Abstract
Patterns of blood transfusion practice over an eight-year-period (1977–1984) are described. Use of blood and blood products increased annually as did the number of patients crossmatched and transfused. Programs such as the “Blood Group & Antibody Screen” and the “Maximum Surgical Blood Order Schedule” were important in improving transfusion practices. There was improvment in blood use by all subspecialties; the overall C:T (crossmatched:transfused blood) ratio declined from 4.4 to 2.8. Approximately a quarter of both crossmatches performed and transfusions of red cells were associated with cardiac surgery. Incidence of outdated units of blood declined markedly (2.6 per cent in 1984), as did requests for and administration of single unit transfusions. Seven per cent of patients received one unit of blood during hospitalization; since 85 per cent of these were associated with surgery (57 per cent cardiac surgery), it is suggested that single unit transfusions may sometimes be more appropriate than inappropriate. Two per cent of patients had clinically significant alloanti-bodies. About two per cent of patients had positive direct antiglobulin tests; nine per cent of the sera of these patients contained both auto and alloantibodies. Such data are important for transfusion quality assurance as well as for optimal logistical use of facilities both at hospital Blood Bank and blood collection agency levels.
Résumé
Les indications et la pratique de transfusion pour une période de huit ans (1977–1984) sont décrites. L’utilisa-tion du sang ainsi que ses dérivés a augmenté chaque année avec l’augmentation du nombre de patients qui ont été groupés et transfuses. Des programmes tels que “Blood Group et Antibody Screen” et le “Maximum Surgical Blood Order Schedule” ont ameliore a’une façon significative la pratique des transfusions. Il y avail une amélioration dans l’utilisation du sang par toutes les sous-spécialités: en général le taux C:T (patients groupés sur quantité de sang transfusé) a diminué de 4.4 à 2.8. Approximativement le quart des patients groupés et du sang transfusé étaient reliés à la chirurgie cardiaque. L’incidence d’unité de sang dont la date est expirée a diminuée remarquablement (2.6 pour cent en 1984), il en est ainsi des demandes pour l’administration d’une seule unité de sang. Sept pour cent des patients ont reçu une unité de sang lors de l’hospitalisation; puisque 85 pour cent de ceux là étaient associés avec la chirurgie (57pour cent pour la chirurgie cardiaque), il est suggéré que la transfusion d’une seule unité de sang peut des fois être plus appropriée qu’inappropriee. Deux pour cent des patients ont présenté des alloanticorps cliniquement significatifs. A peu pres deux pour cent des patients présentaient un test positif aux anti-globulines directes: neuf pour cent du sérum de ces patients contenait des autoanticorps ainsi que des alloanticorps. De telles données sont importantes afin d’assurer une bonne qualité de transfusion ainsi qu’une bonne utilisation optimale des services des banques de sang hospitallers ainsi que de la Croix Rouge.
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References
Mollison PL. Blood transfusion in clinical medicine. 7th ed. Oxford: Blackwell, 1981.
Widmann FK, ed. Technical manual. 8th ed. Washington: American Association of Blood Banks, 1981.
Kelton JG, Perrault RA, Blajchman MA. Substitution of the “group-and-screen” for the full cross- match in elective operations. Can Anaesth Soc J 1983; 30:641–5.
Friedman BA, Oberman HA, Chadwick AR, Kingdon KI. The maximum surgical blood order schedule and surgical blood use in the United States. Transfusion 1976; 16:380–7.
Blajchman MA, Herst R, Perrault RA. Blood component therapy in anaesthetic practice. Can Anaesth Soc J 1983; 30:382–9.
Friedman BA. An analysis of surgical blood use in United States hospitals with application to the maximum surgical blood order schedule. Transfusion 1979; 19:268–78.
Farmer E, Ham JM. The ordering of blood for elective surgical operations. Aust NZ J Surg 1981; 51:68–71.
Mintz PD, Nordine RB, Henry JB, Webb WR. Expected hemotherapy in elective surgery. NY State J Med 1976; 76:532–7.
Huang ST, Lair J, Floyd DM, Cole GW. Type and hold system for better blood utilization. Transfusion 1980; 20:725–8.
Boral LI, Henry JB. The type and screen: a safe alternative and supplement in selected surgical procedures. Transfusion 1977; 17:163–8.
Roualt C, Greenhagen J. Reorganization of blood ordering practices. Transfusion 1978; 18:448–53.
Myhre BA. Quality control in blood banking. New York: John Wiley & Sons, 1974:183.
Roualt CL. Appropriate pretransfusion testing.In: Treacy M. Ed. Pretransfusion Testing for the ’80s. Washington: American Association of Blood Banks, 1980.
Grindon AJ, Tomasulo PS, Bergin JJ, Klein HG, Miller JD, Mintz PD. The hospital transfusion committee: guidelines for improving practice. JAMA 1985;253:540–4.
Sherman MM, Dobnik DB, Dennis RC, Berger RL. Autologous blood transfusion during cardiopulmonary bypass. Chest 1976; 70:592–5.
Brenner BJ, Raines JK, Darling RC. Intra-operative autotransfusion in abdominal aortic resections. Arch Surg 1973; 107:78–84.
Kaplan JA, Cannarella C, Jones EL, Kutner MH, Hatcher CR, Dunbar CW. Autologous blood transfusion during cardiac surgery: a re-evaluation of three methods. J Thorac Cardiovasc Surg 1977; 74:4–10.
Pliant MB, McGoon DC, Tarhan S. Failure of autologous whole blood to reduce banked-blood requirements in open-heart surgical patients. J Thorac Cardiovasc Surg 1975; 70:338–43.
Roche JK, Stengle JM. Open-heart surgery and the demand for blood. JAMA 1973; 225:1516–21.
Fauchet R, Genetet B, Gueguen M, Leguerriere A, Rioux C, Logeais Y. Transfusion therapy and HLA antibody response in patients undergoing open-heart surgery. Transfusion 1982; 22:320–2.
Spielmann W, Seidl S. Prevalence of irregular red cell antibodies and their significance in blood transfusion and antenatal care. Vox Sang 1974; 26:551–9.
Walker RH. Is a crossmatch utilizing the indirect antiglobulin test necessary for patients with a negative antibody screen?In: Current Topics in Blood Banking. Ann Arbor: University of Michigan, 1977.
Tovey GH. Preventing the incompatible blood transfusion. Haematologia 1974; 8:389–91.
Giblett ER. Blood group alloantibodies: an assessment of some laboratory practices. Transfusion 1977; 17:299–308.
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Freedman, J., Lim, C., Wright, J. et al. Changing patterns of transfusion practice in a tertiary care hospital from 1977 to 1984. Can Anaesth Soc J 33, 458–465 (1986). https://doi.org/10.1007/BF03010971
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DOI: https://doi.org/10.1007/BF03010971