Literature DB >> 19245901

Transfusion insurgency: practice change through education and evidence-based recommendations.

Mary-Margaret Brandt1, Ilan Rubinfeld, Jack Jordan, Dhaval Trivedi, H Mathilda Horst.   

Abstract

BACKGROUND: In 2000, we implemented an evidence-based guideline in the surgical intensive care unit (SICU) using a transfusion threshold of hemoglobin <8 g/dL. We hypothesized that continual education on the transfusion protocol would decrease transfusions.
METHODS: We analyzed 2-month samples of admissions in even-numbered years from 1998 to 2006. Any infusion of packed red blood cells (PRBCs) was included.
RESULTS: We analyzed data from 2,138 patients resulting in 5,130 transfusions. Thirty-six patients received >20 U of blood. The only difference between groups occurred in 2006 when renal failure increased. Transfusions decreased from 3.2 +/- 0.34 (SE) to 1.7 +/- 0.2. The number of patients who received blood also decreased. Mortality and length of stay (LOS) were not different among the groups. Every unit of blood transfused increased the mortality risk by 14%.
CONCLUSIONS: Implementation of an evidence-based transfusion guideline reduced the number of infused units and patients transfused without an increase in mortality.

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Year:  2009        PMID: 19245901     DOI: 10.1016/j.amjsurg.2008.10.004

Source DB:  PubMed          Journal:  Am J Surg        ISSN: 0002-9610            Impact factor:   2.565


  5 in total

1.  The effect of the perioperative blood transfusion and blood conservation in cardiac surgery Clinical Practice Guidelines of the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists upon clinical practices.

Authors:  Donald S Likosky; Daniel C FitzGerald; Robert C Groom; Dwayne K Jones; Robert A Baker; Kenneth G Shann; C David Mazer; Bruce D Spiess; Simon C Body
Journal:  J Extra Corpor Technol       Date:  2010-06

2.  An in-vitro comparison between Hemobag and non-Hemobag ultrafiltration methods of salvaging circuit blood following cardiopulmonary bypass.

Authors:  Ed Delaney; David Rosinski; Harvey Ellis; Keith A Samolyk; Jeffrey B Riley
Journal:  J Extra Corpor Technol       Date:  2010-06

3.  Evaluation of RBC Transfusion Practice in Adult ICUs and the Effect of Restrictive Transfusion Protocols on Routine Care.

Authors:  Kevin P Seitz; Jonathan E Sevransky; Greg S Martin; John D Roback; David J Murphy
Journal:  Crit Care Med       Date:  2017-02       Impact factor: 7.598

4.  Rational use of blood: how to do it?

Authors:  Helio Moraes-Souza
Journal:  Rev Bras Hematol Hemoter       Date:  2013

5.  Behaviour modification interventions to optimise red blood cell transfusion practices: a systematic review and meta-analysis.

Authors:  Lesley J J Soril; Thomas W Noseworthy; Laura E Dowsett; Katherine Memedovich; Hannah M Holitzki; Diane L Lorenzetti; Henry Thomas Stelfox; David A Zygun; Fiona M Clement
Journal:  BMJ Open       Date:  2018-05-18       Impact factor: 2.692

  5 in total

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