSP is necessary since on-site conversion is limited by platelet age. Product shortages decrease with increased CSP inventory, but CSP wastage increases. It was also determined that, because relatively few RTP units can be converted on-site, RTP wastage is not significantly decreased with the introduction of CSP.
CONCLUSION
CONCLUSIONS
Given the clinical benefits for treatment of trauma, CSP is a desirable addition to a blood formulary. However, it is unlikely that significant reductions in RTP wastage will occur because of the introduction of CSP.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2248-2255Subventions
Organisme : Canadian Blood Services Operating Grant
Organisme : Natural Sciences and Engineering Research Council of Canada
ID : RGPIN/03232-2022
Informations de copyright
© 2023 The Authors. Transfusion published by Wiley Periodicals LLC on behalf of AABB.
Références
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