scholarly journals Red blood cell transfusions in very and extremely low birthweight infants under restrictive transfusion guidelines: is exogenous erythropoietin necessary?

2001 ◽  
Vol 84 (2) ◽  
pp. 96F-100 ◽  
Author(s):  
A R Franz
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Low Birthweight ◽  
Restrictive Transfusion ◽  
Red Blood Cell Transfusions ◽  
Transfusion Guidelines ◽  
Extremely Low Birthweight

Multiple red blood cell transfusions and iron overload in very low birthweight infants

Vox Sanguinis ◽  
2017 ◽  
Vol 112 (5) ◽  
pp. 453-458 ◽  
Author(s):  
J. D. Treviño-Báez ◽  
E. Briones-Lara ◽  
J. Alamillo-Velázquez ◽  
M. I. Martínez-Moreno
Keyword(s):  
Blood Cell ◽  
Iron Overload ◽  
Red Blood Cell ◽  
Low Birthweight ◽  
Very Low Birthweight ◽  
Red Blood Cell Transfusions ◽  
Very Low Birthweight Infants

Adequacy of Physician Documentation of Red Blood Cell Transfusion and Correlation With Assessment of Transfusion Appropriateness

2006 ◽  
Vol 130 (4) ◽  
pp. 474-479 ◽  
Author(s):  
Mark T. Friedman ◽  
Amber Ebrahim
Keyword(s):  
Blood Cell ◽  
Red Blood Cells ◽  
Red Blood Cell ◽  
Blood Cells ◽  
Assessment Process ◽  
Red Blood Cell Transfusion ◽  
Major Function ◽  
Red Blood Cell Transfusions ◽  
Enhance Efficiency ◽  
Transfusion Guidelines

Abstract Context.—A major function of the hospital transfusion service is to assess the appropriateness of blood transfusion. Inadequate documentation of transfusions may hamper this assessment process. Objective.—To correlate the level of physician documentation of transfusion with the ability to justify transfusion. Design.—Retrospective review of red blood cell transfusions in adult patients in 2 hospital facilities during 1-week audit periods of each month from April 2001 to March 2003. Assessment forms were used to classify the level of physician documentation of transfusions into 3 groups: adequately, intermediately, and inadequately documented. Transfusions were deemed justified or not via comparison with hospital transfusion guidelines. Results.—There were 5062 audited red blood cells transfused to 2044 adult (≥18 years) patients. Medical records from 154 patients transfused with 257 units of red blood cells during 172 transfusion events were reviewed after initial screenings of hemoglobin/hematocrit values failed to justify the transfusions. Nine percent of adequately documented, 50% of intermediately documented, and 73% of inadequately documented transfusion events could not be justified. Transfusion events with suboptimal (intermediate and inadequate) documentation accounted for 49% of all medical record–reviewed transfusion events and 62% could not be justified. The correlation between inadequate documentation and failure to justify transfusion was significant (P < .001), as was the correlation between suboptimal documentation and failure to justify transfusion (P = .03). Conclusions.—There is a significant correlation between suboptimal documentation and failure to justify transfusions. Educating clinicians to improve documentation along with appropriate indications for transfusions may enhance efficiency of blood utilization assessment and lead to reduced rates of unjustifiable transfusions.

Methodologic quality assessment of red blood cell transfusion guidelines and the evidence base of more restrictive transfusion thresholds

Transfusion ◽  
2015 ◽  
Vol 56 (2) ◽  
pp. 472-480 ◽  
Author(s):  
Hans Van Remoortel ◽  
Emmy De Buck ◽  
Tessa Dieltjens ◽  
Nele S. Pauwels ◽  
Veerle Compernolle ◽  
...  
Keyword(s):  
Blood Cell ◽  
Quality Assessment ◽  
Red Blood Cell ◽  
Evidence Base ◽  
Red Blood Cell Transfusion ◽  
Restrictive Transfusion ◽  
Methodologic Quality ◽  
Transfusion Guidelines

Association, among very-low-birthweight neonates, between red blood cell transfusions in the week after birth and severe intraventricular hemorrhage

Transfusion ◽  
2013 ◽  
Vol 54 (1) ◽  
pp. 104-108 ◽  
Author(s):  
Robert D. Christensen ◽  
Vickie L. Baer ◽  
Diane K. Lambert ◽  
Sarah J. Ilstrup ◽  
Larry D. Eggert ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Intraventricular Hemorrhage ◽  
Low Birthweight ◽  
Very Low Birthweight ◽  
Red Blood Cell Transfusions

scholarly journals Safety of a Restrictive versus Liberal Approach to Red Blood Cell Transfusion on the Outcome of AKI in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial

