Blood Transfusion in the 21st Century

Friedman, Mark T.; Avadhani, Vaidehi; Gilmore, Sandra; Madrigal, Emilio

doi:10.15190/d.2014.3

Cited by 8 publications

(6 citation statements)

References 38 publications

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“…The total number of whole blood/RBC units transfused in 2011 was 13.8 million units, representing an 8.2% decrease in transfusions from the prior surveyed year of 2008; and this trend continued in the latest (2013) report, which showed a 4.4% decline in the number of transfused units compared with 2011 . The implementation of an evidence‐based, multidisciplinary approach to optimizing care of patients who might need a transfusion in the form of PBM is essential to the success of any health care system . After the inception of a PBM at hospital Site A in mid‐2009 and the implementation of PA across all sites, our hospitals and the patients they serve have benefited from a decline in the rate of unnecessary and potentially harmful TEs.…”

Section: Discussionmentioning

confidence: 99%

“…3,12 The implementation of an evidence-based, multidisciplinary approach to optimizing care of patients who might need a transfusion in the form of PBM is essential to the success of any health care system. 13 After the inception of a PBM at hospital Site A in mid-2009 and the implementation of PA across all sites, our hospitals and the patients they serve have benefited from a decline in the rate of unnecessary and potentially harmful TEs. Since the implementation of PA and other blood conservation strategies noted above, over 13,000 RBC units have been saved at an estimated cost of $2.9 million for product acquisition.…”

Section: Discussionmentioning

confidence: 99%

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Adequacy of physician documentation and correlation with assessment of transfusion appropriateness: a follow‐up study in the setting of prospective audits and patient blood management

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adequacy of physician documentation and correlation with assessment of transfusion appropriateness: a follow‐up study in the setting of prospective audits and patient blood management

et al. 2016

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“…While the actuarial risk of immediate mortality associated with RBC transfusion is of the same order of magnitude as being struck by lightning, [60][61][62] real concerns about morbidity and mortality exist. Transfusion risks are routinely reported by established reporting agencies including the US Food and Drug Association (FDA), 63 the National Healthcare Safety Network Hemovigilance Module in the US, 64 the UK's Serious Hazards of Transfusion (SHOT) program, 62 and the Canadian Transfusion Transmitted Injuries Surveillance System (TTISS).…”

Section: What Is the Risk Associated With Rbc Transfusion?mentioning

confidence: 99%

When to transfuse your acute care patient? A narrative review of the risk of anemia and red blood cell transfusion based on clinical trial outcomes

Hare

Cazorla-Bak

et al. 2020

Can J Anesth/J Can Anesth

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This narrative review critically evaluates the evidence for risk of anemia and red blood cell (RBC) transfusion. For this purpose, it assesses large prospective randomized-controlled trials (RCTs) in medical, surgical, and critical care patient populations in which the impact of specific hemoglobin transfusion thresholds are compared. In these trials, the risks of anemia relative to those of RBC transfusion are assessed. The results of published systematic reviews and meta-analyses are also discussed.Lastly, recommendations for patient blood management and treatment of anemia are explored. The main conclusion of this review emphasizes that the decision to transfuse RBCs is complex and depends on the interaction between multiple factors including the balance between the risk of anemia and the risk of RBC transfusion, existing patient comorbidities, and medical and surgical exposures. The transfusion thresholds recommended by current

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“…19,20 However, although transfusion has become much safer through regulatory measures, donor screening, improvements in quality of the blood supply, and because of highly sensitive assays for infectious diseases, especially HIV and hepatitis C, whereby the risk has been reduced to ,1 per 1-2,000,000 units transfused, the risks of transfusion can never be entirely eliminated. 21,22 This particularly holds true for certain risks and complications in which the mechanisms are not yet fully understood, such as TRALI and TRIM, while for many of the infectious risks, assays are not yet available for blood donor testing and perhaps would be prohibitively costly to test for all of them. In addition, there remains the possibility that previously unidentified risks may emerge to threaten the safety of the blood supply.…”

Section: Patient Perspectives On Blood Transfusion and Informed Consentmentioning

confidence: 99%

Patient inclusion in transfusion medicine: current perspectives

Friedman¹,

Bizargity²,

Gilmore³

et al. 2015

IJCTM

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Patients may have differing perceptions about blood transfusions based on their backgrounds, values, education levels, or cultural or religious beliefs, which may or may not be accurate. Unfortunately, despite the fact that transfusions are associated with a number of infectious and noninfectious risks, and in spite of the fact that there are ethical, accreditation, and regulatory requirements to provide information regarding transfusion risks, benefits, and alternatives to patients, transfusion consent remains inconsistently obtained. This can partly be attributed to the fact that clinicians may take on a paternalistic approach to transfusion decisions as well as to the fact that many clinicians have knowledge gaps in transfusion medicine that prevent them from obtaining transfusion consent adequately. As a result, unlike the case with other medical and surgical therapies, most patients are not included in the making of informed decisions regarding the need for transfusion versus alternative therapies, leading to many situations in which the transfusions provide little benefit to them. Recently however, a number of organizations, such as the American Association of Blood Banks and The Joint Commission in the US, have promoted multidisciplinary, evidence-based treatment strategies that aim to minimize the need for blood transfusion, the so-called patient blood management (PBM) protocols. PBM strategies are expected to improve blood utilization through optimization of patients who may need blood transfusions via measures such as preoperative anemia management, intraoperative cell salvage, and improved transfusion guidelines. PBM strategies also focus on enhanced requirements for transfusion education and shared decision making, including informed consent and, thus, promote a patient-centered approach as defined by the Institute of Medicine.

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Blood Transfusion in the 21st Century

Abstract: Blood transfusion is a common procedure in the hospital setting, and the safety of the blood supply has been vastly improved over

Cited by 8 publications

References 38 publications

Adequacy of physician documentation and correlation with assessment of transfusion appropriateness: a follow‐up study in the setting of prospective audits and patient blood management

Adequacy of physician documentation and correlation with assessment of transfusion appropriateness: a follow‐up study in the setting of prospective audits and patient blood management

When to transfuse your acute care patient? A narrative review of the risk of anemia and red blood cell transfusion based on clinical trial outcomes

Patient inclusion in transfusion medicine: current perspectives

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