الهام خلف عادلی

Given transfusion complications, high expenses, inadequacy of resources and time constraint in ensuring blood products, it is necessary to investigate the status of blood consumption and factors affecting the proper use of products.  In this study, the consumption status of RBCs was investigated in Imam Khomeini Hospital in Mahallat city.

In this retrospective descriptive cross-sectional study, patient hemoglobin data were collected at the time of hospitalization, at the time of blood order, after blood administration, and at discharge. At the same time, the data on physician name, reason for hospitalization, platelet count, patient PT and PTT tests, and ratio of crossmatch by blood transfusion (C/T) were collected.

Out of 356 patients injected with RBCs, 91.7% were anemic at the time of blood request and 51.7% had the hemoglobin levels higher than 8 g/dL and received RBCs. The average C/T index was 1.06 with the highest value (1.8) pertaining to the surgical department and the lowest to the dialysis ward. There was no significant correlation between age, gender, PT, PTT, cause of hospitalization, and physician with frequency of blood transfusion.

  The results showed C/T ratio to transfusion being lower than the acceptable value and indicated the ratio of blood order to transfusion being desirable. There was a significant correlation between blood order and hemoglobin reduction. Given the average hemoglobin threshold of patients at the time of blood order, it has been shown that mainly liberal transfusion strategy has been used in the hospital.

Considering with the variability in the rate of blood and blood consumption in different medical centers, study of the transfusion practices in hospitals can affect the policies and planning related to the transfusion management. The aim of this study was to evaluate the transfusion practices in Rajaie cardiovascular hospital.

In this cross sectional study, we collected data from 399 adult patients underwent cardiac surgery at Ri cardiovascular medical center from February to July 2018 .The number of reserved and transfused units of blood components, frequency of transfused patients, and the frequency of blood components consumption were recorded. The frequency of transfused patients and number of blood components consumed were compared considering with the type of surgery. The data were analyzed by one way ANOVA and chi-square tests.

71% (282) of patients received at least one unit of blood product. 65% (259) of patients received RBC, 21% (83) FFP and 18% (71) received platelet. Of the 749 reserved RBC units, 256 units (34%) were transfused. 25% of patients had preoperative anemia. The mean trigger of hemoglobin for transfusion was 10.3 ± 3.1 g/dL. Comparison of the frequency of transfused patients as well as mean number of blood components did not show significant difference considering with the type of surgery.

Considering with the high rate of transfusion in this center, following a restrictive threshold of hemoglobin according to the blood transfusion guidelines as well as implementation of a preoperative anemia management guideline and MSBOS is recommended.