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Objective: Coronavirus disease(COVID-19) rapidly spread worldwide after its first report in December 2019, in China. This spread drastically reduced the number of blood donations, thereby creating a shortage at blood banks in the whole world. Turkish Red Crescent (TRC) is the only legal authority that organizes collection, production, storage and distribution of blood and blood products in Turkey. Only in case of emergency TRC gives permanent permission to hospitals; for collecting blood and producing its components through their own transfusion centers. This report describes how the COVID-19 impacted blood supplies of TRC and hospital demands in Turkey with an aim to improve the management of blood supply and demand during the COVID-19 and future pandemics. Method: A cross-sectional study was conducted within a period of nine months from November 1, 2019 to July 31, 2020. Data were retrospectively obtained from donor attendance and blood inventory records of TRC and included; 1) the number of donated units of apheresis platelet concentrates (APC) and blood to TRC, 2) the number of units of APC and erythrocyte suspensions (ES) supplied by the hospitals themselves, 3) the number of units of APC and ES supplied to hospitals by TRC (APCH and ESH). The periods before (first period) and after (third period) emergence of COVID-19 outbreak in Turkey were compared. Results: An increase of 52% in the number of APC donations, but a decrease of 22% in the number of blood donations (NBDs) were detected in the third period compared to the first one. Mean APCH values were 7081±550 and 5121±55 units in the first and third periods,respectively. The mean ESH values in the first, and third periods were 873±326, and 3694±3143 units. Conclusion: It is obvious that we have learnt many lessons from the COVID-19 pandemic, like how to face challenges in maintaining the balance between blood demand and blood supply. Utilizing media to encourage donors and implementation of Patient Blood Management on national and institutional levels may be some of the key components of a comprehensive strategy. The collaboration of Ministry of Health, TRC and hospitals was successful in securing a balance between blood supply and demand in Turkey, on which COVID-19 pandemic impacted significantly. [ABSTRACT FROM AUTHOR]

Background/aim: Cardiac surgery, especially in the presence of cardiopulmonary bypass (CPB), is associated with an inflammatory reaction that may promote microcirculatory alterations, in addition to the general impact on system hemodynamics. Anemia and transfusion make patients more susceptible to the deleterious effects of CPB. In this study, it was aimed to evaluate the effect of dilutional anemia, which is caused by CPB and can be treated with 1-2 units of red blood cell (RBC) transfusion, on global tissue oxygenation parameters in cardiac surgery patients. Materials and methods: This prospective observational study comprised 127 patients who had a relatively stable operation period without any major anesthetic or surgical complications (e.g., operation duration >5 h, bleeding or hemodilution requiring more than 1-2 units of RBCs, or unstable hemodynamics, requiring inotropic support of more than 5 µg/kg/min dopamine). Patients were observationally divided into two groups: minimally transfused (Group Tr) and nontransfused (Group NTr). Global tissue oxygenation parameters were evaluated after anesthesia induction (T1) and at the end of the operation (T3) and compared between the groups. Results: Group Tr consisted of patients who had significantly lower preoperative hemoglobin values than Group NTr patients. The dilutional anemia of all Group Tr patients could be corrected with 1 unit of RBCs. The lactate levels at T3, increment rates of lactate, and venoarterial carbon dioxide pressure difference (ΔpCO2) levels [(T3 - T1) : T1] in Group Tr were significantly higher than those in Group NTr. Conclusion: Dilutional anemia as a result of CPB mostly occurs in patients with borderline preoperative hemoglobin concentrations and its correction with RBC transfusion does not normalize the degree of microcirculatory and oxygenation problems, which the patients are already prone to because of the nature of CPB. Preventing dilutional anemia and transfusion, especially in patients with preoperative borderline hemoglobin levels, may therefore reduce the burden of impaired microcirculation-associated organ failure in on-pump cardiac surgery. [ABSTRACT FROM AUTHOR]

Awareness about complications of transfusions of blood and blood products, their effects on mortality and morbidity and cost burden has increased in recent years which created the need for a new approach to transfusion practice. This new approach, defined as "Patient Blood Management (PBM)" aims to transfuse the right blood product to the right patient at the right time. Alteration of transfusion habits according to this new approach is quite difficult as seen in changing many established, traditional medical practices. Although there have been an increasing number of publications about the aim, context and results of PBM, there is limited studies and experience about the efficient implementation of this practice. In this article, the reports and clinical experiences of countries like USA and Australia that widely and successfully use this PBM project are reviewed. [ABSTRACT FROM AUTHOR]