Vasiliy Sim1, Lillian S Kao2, Jessica Jacobson3, Spiros Frangos3, Susan Brundage4, Chad T Wilson3, Ron Simon3, Nina E Glass3, H Leon Pachter3, S Rob Todd5. 1. Department of Surgery, Brookdale University Hospital and Medical Center, Brookdale Plaza, Brooklyn, NY 11212, USA. 2. Department of Surgery, UTHealth, 7000 Fannin Street, Houston, TX 77030, USA. 3. Department of Pathology, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA. 4. Department of Surgery, Queen Mary University of London, Mile End Road, London E1 4NS, UK. 5. Department of Pathology, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA. Electronic address: srtodd@nyumc.org.
Abstract
BACKGROUND: The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically ill patients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons. METHODS: A survey of PRBC transfusion practices was administered to the American Association for the Surgery of Trauma members. The scenarios examined hemoglobin thresholds for which participants would transfuse PRBCs. RESULTS: A hemoglobin threshold of less than or equal to 7 g/dL was adopted by 45% of respondents in gastrointestinal bleeding, 75% in penetrating trauma, 66% in sepsis, and 62% in blunt trauma. Acute care surgeons modified their transfusion trigger significantly in the majority of the modifications of these scenarios, often inappropriately so. CONCLUSIONS: This study documents continued evidence-practice gaps and wide variations in the PRBC transfusion practices of acute care surgeons. Numerous clinical factors altered such patterns despite a lack of supporting evidence (for or against).
BACKGROUND: The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically illpatients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons. METHODS: A survey of PRBC transfusion practices was administered to the American Association for the Surgery of Trauma members. The scenarios examined hemoglobin thresholds for which participants would transfuse PRBCs. RESULTS: A hemoglobin threshold of less than or equal to 7 g/dL was adopted by 45% of respondents in gastrointestinal bleeding, 75% in penetrating trauma, 66% in sepsis, and 62% in blunt trauma. Acute care surgeons modified their transfusion trigger significantly in the majority of the modifications of these scenarios, often inappropriately so. CONCLUSIONS: This study documents continued evidence-practice gaps and wide variations in the PRBC transfusion practices of acute care surgeons. Numerous clinical factors altered such patterns despite a lack of supporting evidence (for or against).
Authors: Lavanya Yohanathan; Natalie G Coburn; Robin S McLeod; Daniel J Kagedan; Emily Pearsall; Francis S W Zih; Jeannie Callum; Yulia Lin; Stuart McCluskey; Julie Hallet Journal: J Gastrointest Surg Date: 2016-03-29 Impact factor: 3.452
Authors: David C Fitzgerald; Annie N Simpson; Robert A Baker; Xiaoting Wu; Min Zhang; Michael P Thompson; Gaetano Paone; Alphonse Delucia; Donald S Likosky Journal: J Thorac Cardiovasc Surg Date: 2020-05-13 Impact factor: 5.209