Risks Associated with Under‐Transfusion

Wahr, Joyce A.

doi:10.1111/j.1778-428x.2000.tb00035.x

Cited by 3 publications

(3 citation statements)

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“…Failure to adequately resuscitate infants with low circulating blood volumes can quickly evolve into myocardial ischemia, hemodynamic collapse, and/or death. 2,22 There was an increased tendency for postoperative transfusion in our patients with higher levels of blood loss, likely the result of inadequate intraoperative blood replacement. Interestingly, patients who required postoperative blood transfusions had a significantly longer mean hospital LOS than those patients not receiving postoperative blood transfusions.…”

Section: Discussionmentioning

confidence: 91%

“…21 Conversely, undercorrection of blood loss can result in anemia, myocardial ischemia, hemodynamic instability, and/or death. 22 Analyses of blood loss during craniofacial surgery have found that mean EBL underestimated mean calculated blood loss (CBL) by 30% to 66% across different types of repairs. 1 determine blood loss holds true across a wide range of volume loss and if reliance on this measure to guide transfusion decisions has measurable clinical implications.…”

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confidence: 99%

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Blood Loss Estimation During Fronto-Orbital Advancement

Seruya¹,

Oh²,

Rogers³

et al. 2012

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

Blood Loss Estimation During Fronto-Orbital Advancement

Seruya¹,

Oh²,

Rogers³

et al. 2012

Journal of Craniofacial Surgery

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“…The inherent risks of anemia, particularly with cardiovascular disease, under‐transfusion, and the ethical concerns of withholding transfusions, are common criticisms of interventions aimed at reducing blood utilization 26,27 . Only four under‐transfusion events (without a clear medical or religious reason) occurred in this study following the adoption of a restrictive transfusion strategy.…”

Section: Discussionmentioning

confidence: 83%

A prospective multi‐faceted interventional study of blood bank technologist screening of red blood cell transfusion orders: The START study

et al. 2021

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Background Transfusion of red blood cells (RBC) is a common procedure, which when prescribed inappropriately can result in adverse patient outcomes. This study sought to determine the impact of a multi‐faceted intervention on unnecessary RBC transfusions at hospitals with a baseline appropriateness below 90%. Study Design and Methods A prospective medical chart audit of RBC transfusions was conducted across 15 hospitals. For each site, 10 RBCs per month transfused to inpatients were audited for a 5‐month pre‐ and 10‐month post‐intervention period, with each transfusion adjudicated for appropriateness based on pre‐set criteria. Hospitals with appropriateness rates below 90% underwent a 3‐month intervention which included: adoption of standardized RBC guidelines, staff education, and prospective transfusion order screening by blood bank technologists. Proportions of RBC transfusions adjudicated as appropriate and the total number of RBC units transfused per month in the pre‐ and post‐intervention period were examined. Results Over the 15‐month audit period, at the 13 hospital sites with a baseline appropriateness below 90%, 1950 patients were audited of which 81.2% were adjudicated as appropriate. Proportions of appropriateness and single‐unit orders increased from 73.5% to 85% and 46.2% to 68.2%, respectively from pre‐ to post‐intervention (P < .0001). Pre‐ and post‐transfusion hemoglobin levels and the total number of RBCs transfused decreased from baseline (P < .05). The median pre‐transfusion hemoglobin decreased from a baseline of 72.0 g/L to 69.0 g/L in the post‐intervention period (P < .0001). RBC transfusions per acute inpatient days decreased significantly in intervention hospitals, but not in control hospitals (P < .001). The intervention had no impact on patient length of stay, need for intensive care support, or in‐hospital mortality. Conclusion This multifaceted intervention demonstrated a marked improvement in RBC transfusion appropriateness and reduced overall RBC utilization without impacts on patient safety.

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Erythrocyte transfusion: friend or foe?

Hardy

Bélisle

2001

Can J Anesth

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Risks Associated with Under‐Transfusion

Cited by 3 publications

References 44 publications

Blood Loss Estimation During Fronto-Orbital Advancement

Blood Loss Estimation During Fronto-Orbital Advancement

A prospective multi‐faceted interventional study of blood bank technologist screening of red blood cell transfusion orders: The START study

Erythrocyte transfusion: friend or foe?

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