A Third of Perioperative Blood Transfusions in the ICU Does Not Follow Guideline Recommendations - A Retrospective Analysis
Journal Title: Journal of Intensive and Critical Care - Year 2017, Vol 3, Issue 4
Abstract
Objective: This study evaluates the relevance of transfusion guidelines for clinical transfusion practice. Background: There is little data available on current practice related to appropriate use of blood products. Recent data suggest incorrect use and over transfusion in Europe. In Germany, indications for transfusion and administration of blood products are strict and detailed. However, in clinical practice, alignment of transfusion guidelines to clinical situations seems to be difficult for physiciansespecially in complex diseases and severity such as in critical care. We hypothesized that significant practice variability exists with regard to guidelines adherence in critically ill. Materials and methods: Data sets of transfused patients from a surgical intensive care unit of a university center retrospectively were analyzed over a 12 month period. Indications for blood products were compared with guidelines focusing on numbers of ordered and administered units as well as transfusion triggers. Results: In total, during the study period, 450 packed red cells (PRC, 249 orders), 454 fresh frozen plasma (FFP) (201) and 43 platelet units (PC) (29) were given to 89 patients. The mean number of administered PRC was 5.8+/-6.6 (mean +/- SD) units. Double units were administered in 57.4%. Discordant to actual guidelines, 75 (30.12%) PRC`s, 79 (39.30%) FFP's and 9 (31.03%) of PC orders were given without indication. Fresh frozen plasma was administered in ineffective dosage in 83.6% (mean 7.3 ml/kg body weight), platelet transfusion despite intact platelet function in 30.2% and beyond platelet counts of 100 000/μl in 60%. Conclusion: Detailed guidelines for transfusion of blood products were not followed in daily practice in a third of all applications. The reasons for malcompliance are key for improvement.
Authors and Affiliations
Nguyen XD, Ghazari A, Arndt C, Fleiter B, Frietsch T
Keywords
Related Articles
- EP ID EP301137
- DOI 10.21767/2471-8505.100100
- Views 50
- Downloads 0
Extubations in the PICU- Where are We Now?
In the future, utilization of mechanical ventilation will continue to rise. It is anticipated that mechanical ventilation may be required in up to 50% of critically ill and/or injured infants, children, and adolescents i...
More than Expectorant: New Scientific Data on Ambroxol in the Context of the Treatment of Bronchopulmonary Diseases
Background:Ambroxol has been established for decades in the treatment of acute and chronic respiratory diseases. A reassessment of the benefit-risk was conducted recently. Objective: What new scientific data, relevant fo...
Reduction of Blood Pressure by Electro Acupuncture in Mild to Moderate Hypertensive Patients: Randomized Controlled Trial
There is a growing interest in integrative medical treatments such as acupuncture on hypertension although therapy to control high blood pressure (BP) is available. We have demonstrated in a series of experimental invest...
The Influence of Human Soluble Recombinant Thrombomodulin on In-Hospital Mortality in Patients with Acute Respiratory Distress Syndrome and Disseminated Intravascular Coagulation: A Retrospective Multicenter Study
Background: Patients with acute respiratory distress syndrome (ARDS) often develop disseminated intravascular coagulation (DIC), which can worsen clinical outcomes. Anticoagulant therapy such as human soluble recombinant...
Coping Patterns in a Mother of a Child with Multiple Congenital Anomalies: A Case Study
Objective: To study the coping pattern of a mother of a child with multiple congenital anomalies (MCAs) based on interview data. Methods: The mother of a child born at Tohoku University Hospital, Japan, who was diagnose...