Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Students' Scientific Society, Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
Transfus Apher Sci. 2022 Apr;61(2):103323. doi: 10.1016/j.transci.2021.103323. Epub 2021 Nov 19.
Red blood cell (RBC) transfusion (RBCT) is one of the most frequently performed procedures in inpatients within modern hospital systems. However transfusion practices may vary by an institution or even by a prescribing physician. In order to assess the current RBCT practice in our institution, we performed a detailed analysis of RBCTs.
We performed a retrospective analysis of all RBCTs in our institution between January 2018 and December 2019. The data collected included: age, sex, type of RBC, number of single and multiple unit RBCTs in bleeding and nonbleeding patients, number of multiple unit RBCTs in non-bleeding patients with and without hemoglobin (Hb) concentration determination after each RBC, primary indication for RBCT, pre-post RBCT Hb concentration in non-bleeding patients, lactate concentration pre-post RBCT in non-bleeding patients.
The indications for RBCT were anemia (2244, 56.2 % RBC) and bleeding (1463, 36.6 % RBC). The most frequently used types of RBCs were RBCs without buffy coat (75.1 %) and leucodepleted RBCs (20.9 %). In non-bleeding patients 45.7 % were multiple unit RBCTs, only 3% were performed with Hb determination following the first unit of RBC, 508 (20.2 %) RBCT were performed with pre-post RBCT lactate concentration determination.
Analysis of the local RBCT practice showed significant room for improvement. Areas of concern were type of RBC ordered, multiple unit transfusions in non-bleeding patients, lack of laboratory control of oxygenation pre-post transfusion or not taking it into account in RBCT decision making. Deficiencies are planned to be addressed by a comprehensive blood utilization review programme.
红细胞（RBC）输血（RBCT）是现代医院系统中住院患者最常进行的程序之一。然而，输血实践可能因机构甚至处方医生而异。为了评估我们机构当前的 RBCT 实践，我们对 RBCT 进行了详细分析。
我们对 2018 年 1 月至 2019 年 12 月期间我们机构的所有 RBCT 进行了回顾性分析。收集的数据包括：年龄、性别、RBC 类型、出血和非出血患者的单个和多个单位 RBCT 数量、非出血患者的多个单位 RBCT 数量，以及在每个 RBC 后是否测定血红蛋白（Hb）浓度、RBCT 的主要指征、非出血患者 RBCT 前后 Hb 浓度、非出血患者 RBCT 前后乳酸浓度。
RBCT 的指征是贫血（2244，56.2% RBC）和出血（1463，36.6% RBC）。最常使用的 RBC 类型是无白细胞 RBC（75.1%）和去白细胞 RBC（20.9%）。在非出血患者中，45.7%为多个单位 RBCT，只有 3%在输注第一单位 RBC 后进行 Hb 测定，508（20.2%）RBCT 在 RBCT 前后进行乳酸浓度测定。
对当地 RBCT 实践的分析表明，有很大的改进空间。需要关注的领域包括 RBC 类型、非出血患者的多个单位输血、输血前后氧合的实验室监测不足或在 RBCT 决策中未考虑这一点。计划通过全面的血液利用审查计划来解决这些不足。
