Atilla Erden, Toprak Selami Koçak, Civriz Bozdağ Sinem, Topçuoğlu Pervin, Arslan Önder
Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey.
Turk J Haematol. 2017 Aug 2;34(3):244-249. doi: 10.4274/tjh.2015.0365. Epub 2015 Feb 20.
The hemoglobin (Hb) content of packed red blood cells (pRBCs) differs in standard volume units. The pRBC transfusions are based on the number of units routinely. We aimed to use pRBCs according to total Hb content and compare the rates of achieving the target Hb concentration levels with the current transfusion practice.
Eighty-nine patients (55 males and 34 females) with median age of 46 years (range: 19-75) were enrolled, and of 178 transfusion episodes, 92 were randomized to the Hb content based-study group and 86 to the unit-based control group. Fifty-one patients were evaluated by 1 and rest of the patients by ≥2 episodes (median: 3; range: 1-7). Suitable pRBCs were detected by the Hemosoft Blood Banking Management & Information System. In the Hb content-based study group, to reduce the number of units, the required Hb was calculated by recipients' height, weight, and Hb levels. When no appropriate units could be found within the inventory, the actual ordered number of units was sent to clinics, as was done for the control group.
In the study group totally, 38 units of pRBCs were transfused with a reduction of 19.8% (38/192) from the original order. The success of finding the matched Hb content was statistically increased with low weight and height and high pRBC storage. The Hb content of transfused pRBC units was significantly higher in the study group than the control group. The ratio of achieving the target Hb level was statistically similar in the control and study group (p=0.125), the successful and unsuccessful group (p=0.325), and the control and unsuccessful group (p=0.438). The relation between the shelf-life of the pRBC units and the rate of achieving the target Hb level was found to be similar between groups (p=0.782).
The number of pRBC transfusions can be minimized since we clearly demonstrated that the efficacy of Hb content-based transfusion is similar to that of unit-based transfusion.
标准体积单位的浓缩红细胞（pRBCs）中的血红蛋白（Hb）含量有所不同。pRBC输血通常基于单位数量。我们旨在根据总Hb含量使用pRBC，并将达到目标Hb浓度水平的比率与当前输血实践进行比较。
纳入89例患者（55例男性和34例女性），中位年龄46岁（范围：19 - 75岁），在178次输血事件中，92次被随机分配到基于Hb含量的研究组，86次被分配到基于单位数量的对照组。51例患者接受1次评估，其余患者接受≥2次评估（中位值：3次；范围：1 - 7次）。通过Hemosoft血液库管理与信息系统检测合适的pRBC。在基于Hb含量的研究组中，为减少单位数量，根据受血者的身高、体重和Hb水平计算所需的Hb。当库存中找不到合适的单位时，将实际订购的单位数量发送到临床，对照组也是如此。
研究组总共输注了38单位的pRBC，比原订单减少了19.8%（38/192）。低体重、低身高和高pRBC储存情况下，找到匹配Hb含量的成功率在统计学上有所提高。研究组中输注的pRBC单位的Hb含量显著高于对照组。对照组和研究组之间、成功组和失败组之间以及对照组和失败组之间达到目标Hb水平的比率在统计学上相似（p = 0.125、p = 0.325、p = 0.438）。发现pRBC单位的保存期限与达到目标Hb水平的比率在各组之间相似（p = 0.782）。
我们明确证明基于Hb含量的输血效果与基于单位数量的输血效果相似，因此可以将pRBC输血的数量降至最低。
