Arewa O P
Department of Haematology and Immunology, College of Health Sciences, Niger Delta University, Nigeria.
Niger J Clin Pract. 2009 Dec;12(4):429-33.
The appropriate use of blood and blood components remains a formidable challenge faced by clinicians particularly in a developing country like Nigeria. The inadequate supply of safe blood implies that measures aimed at ensuring judicious use of the available supply should be continually identified and explored.
Aprospective study to evaluate all blood and blood component transfusions over a period of one year from January to December 2004 was done. The appropriateness of the transfusion with respect to the clinical state and the transfusion needs of the recipient was assessed by a Haematologist.
A total of 682 transfusion episodes were reviewed and analyzed. The commonest indication for use blood/blood component was severe anaemia in 38% of cases. Twenty nine percent of transfusions for moderate anemia, and 36% of fresh frozen plasma transfusions were found to be unnecessary. Inappropriate transfusion is most marked in the setting ofplatelet transfusion with 81% of platelet transfusion being inappropriate.
Enhanced capacity for component preparation, regular auditing of transfusion practices as well as improved communication between the clinicians and laboratory physicians will lead to more judicious use of blood component therapy. The need for the development of guidelines for blood component use in hospitals in line with the national blood transfusion policy is highlighted.
血液及血液成分的合理使用仍然是临床医生面临的一项艰巨挑战,尤其是在像尼日利亚这样的发展中国家。安全血液供应不足意味着应持续确定并探索旨在确保合理使用现有血液供应的措施。
进行了一项前瞻性研究,以评估2004年1月至12月这一年期间所有的血液及血液成分输注情况。由一名血液学家根据受血者的临床状况和输血需求评估输血的合理性。
共审查和分析了682次输血事件。使用血液/血液成分最常见的指征是严重贫血,占病例的38%。发现29%的中度贫血输血以及36%的新鲜冰冻血浆输血是不必要的。不适当输血在血小板输注方面最为明显,81%的血小板输注是不适当的。
提高成分制备能力、定期审核输血操作以及改善临床医生与实验室医生之间的沟通将有助于更合理地使用血液成分疗法。强调了根据国家输血政策制定医院血液成分使用指南的必要性。