Volume 15, Issue 3 (Autumn 2018)                   bloodj 2018, 15(3): 173-181 | Back to browse issues page

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Jahangiryan A, Zadsar M, Chegini A, Alaei M. The consumption rate and the transfusion threshold level of PRBCs in cardiac patients in Tohid Hospital, Sanandaj city. bloodj 2018; 15 (3) :173-181
URL: http://bloodjournal.ir/article-1-1208-en.html
The consumption rate and the transfusion threshold level of PRBCs in cardiac patients in Tohid Hospital, Sanandaj city
A. Jahangiryan , M. Zadsar , A. Chegini , Mastaneh Alaei *
Keywords: Key words: Transfusion, Cardiac Surgery, Iran
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References:
  1. Whitaker BI. The 2011 national blood collection and utilization survey report. USA: Department of Health and Human Services; 2011. p. ?.
  2. Najafi M, Faraoni D. Hemoglobin optimization and transfusion strategies in patients undergoing cardiac surgery. World J Cardiol 2015; 7(7): 377-82.
  3. Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Ferraris VA, Ferraris SP, Saha SP, Hessel EA 2nd, Haan CK, et al. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg 2007; 83(5 Suppl): S27-86.
  4. Retter A, Wyncoll D, Pearse R, Carson D, McKechnie S, Stanworth S, et al. Guidelines on the management of anaemia and red cell transfusion in adult critically illpatients. Br J Haematol 2013;160(4): 445-64.
  5. Carson JL, Grossman BJ, Kleinman S, Tinmouth AT, Marques MB, Fung MK, et al. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med 2012; 157(1): 49-58.
  6. Napolitano LM, Kurek S, Luchette FA, Corwin HL, Barie PS, Tisherman SA, et al. Clinical practice guideline: red blood cell transfusion in adult trauma and critical care. J Trauma 2009; 37(12): 3127-57.
  7. Society   of  Thoracic Surgeons Blood Conservation Guideline Task Force;Ferraris VA, Brown JR, Despotis GJ, et al.Society of Cardiovascular Anesthesiologists Special Task Force on Blood Transfusion; Shore-Lesserson LJ,Goodnough LT, Mazer CD, Shander A, Stafford-SmithM, Waters J; International Consortium for EvidenceBased Perfusion;Baker RA, Dickinson TA, FitzGerald DJ,
 
Likosky DS, Shann KG. 2011 Update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg. 2011;91:944-982.
  1. Williams ML, He X, Rankin JS, Slaughter MS, Gammie JS. Preoperative hematocrit is a powerful predictor of adverse outcomes in coronary artery bypass graft surgery: a report from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg 2013; 96(5): 1628-34.
  2. DeFoe GR, Ross CS, Olmstead EM, Surgenor SD, Fillinger MP, Groom RC, et al. Lowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting. Northern New England Cardiovascular Disease Study Group. Ann Thorac Surg 2001;71(3): 769-76.
  3. Karkouti K, Djaiani G, Borger MA, Beattie WS, Fedorko L, Wijeysundera D, et al. Low hematocrit during cardiopulmonary bypass is associated with increased risk of perioperative stroke in cardiac surgery. Ann Thorac Surg 2005; 80(4): 1381-7.
  4. Murphy GJ, Angelini GD. Indications for blood transfusion in cardiac surgery. Ann Thorac Surg 2006; 82(6): 2323-34.
  5. Vonk AB, Meesters MI, van Dijk WB, Eijsman L, Romijn JW, Jansen EK, et al. Ten-year patterns in blood productutilization during cardiothoracic surgery with cardiopulmonary bypass in a tertiary hospital. Transfusion 2014; 54(10 Pt 2): 2608-16.
  6. Scott DA, Tung HM, Slater R. Perioperative Hemoglobin Trajectory in Adult Cardiac Surgical Patients. J Extra Corpor Technol 2015; 47(3): 167-73.
  7. Hogervorst E, Rosseel P, Bom J, Bentala M, Brand A,
Meer N, et al. Tolerance of intraoperative hemoglobin decrease during cardiac surgery. Transfusion 2014; 54(10 Pt 2): 2696-704.
  1. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999; 282(15): 1458-65.
  2. Goodnough LT, Shander A. Patient blood management. Anesthesiology 2012; 116(6): 1367-76.
  3. Rothschild JM, McGurk S, Honour M, Lu L, McClendon AA, Srivastava P, et al. Assessment of education and computerized decision support interventions for improving transfusion practice. Transfusion 2007; 47(2): 228-39.
  4. Friedman MT, Ebrahim A. Adequacy of physician documentation of red blood cell transfusion and correlation with assessment of transfusion appropriateness. Arch Pathol Lab Med 2006; 130(4): 474-79.
  5. Proceedings from the National Summit on Overuse availablefrom12https://www.jointcommission.org/assets/1/6/National_Summit_Overuse.pdf
  6. Brouwers C, Hooftman B, Vonk S, Vonk A3, Stooker W, Te Gussinklo WH, et al. Benchmarking the use of blood products in cardiac surgery to stimulate awareness of transfusion behaviour. Neth Heart J 2017; 25(3): 207-14.
  7. Foroughi M, Golestani Eraghi M, Ansari Aval Z, Majidi H. Increased demand for blood transfusion in cardiac surgery, simple but unsolved common problem. J Cell Mol Anesth 2017; 2(3): 112-19.
  8. Murphy GJ, Pike K, Rogers CA, Wordsworth S, Stokes EA, Angelini GD, et al. Liberal or restrictive transfusion after cardiac surgery. N Engl J Med 2015; 372(11): 997-1008.
  9. Hajjar LA, Vincent JL, Galas FR, Nakamura RE, Silva CM, Santos MH, et al. Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 2010; 304(14): 1559-67.
  10. Zellinger M. Protocol: Cardiac Surgery Transfusion Triggers; 2015. Available from: https:// www. ctsnet. org/article/protocol-cardiac-surgery-transfusion-triggers.
 
