L C de Gray1, B F Matta. 1. Addenbrooke's Teaching Hospital NHS Trust, Department of Neuroanaesthesia, Cambridge, UK.
Abstract
BACKGROUND AND OBJECTIVE: Surgical treatment of patients presenting with subarachnoid haemorrhage secondary to a leaking cerebrovascular aneurysm involves coiling or clipping. Traditionally all patients undergoing this procedure are cross-matched routinely. With ever-increasing strains on the health budget and transfusion services in particular, as well as the real, albeit low risk of transfusion transmitted disease, we propose that a simple 'group and save', coupled with a reliable 'fast-issue' blood transfusion service should replace this outdated concept. METHOD: To assess this assumption, we carried out a retrospective analysis of 103 patients who underwent clipping or coiling during January to December 2001 in our Neurosurgical Unit. RESULTS: All patients but one had been cross-matched (99%). However, only 33 patients (32%) eventually required a blood transfusion. In real terms, this meant a total of 294 units of blood that had been cross-matched routinely, in our series of 103 patients, were not used. Had these patients only been 'group and saved' and a system of 'fast-issue' been adopted, assuming that none of the patients had abnormal antibodies, the blood transfusion department would have made a saving of 4815.72 pounds sterling for this group of patients. CONCLUSION: We conclude that advances in surgical technique have made routine cross-matching of blood in cerebral aneurysm surgery unnecessary.
BACKGROUND AND OBJECTIVE: Surgical treatment of patients presenting with subarachnoid haemorrhage secondary to a leaking cerebrovascular aneurysm involves coiling or clipping. Traditionally all patients undergoing this procedure are cross-matched routinely. With ever-increasing strains on the health budget and transfusion services in particular, as well as the real, albeit low risk of transfusion transmitted disease, we propose that a simple 'group and save', coupled with a reliable 'fast-issue' blood transfusion service should replace this outdated concept. METHOD: To assess this assumption, we carried out a retrospective analysis of 103 patients who underwent clipping or coiling during January to December 2001 in our Neurosurgical Unit. RESULTS: All patients but one had been cross-matched (99%). However, only 33 patients (32%) eventually required a blood transfusion. In real terms, this meant a total of 294 units of blood that had been cross-matched routinely, in our series of 103 patients, were not used. Had these patients only been 'group and saved' and a system of 'fast-issue' been adopted, assuming that none of the patients had abnormal antibodies, the blood transfusion department would have made a saving of 4815.72 pounds sterling for this group of patients. CONCLUSION: We conclude that advances in surgical technique have made routine cross-matching of blood in cerebral aneurysm surgery unnecessary.
Authors: A Crawford-Sykes; K Ehikhametalor; I Tennant; M Scarlett; R Augier; L Williamson; G Wharfe; H Harding-Goldson Journal: West Indian Med J Date: 2014-03-14 Impact factor: 0.171