In the first months of the Spanish Civil War, the Spanish doctor Frederic Duran Jordà developed a new method of blood transfusion which overcame the era of direct arm-to-arm transfusions. While Duran was experimenting in Barcelona and the Aragon front, hundreds of foreign doctors came to Spain with the help of internationalist associations and offered their services to the Republican government. The Czechoslovak Dr Karel Holubec entered Spain in May 1937 and practiced in a mobile hospital funded by the Czechoslovak Committee to Aid Democratic Spain, receiving blood from Duran's laboratory. This article aims to study how Duran and Holubec transferred the method of blood transfusion to Czechoslovakia through interpersonal contact, conferences, and performances. This paper argues that while individual actors played a crucial role in the diffusion of medical practices, this circulation was determined by a unique historical and socio-political framework. The Spanish Civil War, the International Brigades, and the invasion of Czechoslovakia by Nazi Germany were not only the historical context of medical innovation but an integral part of it.

• MeSH
• History, 20th Century MeSH
• Blood Transfusion * history   methods   MeSH
• Humans MeSH
• Check Tag
• History, 20th Century MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Historical Article MeSH
• Geographicals
• Czechoslovakia MeSH
• Spain MeSH

Cíl: Správné indikace podání transfuzních přípravků (TP) jsou klíčem k účelné a bezpečné hemoterapii. Cílem této práce bylo zhodnotit indikační kritéria podávání TP, porovnat změny v indikacích TP mezi dvěma obdobími a získat podklady pro zkvalitnění hemoterapie v Krajské nemocnici Liberec, a.s. (KNL). Materiál a metoda: Sledovaným souborem byly všechny TP (erytrocyty, trombocyty, plazma) aplikované v KNL v období od 1. 10. 2020 do 30. 9. 2021 a od 1. 8. 2022 do 31. 7. 2023. Z databáze laboratorního informačního systému byly k jednot- livým TP přiřazeny laboratorní výsledky příjemců TP: hemoglobin (Hb), počet trombocytů a protrombinový čas – poměr (PT-R). Výsledky byly přiřazeny, pokud byly vyšetřeny před výdejem TP do předchozího kalendářního dne, tj. do 48 hodin před výdejem TP. Výsledky: V období 2020/21 bylo 35 % erytrocytů deleukotizovaných (ED) vydáno pacientům s Hb > 80g/l, v období 2022/23 32 % ED. Porovnáním hodnot průměrného Hb nebyl zjištěn statisticky významný rozdíl mezi obdobími (p = 0,61), přístup k indikacím ED se nezměnil. V období 2020/2021 bylo pacientům s počtem trombocytů > 50 × 109/l vydáno 29 % TP trombocytů, v období 2022/2023 16 % TP trombocytů. TP trombocytů byly v období 2022/23 vydávány pacientům s nižším počtem trombocytů než v období 2020/21 (p < 0,001). Zda se jednalo o racionalizaci indikací nebo bylo odlišné složení pacientů, nelze posoudit. V období 2020/2021 bylo pacientům s hodnotou PT-R ≤ 1,5 vydáno 52 % klinické plazmy (P), v období 2022/2023 47 % P. Při porovnání hodnot průměrného PT-R nebyl nalezen statisticky významný rozdíl mezi hodnocenými obdobími (p = 0,45). Závěr: Přístup k indikacím TP erytrocytů stejně jako u klinické plazmy byl konzistentní. U TP plazmy byl v porovnání s lite - raturou uvážlivější přístup v případě hraničních indikací. U TP trombocytů došlo k racionalizaci indikací nebo bylo odlišné složení pacientů. Obecně TP byly indikovány racionálně. S výsledky studie budeme dále pracovat.

Aim: Correct indications of blood components (BC) are the key to effective and safe haemotherapy. The aim of this study was to evaluate the indication criteria of BC, to compare the changes in BC indications between two periods and to improve the quality of haemotherapy at the Regional Hospital Liberec, as (KNL). Materials and methods: The study population consisted of all BCs (erythrocytes, platelets, plasma) administered in the KNL in the period from 1 October 2020 to 30 September 2021 and from 1 August 2022 to 31 July 2023. From the database of the laboratory information system, the laboratory results of BC recipients were matched to each BC: haemoglobin (Hb), platelet count, and prothrombin time - ratio (PT-R). These results were matched if they were tested before the administration of the BC within the previous calendar day, i.e., within 48 hours before the issue of the BC. Results: In 2020/21, 35% of red blood cells, leucocyte-depleted in additive solution (ED) were administered to patients with Hb > 80 g/l, and in 2022/23, 32% of ED. Comparison of mean Hb values revealed no statistically significant difference between the periods (p = 0.61), and the approach to ED indications did not change. In 2020/2021, 29% of platelet BCs were administered to patients with platelet counts > 50 × 109/l, and in 2022/2023, 16% of platelet BCs. Platelet BCs were issued to patients with lower platelet counts in 2022/23 than in 2020/21 (p < 0.001). Whether this was a rationalization of indications or a different patient make-up, cannot be assessed. In 2020/2021, 52% of plasma, fresh frozen (P) was administered to patients with a PT-R ≤ 1.5, and in 2022/2023, 47% of P. When comparing mean PT-R values, there was no statistically significant difference between the evaluated periods (p = 0.45). Conclusion: The approach to erythrocyte and plasma BC indications was consistent. A more considered approach was taken for plasma BCs for borderline indications, when compared with the literature. For platelet BCs, indications were rationalized or patient make-up was different. In general, BCs were rationally indicated. We will continue to work with the results of the study.

