Blood & Marrow Stem Cell Transplant

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cryo-preserved re infusion vital sign monitoring

  • 1.  cryo-preserved re infusion vital sign monitoring

    Posted 06-13-2019 11:28
    Hi,

    We are currently doing vital signs q15 minutes during and for 2 hours post our cryo-preserved re infusions, We would like to decrease this to one hour post or decrease the frequency to 30 minutes for the 2 hours following.
    I would like to know what other adult centers are doing. The FACT standard states at least one hour.

    Also - is any one seeing delayed DMSO reactions? We are sing infusion reactions during or immediately after completion but not 1-2 hours later.

    Thank you for your help.




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    Rebecca St.Jean
    Leukemia/BMT program of BC
    RN BSN CON(c) BMTCN CNE
    rebecca.stjean@vch.ca
    604-875-4111 loc 61885
    Vancouver, BC, Canada
    ------------------------------


  • 2.  RE: cryo-preserved re infusion vital sign monitoring

    Posted 07-10-2019 13:21
    ​Hello Rebecca,

    We do vitals 5 mins into infusion, every 15 minutes, end of infusion and 1 hr post infusion for cryopreserved cells. FACT does mention the 1hr post infusion and states that you may want it to be more frequent than typical blood transfusion vitals. We like to know that the patient is tolerating the DMSO and will adjust the rate at the 5 min mark depending on how they are tolerating the infusion. For fresh cells, we do q15 for the first hour, hourly, end of infusion, 1 hr post.

    Hope that helps!
    Thanks!
    Brianne Cohen, MSN, RN, BMTCN
    VCU Health
    Richmond, VA

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    Brianne Cohen, BSN, RN, BMTCN
    Clinical Coordinator
    VCU Health
    Richmond, VA
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  • 3.  RE: cryo-preserved re infusion vital sign monitoring

    Posted 07-10-2019 17:20
    Hi there,

    We do vitals pre and post each auto bag (which infuse no slower than over 20 minutes) and then q30 minutes for 4 hours after last bag.

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    Lenise Taylor
    Seattle Cancer Care Alliance/Univeristy or Washington/ Fred Hutch
    Clinical Nurse Specialist
    Seattle Cancer Care Alliance
    Maple Valley WA
    [Phone
    Ltaylor@seattlecca.orgSeattle Cancer Care Alliance
    ------------------------------



  • 4.  RE: cryo-preserved re infusion vital sign monitoring

    Posted 07-11-2019 09:20

    Lenise, why the 4 hour observation after auto infusion?  Do you have reference to that amount of time that you could share?  In the responses thus far the observation is anywhere from 1 hour to your 4.  That's quite a range. 

    Thanks,

    Joy

    Joy Lombardi, BSN, RN, OCN

    Nursing Director

    Huntsman Outpatient Infusion

    Huntsman Cancer Institute

    801-585-9822

    Joy.lombardi@hci.utah.edu

     

                  

     

    Changing the DNA of Cancer Care

     

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  • 5.  RE: cryo-preserved re infusion vital sign monitoring

    Posted 07-11-2019 10:35
    Hi Joy,

    i agree, quite the range. Dare I say, because we've always done it this way?  Our medical director is pretty progressive so I've not questioned it. Based on responses, it's clearly time.

    Thanks!

    ------------------------------
    Lenise Taylor
    Seattle Cancer Care Alliance/Univeristy or Washington/ Fred Hutch
    Clinical Nurse Specialist
    Seattle Cancer Care Alliance
    Maple Valley WA
    [Phone
    Ltaylor@seattlecca.orgSeattle Cancer Care Alliance
    ------------------------------



  • 6.  RE: cryo-preserved re infusion vital sign monitoring

    Posted 07-11-2019 10:37
    Hi Joy,

    These are the monitoring parameters we've had in place for decades.  Based on responses, I'll take this back to our medical director.  

    Thanks everyone!

    Lenise

    Lenise Taylor, MN, RN, AOCNS, BMTCN
    BMT/Immunotherapy/FACT CNS
    Seattle Cancer Care Alliance, Fred Hutch, University of Washington
    (206)300-6656 (cell)
    Outlook for iOS
    **Confidentiality Notice** This communication may contain privileged and confidential information intended for the addressee. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of this information (including reliance thereon) is strictly prohibited. If you have received this communication in error, please notify us immediately and then destroy all copies of the communication. To view our complete Notice of Privacy Practices, visit our website at www.seattlecca.org.





  • 7.  RE: cryo-preserved re infusion vital sign monitoring

    Posted 07-11-2019 07:58
    For cryopreserved cells our patients are on a bedside monitor. We do vitals every 15 minutes throughout infusion and continue the monitor and Q 15 minute vitals for 1 hour post completion of transplants.  We have seen a few late reactions but agree generally the happen during the infusion if at all. ​

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    Janice Taylor RN BSN, OCN, BMTCN
    Manager BMT Program
    Geisinger Health System
    Danville PA
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