García Gala J M, Rodríguez Vicente P, Bernal del Castillo T, Martínez Revuelta E, Corte Buelga J R, Rodríguez Luengo J, Vargas Pabón M
Servicio de Hematología, Hospital Central de Asturias, Oviedo.
Sangre (Barc). 1996 Feb;41(1):19-23.
Transfusion is not devoid of adverse effects; therefore every transfusional procedure must be indicated correctly. With this in mind in 1991 transfusion guidelines were published by our Hospital Transfusion Committee. Four years later, a retrospective audit was performed.
We have evaluated all blood component orders (order is a transfusion request) during one month, classifying them as appropriate or inappropriate according to the transfusion guidelines. The evaluation was performed 24 hours after transfusion. The results obtained were compared with the ones obtained before the published transfusion guidelines.
481 transfusion orders were studied. 87 percent (420/481) were considered appropriate according to the transfusion guidelines. These 481 orders referred to the transfusion of 1178 units to 293 patients. 12 percent of the transfused units was considered as inappropriate. 16 percent of the patients (48/239) had at least on inappropriate transfusion procedure. The comparison with the data obtained in 1991 showed a significant increase of the appropriate transfusion orders (74 versus 87 percent). The use of fresh frozen plasma showed the greatest incidence in inappropriate use, mainly in haemorrhagic disorders without factor deficit. The patients with haemoglobin levels between 70 and 100 g/L without signs of hypoxia were the most important cause of inappropriate use of red cell concentrates. And the patients with platelet levels > 20 x 10(9)/L were the major cause of inappropriate use of platelet concentrates.
Transfusion guidelines knowledge improves the use of blood components.
输血并非没有不良反应；因此，每一次输血程序都必须正确指明。出于这一考虑，我院输血委员会于1991年发布了输血指南。四年后，进行了一次回顾性审计。
我们评估了一个月内所有血液成分订单（订单即输血申请），根据输血指南将其分类为适当或不适当。评估在输血后24小时进行。将获得的结果与发布输血指南之前获得的结果进行比较。
研究了481份输血订单。根据输血指南，87%（420/481）被认为是适当的。这481份订单涉及向293名患者输注1178单位血液。12%的输注单位被认为是不适当的。16%的患者（48/239）至少有一次不适当的输血程序。与1991年获得的数据相比，适当输血订单显著增加（从74%增至87%）。新鲜冰冻血浆的使用在不适当使用中发生率最高，主要是在无因子缺乏的出血性疾病中。血红蛋白水平在70至100 g/L之间且无缺氧迹象的患者是不适当使用红细胞浓缩物的最重要原因。血小板水平>20×10⁹/L的患者是不适当使用血小板浓缩物的主要原因。
输血指南知识可改善血液成分的使用。
