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Local newspaper publishes damning report against blood transfusion


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I work in Fredericksburg VA in the Blood Bank. A local newspaper published an article this past Sunday (link included). The staff here were flabbergasted about some of the sweeping statements and are nervous about an influx of patients demanding blood attributes that could compromise our inventory. We have a very, very few patients who request "the freshest blood" we have, but if we get a lot of requests and have to accommodate them we could really find ourselves with a lot of wastage. Frankly, I have concerns that this article is ethically unsound. 

 

We did share this with our pathologist who "<sarcasm> loved it </sarcasm>" just to give him a heads up in case any issues arise from this. 

If anyone would read this and share their thoughts on the content and some techniques for dealing with potential fallout (this newspaper is pretty influential in the area as it was created and ran by a highly regarded family and has been around for generations and is the only local paper of the area), myself and my coworkers would appreciate it. Thanks in advance!

 

http://www.freelancestar.com/2014-03-30/articles/32482/column-dont-assume-this-procedure-is-safe/

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Wow, I am shocked!  First of all, it is an Intern who wrote that....why would any reputable newspaper take such strong (and misleading) statements from an Intern?!  There really needs to be a reputable Physician who can respond to that...in that newspaper.  I think that was incredibly irresponsible on the part of both the Intern; and the newspaper.  His comments are made as "statements" as if there is no further explanation or elaboration needed.

I hope you can get the support you need.

 

Brenda Hutson

 

I work in Fredericksburg VA in the Blood Bank. A local newspaper published an article this past Sunday (link included). The staff here were flabbergasted about some of the sweeping statements and are nervous about an influx of patients demanding blood attributes that could compromise our inventory. We have a very, very few patients who request "the freshest blood" we have, but if we get a lot of requests and have to accommodate them we could really find ourselves with a lot of wastage. Frankly, I have concerns that this article is ethically unsound. 

 

We did share this with our pathologist who "<sarcasm> loved it </sarcasm>" just to give him a heads up in case any issues arise from this. 

If anyone would read this and share their thoughts on the content and some techniques for dealing with potential fallout (this newspaper is pretty influential in the area as it was created and ran by a highly regarded family and has been around for generations and is the only local paper of the area), myself and my coworkers would appreciate it. Thanks in advance!

 

http://www.freelancestar.com/2014-03-30/articles/32482/column-dont-assume-this-procedure-is-safe/

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Interesting!!!  As expected the article emphasized the "possible" negative side of transfusions.  The presentation of the information was decidedly negative as opposed to informative.  As with all medical procedures, we all know that transfusion is not without risk.  My best suggestion would be to arm yourself with as much accurate information as possible.  Be able to tell those who ask what the risks are to the best of the knowledge available. 

I personally remember in the early '80s stating that HIV is not transmitted via blood transfusion, that was the best info I had at the time.  Later we were able to actually quantify the risk of HIV as well as Hep B and Hep C.   

 

You might also be able to put together a "fact sheet" if one does not already exist some where which lists the possible risks of transfusion and the likely hood of each occurring. Accurate info, or at least as accurate as is available is your only real response to something like this. 

 

Good luck and let us know how it turns out.  :disbelief:

Edited by John C. Staley
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NOTE:  The author is an internist (not an intern.)  I wonder if he always believes everything that he hears in every lecture he attends, particularly in a situation like this where there is no evidence that the lector has any advanced training or credentials in Transfusion Medicine.

 

As John pointed out, a transfusion is not without risk, and I do think that not all transfusions are warranted.  However, I would greatly appreciate it if the author would provide the reference(s) for the "research studies" that arrived at the conclusion that "blood transfusions do not improve oxygen delivery to the body at all."  I would be very interested in seeing the design of the study and the data it yielded.

 

(I'm also a little "miffed".....how come my "profit margin" doesn't go up if we issue more units from our Transfusion Service???)

 

I'm sorry, Amber, that I haven't really given you any techniques to deal with the "fallout" that you may experience other than to do as John recommended and be able to cite statistics and references from reputable researches.

 

Donna

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Actually, except for the dumb comment about our profit margin (there is none, but it's quite the opposite), most of what he said was accurate.  His delivery of the facts could have been better stated and less inflammatory.  But this is what we are seeing when we do Patient Blood Management.  Less patients transfused, but they have better outcomes.

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Its funny that the author mentions the fact that the blood supply system is a billion dollar industry in the US, -- he does not point out that almost all of it is not-for-profit.  (i wonder if the author and the expert lecturer he refers to are not for profit?)

 

This is the internet - a blog no less.  ALL of the information there is going to be inflammatory and filled with half-truths and distortions.  That's what the internet is for, isn't it? 

 

Bloggers exist because we like to read about adversity.  Who wants to read about how safe the blood supply is?  Asking for some kind of response for a counter-argument form "the other side" would only validate the authority of the blogger.  Its undignified.  Try to forget about it.

 

If a patient asks about any "controversy" generated by this article, ask him who they trust with thier health - thier own doctor or some blogger?

 

Scott

Edited by SMILLER
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Times are changing.  I totally agree with Dr. Blumberg on this one.