• MeSH
• Plasma MeSH
• Blood Transfusion methods   MeSH
• Humans MeSH
• Blood Component Transfusion * methods   MeSH
• Erythrocyte Transfusion methods   MeSH
• Platelet Transfusion methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Clinical Study MeSH

Massive bleeding causes approximately 50% of deaths in patients with major trauma. Most patients die within 6 h of injury, which is preventable in at least 10% of cases. For these patients, early activation of the massive transfusion protocol (MTP) is a critical survival factor. With severe trauma, high-mobility group box 1 (HMGB-1, i.e., amphoterin) is released into the blood, and its levels correlate with the development of a systemic inflammatory response, traumatic coagulopathy, and fibrinolysis. Previous work has shown that higher levels of HMGB-1 are associated with a higher use of red blood cell transfusions. We conducted a retrospective analysis of previous prospective single-center study to assess the value of admission HMGB-1 levels in predicting activation of MTP in the emergency department. From July 11, 2019, to April 23, 2022, a total of 104 consecutive adult patients with severe trauma (injury severity score > 16) were enrolled. A blood sample was taken at admission, and HMGB-1 was measured. MTP activation in the emergency department was recorded in the study documentation. The total amount of blood products and fibrinogen administered to patients within 6 h of admission was monitored. Among those patients with massive bleeding requiring MTP activation, we found significantly higher levels of HMGB-1 compared to patients without MTP activation (median [interquartile range]: 84.3 μg/L [34.2-145.9] vs. 21.1 μg/L [15.7-30.4]; p < 0.001). HMGB-1 level showed good performance in predicting MTP activation, with an area under the receiver operating characteristic curve of 0.84 (95% CI 0.75-0.93) and a cut-off value of 30.55 μg/L. HMGB-1 levels correlated significantly with the number of red blood cell units (rs [95% CI] 0.46 [0.28-0.61]; p < 0.001), units of fresh frozen plasma (rs 0.46 [0.27-0.61]; p < 0.001), platelets (rs 0.48 [0.30-0.62]; p < 0.001), and fibrinogen (rs 0.48 [0.32-0.62]; p < 0.001) administered in the first 6 h after hospital admission. Admission HMGB-1 levels reliably predict severe bleeding requiring MTP activation in the emergency department and correlate with the amount of blood products and fibrinogen administered during the first 6 h of hemorrhagic shock resuscitation.Trial registration: NCT03986736. Registration date: June 4, 2019.

• MeSH
• Biomarkers blood   MeSH
• Adult MeSH
• Blood Transfusion * methods   MeSH
• Hemorrhage * blood   therapy   etiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Prospective Studies MeSH
• HMGB1 Protein * blood   MeSH
• Wounds and Injuries * blood   therapy   complications   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Injury Severity Score MeSH
• Emergency Service, Hospital MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Consensus Development Conferences as Topic * MeSH
• Blood Transfusion methods   MeSH
• Hemorrhage * therapy   MeSH
• Humans MeSH
• Interdisciplinary Communication MeSH
• Attitude MeSH
• Wounds and Injuries therapy   MeSH
• Check Tag
• Humans MeSH

• MeSH
• Anemia * MeSH
• Cytogenetic Analysis MeSH
• Clinical Trials as Topic MeSH
• Blood Transfusion methods   MeSH
• Humans MeSH
• Myelodysplastic Syndromes * diagnosis   drug therapy   genetics   classification   MeSH
• Prognosis MeSH
• Antineoplastic Agents * classification   MeSH
• Hematopoietic Stem Cell Transplantation MeSH
• Check Tag
• Humans MeSH
• Publication type
• Editorial MeSH