2019 ◽  
Vol 30 (7) ◽  
pp. 1294-1304 ◽  
Author(s):  
Amit X. Garg ◽  
Neal Badner ◽  
Sean M. Bagshaw ◽  
Meaghan S. Cuerden ◽  
Dean A. Fergusson ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Primary Outcome ◽  
Red Blood Cell Transfusion ◽  
Restrictive Transfusion ◽  
Red Blood Cell Transfusions ◽  
Liberal Approach ◽  
Care Costs ◽  
Care Ward

BackgroundSafely reducing red blood cell transfusions can prevent transfusion-related adverse effects, conserve the blood supply, and reduce health care costs. Both anemia and red blood cell transfusion are independently associated with AKI, but observational data are insufficient to determine whether a restrictive approach to transfusion can be used without increasing AKI risk.MethodsIn a prespecified kidney substudy of a randomized noninferiority trial, we compared a restrictive threshold for red blood cell transfusion (transfuse if hemoglobin<7.5 g/dl, intraoperatively and postoperatively) with a liberal threshold (transfuse if hemoglobin<9.5 g/dl in the operating room or intensive care unit, or if hemoglobin<8.5 g/dl on the nonintensive care ward). We studied 4531 patients undergoing cardiac surgery with cardiopulmonary bypass who had a moderate-to-high risk of perioperative death. The substudy’s primary outcome was AKI, defined as a postoperative increase in serum creatinine of ≥0.3 mg/dl within 48 hours of surgery, or ≥50% within 7 days of surgery.ResultsPatients in the restrictive-threshold group received significantly fewer transfusions than patients in the liberal-threshold group (1.8 versus 2.9 on average, or 38% fewer transfusions in the restricted-threshold group compared with the liberal-threshold group; P<0.001). AKI occurred in 27.7% of patients in the restrictive-threshold group (624 of 2251) and in 27.9% of patients in the liberal-threshold group (636 of 2280). Similarly, among patients with preoperative CKD, AKI occurred in 33.6% of patients in the restrictive-threshold group (258 of 767) and in 32.5% of patients in the liberal-threshold group (252 of 775).ConclusionsAmong patients undergoing cardiac surgery, a restrictive transfusion approach resulted in fewer red blood cell transfusions without increasing the risk of AKI.

scholarly journals Perioperative Changes in Hemoglobin Levels During Major Hepatopancreatic Surgery in Transfused and Non-Transfused Patients

2020 ◽  
pp. 145749692096436
Author(s):  
J.P. Lammi ◽  
M. Eskelinen ◽  
J. Tuimala ◽  
T. Selander ◽  
J. Saarnio ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Cell ◽  
Partial Hepatectomy ◽  
Red Blood Cell ◽  
Total Pancreatectomy ◽  
Trigger Points ◽  
Red Blood Cell Transfusion ◽  
Hepatic Surgery ◽  
Restrictive Transfusion ◽  
Red Blood Cell Transfusions

Background: Several studies have shown that restrictive transfusion policies are safe. However, in clinical practice, transfusion policies seem to be inappropriate. In order to assist in decision-making concerning red blood cell transfusions, we determined perioperative hemoglobin (Hb) levels during major pancreatic and hepatic operations. Methods: Patients who underwent major pancreatic or hepatic resections between 2002 and 2011 were classified into the transfused (TF+) and non-transfused (TF) groups. The perioperative Hb values of these patients were evaluated at six points in time. Results: The study included 1596 patients, of which 785 underwent pancreatodu-odenectomy, 79 total pancreatectomy, and 732 partial hepatectomy. Similar perioperative changes in Hb levels were seen in all patients regardless of whether they received a blood transfusion. In patients undergoing pancreatoduodenectomy and total pancreatectomy, the median of the lowest measured hemoglobin values was 89.2 g/L and in partial hepatectomy patients 92.6 g/L, and these were assumed to be the trigger points for red blood cell transfusion. Conclusion: Despite guidelines on blood transfusion thresholds, restrictive blood transfusion policies were not observed during our study period. After major pancreatic and hepatic surgery, Hb levels recovered without transfusions. This should encourage clinicians to obey the restrictive blood transfusion policies after major hepatopancreatic surgery.

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