Objective: To provide evidence for improving emergency blood supply protocols by analyzing the clinical characteristics and disease distribution of emergency transfusion patients, especially those receiving≥10 units of red blood cells (RBCs). Methods: The data of 4 157 patients who urgently applied for large-volume blood transfusion in various hospitals in Shanghai from May 2024 to April 2025 were selected and analyzed statistically. Results: Tertiary gradeA hospitals accounted for the largest proportion of total transfusion volume (U) (48.79%, 8 420/17 256.5), with no statistically significant differences in RBC transfusion volumes among hospitals of different grades (P>0.05). All blood products are most widely used in tertiary hospitals. Obstetric blood transfusion (U)(19.07%, 3 277.5/17 190.5) was the most frequent. A-mong the hospitals of patients who received emergency blood transfusion with red blood cell suspension≥10 U, tertiary gradeA hospitals also had the largest transfusion volume (U)(47.19%, 1 107/2 346). In terms of disease types, the top three diseases in terms of blood transfusion volume (U) were obstetric transfusion (24.59%, 572/2 326), digestive diseases (14.53%, 338/2 326) and tumors (14.19%, 330/2 326). Conclusion: Tertiary grade A hospitals are the main demand units for emergency blood transfusion, with pregnant women and cancer patients being the core blood-using groups. It is suggested that the safety, timeliness and sufficiency of emergency blood transfusion be guaranteed by establishing a hierarchical blood supply mechanism, formulating single-disease blood transfusion plans and promoting precise blood transfusion guided by thromboelastography.

Objective: To explore the related factors of subependymal hemorrhage (SEH) and cerebral hemodynamic changes. Methods: From October 2012 to October 2017, 200 cases of children with subependymal hemorrhage diagnosed by ultrasound in our department of pediatrics were selected as the observation group , and a total of 150 children who were admitted to the Department of Pediatrics in the same period due to craniocerebral diseases and other serious diseases were selected as control group. The independent risk factors of the children in the observation group were analyzed, and the difference of the maximum systolic blood flow velocity (SV), the diastolic maximum flow velocity (DV), the systolic and diastolic velocity ratio (S/D), the resistance index (RI), and the pulsatile index (PI) were compared between the two groups. Results: Neonatal asphyxia, preterm birth, acidosis, neonatal respiratory distress syndrome (NRDS), patent ductus arteriosus and coagulation dysfunction were independent risk factors for subependymal hemorrhage. The bleeding side SV and DV of the observation group were higher than those of the control group, with statistically significant difference (P<0.001). In the observation group, the bleeding side SV and DV were higher than those of the healthy side, with statistically significant difference (P<0.001). There was no significant difference in bleeding side SV, DV, S/D, RI and PI in 110 cases of single side ependymal hemorrhage (P>0.05). Conclusions Children with ependymal hemorrhage can observe the hemodynamic indexes of anterior cerebral artery (ACA) dynamically by craniocerebral ultrasound, and judge the therapeutic effect by evaluating the systolic and diastolic blood flow velocity, so as to prevent the further aggravation of subependymal hemorrhage