 
 
 


 
 
 
 
Sci J Iran Blood Transfus Organ 2018; 15(3): 173-181
Original Article
 

 

The consumption rate and the transfusion threshold level of PRBCs in cardiac patients in Tohid Hospital, Sanandaj city
 
Jahangirian A.1, Zadsar M.2, Chegini A.2, Alaei M.2
 
 
1Tohid Hospital, Sanandaj, Iran
2Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
 
 
Abstract
Background and Objectives
Transfusion is the most prevalent approach in surgery. Cardiac surgery is one of the most blood consuming operations. High transfusion trigger is indicative of inappropriate PRBC usage. Therefore, we decided to evaluate PRBC usage and transfusion triggers in cardiac surgery in a hospital in Kurdistan province.
 
Materials and Methods
In this descriptive study, files of all patients having undergone cardiac surgery during 1394 were studied. Information regarding preoperative Hb, transfusion trigger, units of transfused PRBC and related wards in which transfusion had been taken place was extracted. SPSS 16 Chicago, T-student and one way ANOVA, and χ2 exams were respectively used for data analysis, the mean difference, and ratio comparison.
 
Results
Among 105 patients, 37 (35.2%) women and 68 (64.8%) men, with the mean age of 62 ± 10.7, 77 received at least one blood product. Meanwhile, 70 (66.6%) patients received PRBC in at least one stage of their postoperative hospitalization. Mean transfusion trigger was obtained to be  11.7 ± 1.9 (11.4  and 12.1 in women and men, respectively). Women generally showed  lower Hb levels (p = 0.025) , although this did not prove to be statistically significant in peri- operative PRBC transfusion rate. Mean PRBC usage in operating room, ICU and postoperative wards were 1.00 ± 1.22 , 1.26 ± 1.70, and 0.17 ± 0.52, respectively.
 
Conclusions 
The results revealed that the mean transfusion rates and triggers in our study are higher compared with similar studies. Serious revision in adopting appropriate transfusion triggers and managing transfusion cases is absolutely essential.
 
Key words: Transfusion, Cardiac Surgery, Iran
 
 
 
 
 
Received: 27 May 2018
Accepted:  7  Jul   2018
 
 

Correspondence: Alaei M., MD. Pathologist. Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine.
P.O.Box: 14665-1157, Tehran, Iran. Tel: (+9821) 82052234; Fax: (+9821) 88628741
E-mail: alaeimastaneh@hotmail.com

 
Type of Study: Research | Subject: Blood transfusion medicine
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