 

Just published today:

 

https://jama.jamanetwork.com/article.aspx?articleid=1853162

 

From an editorial about the article:

The bottom line, according to co-author Neil Blumberg, MD, of the University of Rochester Medical Center in Rochester, N.Y., is that "transfusions have many more risks than we have realized previously."

The prevailing view, he told MedPage Today, has been that transfusion can't hurt and might help.

"In fact, the reverse is true," he said. "Most transfusions as we now give them may well do harm, and probably aren't doing any good."

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I am surprised to see nothing mentioned of heart strain and blood pressure, not to mention litigation for not transfusing. When speaking with RN's they often mention how the patient's blood pressure is improving with transfusion.

 

Blood pressure improves with the infusion of any fluid.  Blood products should not be given just for low blood pressure.

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Blood pressure improves with the infusion of any fluid.  Blood products should not be given just for low blood pressure.

That's true, but there is supposedly less strain on the heart with improved oxygen transport and consequently an improved blood pressure with transfusion of packed red cells. This seems to be the general logic. And frankly, after reading through this article again there is no references offered and only name dropping as evidence.

Edited by rravkin@aol.com
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Ha...that's what I get for reading too quickly (being too upset at what I was reading).  :angry: Thanks for the correction.

Brenda

 

NOTE:  The author is an internist (not an intern.)  I wonder if he always believes everything that he hears in every lecture he attends, particularly in a situation like this where there is no evidence that the lector has any advanced training or credentials in Transfusion Medicine.

 

As John pointed out, a transfusion is not without risk, and I do think that not all transfusions are warranted.  However, I would greatly appreciate it if the author would provide the reference(s) for the "research studies" that arrived at the conclusion that "blood transfusions do not improve oxygen delivery to the body at all."  I would be very interested in seeing the design of the study and the data it yielded.

 

(I'm also a little "miffed".....how come my "profit margin" doesn't go up if we issue more units from our Transfusion Service???)

 

I'm sorry, Amber, that I haven't really given you any techniques to deal with the "fallout" that you may experience other than to do as John recommended and be able to cite statistics and references from reputable researches.

 

Donna

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Yes, times are changing and a "side" to what he says is true.  However, the way in which he has written this will serve (I believe) only to alarm the public into thinking they should not get a transfusion and that it would be a bad thing; period.  That could have detrimental results for some.  It was a very one-sided review (and strong at that); perhaps best left for a discussion at a Blood Bank Meeting than a statement to the layperson.

Brenda

 

Times are changing.  I totally agree with Dr. Blumberg on this one.

 

Just published today:

 

https://jama.jamanetwork.com/article.aspx?articleid=1853162

 

From an editorial about the article:

The bottom line, according to co-author Neil Blumberg, MD, of the University of Rochester Medical Center in Rochester, N.Y., is that "transfusions have many more risks than we have realized previously."

The prevailing view, he told MedPage Today, has been that transfusion can't hurt and might help.

"In fact, the reverse is true," he said. "Most transfusions as we now give them may well do harm, and probably aren't doing any good."

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Have you tried contacting your own hospital's Risk Management Dept for help - they can usually help with risk figures for a "fact" scheet.  Also, your hospital's Public Relations officer (if you have something like that), could be approached to put together a reasoned and measured response to the article that the paper would probably be willing to print in the interest of full disclosure.  Make sure your facts are correct and verifiable - they may be challenged.  Good data can come from UBS, ARC and other distribution networks.

 

And yeah - it takes a multi-million dollar industry to keep blood on the shelves that almost no insurance company or the government are fully reimbursing!  Profit margin indeed!

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  • 2 weeks later...
  • 3 weeks later...

Don't you wish that the public could understand that almost all issues are nuanced and can't be reduced to some neanderthal idea like "blood bad", "no blood good.."  Kind of like the current "gluten free" craze.  It's not that simple folks!  Risk benefit ratios; individual circumstances etc. etc.

 

Nope, mabel adams bad. :lol:

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  • 4 weeks later...

Actually, except for the dumb comment about our profit margin (there is none, but it's quite the opposite), most of what he said was accurate.  His delivery of the facts could have been better stated and less inflammatory.  But this is what we are seeing when we do Patient Blood Management.  Less patients transfused, but they have better outcomes.

 

Most?  I have never seen any article claiming that blood transfusion was linked to autoimmune diseases.  And if transfused stem cells were causing those symptoms by definition it is not an "auto" immune disease.

 

This article contains some truth but what is there is put in the most alarmist and misleading way.  It seems calculated to gain himself notoriety at the expense of others inluding the medical community and patients as well.

 

Sadly, this is not the first newspaper article slamming the blood industry with falsehoods and misrepresentations, and it is unlikely to be the last.

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Blood pressure improves with the infusion of any fluid.  Blood products should not be given just for low blood pressure.

Blood pressure increases with the infusion of fluid.  That is not necessarily an improvement especially in patients with CHF.  Infusing cells can also increase blood viscosity which is not always beneficial either.  But no, one does not transfuse in order to rescussitate a patient's BP.

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The Doctor has some great point. It is common sense that when you are receiving a blood product that is not yours to being with, there will be a consequence. I do not agree with the statement “in Third World countries where blood transfusions are not available" this is totally wrong.

 

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