• MeSH
• Clinical Studies as Topic methods   MeSH
• Blood Transfusion * methods   MeSH
• Hemorrhage blood   therapy   MeSH
• Humans MeSH
• Organization and Administration standards   MeSH
• Wounds and Injuries * blood   therapy   MeSH
• Emergency Medical Services methods   MeSH
• Check Tag
• Humans MeSH

Život ohrožující krvácení je jedním z nejzávažnějších akutních stavů v medicíně. Tato situace vyžaduje multimodální terapii, jejíž nedílnou součástí je i podávání transfuzních přípravků a krevních derivátů, které bývá standardizováno pomocí doporučených postupů. Pro Českou republiku a Slovensko je v současnosti platný dokument „Diagnostika a léčba život ohrožujícího krvácení u dospělých pacientů v intenzivní a perioperační péči. Česko-slovenský mezioborový doporučený postup“ z roku 2017. V roce 2023 byl publikován update obou evropských doporučení, ze kterých zmíněný mezioborový postup majoritně vychází. Cílem této práce je identifikovat a představit změny v evropských doporučených postupech pro život ohrožující krvácení, které se objevily od roku 2017. Celkem jsou zahrnuty 4 texty, jejichž analýza je rozčleněna dle jednotlivých transfuzních přípravků a krevních derivátů. Samotný text práce nabízí kromě představení nových evropských doporučených postupů pro léčbu život ohrožujícího krvácení také jejich srovnání s česko-slovenským postupem z roku 2017.

Major bleeding is one of the most serious emergencies in medicine. This situation requires a complex therapeutic approach, including standardised administering transfusion products and blood derivatives. In the Czech Republic and Slovakia, the document “Diagnosis and Treatment of Life-Threatening Bleeding in Adult Patients in Intensive and Perioperative Care. Czech-Slovak Interdisciplinary Guideline” from 2017 remains valid. In 2023, an update of both European guidelines, from which the mentioned interdisciplinary procedure predominantly derives, was published. This work aims to identify and present changes in the European guidelines for severe bleeding since 2017. A total of 4 texts are included. Their analysis was divided according to individual transfusion products and blood derivatives. This work not only presents the new European guidelines for treating severe bleeding, but also compares these with the Czech-Slovak guideline from 2017.

• MeSH
• Antifibrinolytic Agents pharmacology   therapeutic use   MeSH
• Factor VIII pharmacology   therapeutic use   MeSH
• Fibrinogen pharmacology   therapeutic use   MeSH
• Plasma MeSH
• Blood Transfusion methods   MeSH
• Hemorrhage * therapy   MeSH
• Humans MeSH
• Prothrombin pharmacology   therapeutic use   MeSH
• Practice Guidelines as Topic MeSH
• Erythrocyte Transfusion methods   MeSH
• Platelet Transfusion methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Blood Group Antigens classification   MeSH
• Blood Donation MeSH
• Blood Preservation classification   methods   MeSH
• Plasma MeSH
• Blood Transfusion * methods   MeSH
• Humans MeSH
• Blood Specimen Collection MeSH
• Transfusion Reaction classification   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Management pacienta se závažným traumatickým krvácením zahrnuje postupy damage control resuscitation, jejichž součástí je kromě chirurgického řešení krvácení aplikace masivního transfuzního protokolu. Cílem tohoto sdělení je představit masivní transfuzní protokol a vybrané skórovací systémy pro včasnou detekci závažně krvácejících pacientů. Využití standardizovaného protokolu aktivace masivního transfuzního protokolu vede ke snížení letality na vykrvácení a spotřeby transfuzních přípravků v traumacentrech.

The management of severe traumatic bleeding includes damage control resuscitation procedures including, in addition to surgical bleeding control, the application of the massive transfusion protocol. The aim of this paper is to present the massive transfusion protocol and selected scoring systems for an early detection of patients with severe post-traumatic bleeding. The use of a standardized protocol to activate the massive transfusion protocol reduces lethality due to severe traumatic bleeding and the consumption of blood products in trauma centers.

• Keywords
• masivní transfuzní protokol,
• MeSH
• Blood Transfusion * methods   MeSH
• Hemorrhage etiology   therapy   MeSH
• Humans MeSH
• Resuscitation methods   MeSH
• Trauma Centers MeSH
• Check Tag
• Humans MeSH

• MeSH
• ABO Blood-Group System MeSH
• Blood Group Antigens classification   MeSH
• Blood Transfusion, Autologous classification   MeSH
• Blood Preservation MeSH
• Blood Transfusion * methods   MeSH
• Humans MeSH
• Blood Group Incompatibility MeSH
• Transfusion Reaction classification   pathology   therapy   MeSH
• Blood Component Removal MeSH
• Transfusion Medicine * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH