Assessment of the urgency and deferability of transfusion to inform emergency blood planning and triage: the Bloodhound prospective audit of red blood cell use

Shortt, Jake; Polizzotto, Mark N.; Waters, Neil; Borosak, Marija; Moran, Martine; Comande, Mary; Devine, Alexandra; Jolley, Damien; Wood, Erica M.

doi:10.1111/j.1537-2995.2009.02305.x

Cited by 45 publications

(45 citation statements)

References 17 publications

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“…This in itself poses a danger, as the risks of homologous blood transfusion cannot be over emphasized. [1234] Measures to minimize intra-operative blood loss including optimal preoperative physiological status, use of appropriate surgical approach, gentle and delicate tissue dissection, surgical expertise, rational use of electrocautery, and others should be employed during this procedure.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of intra- and post-operative blood loss in total hip arthroplasty at the national orthopaedic hospital, Lagos

Ugbeye¹,

Lawal²,

Ayodabo³

et al. 2017

Niger J Surg

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Background:Severe hip pain with associated significant functional limitation is the major indication for total hip replacement, a rewarding and gratifying procedure. However, significant blood loss can occur in the intra- and post-operative periods, posing a major challenge and necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this study was to evaluate blood loss after primary total hip replacement, and to determine the effect of surgical time on blood loss.Patients and Methods:A prospective study of blood loss after total hip arthroplasty in 41 patients. All cases were primary total hip arthroplasty done by one surgeon. Intra- and post-operative blood losses were recorded in two groups of patients (surgical time <2 h and surgical time >2 h), and the effect of these on blood loss was evaluated.Results:The mean intra- and post-operative blood losses were 1222.7 ml and 574.3 ml, respectively. These showed a strong positive correlation with total blood loss (r = 0.790, P < 0.001 and r = 0.517, P < 0.001). Higher intra- and post-operative blood losses were recorded in patients with surgical time >2 h, with a significant difference on postoperative days 2 and 3 (P = 0.003 and P = 0.014, respectively).Conclusion:Blood loss in total hip replacement is an important factor and may be influenced by a shorter surgical time.

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Section: Introductionmentioning

confidence: 99%

An evaluation of intra- and post-operative blood loss in total hip arthroplasty at the national orthopaedic hospital, Lagos

Ugbeye¹,

Lawal²,

Ayodabo³

et al. 2017

Niger J Surg

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“…It is associated with mortality, morbidity and increased costs (Campbell et al, 2015), and accounts for a substantial proportion of red blood cells (RBCs) transfusedapproximately 12% in an Australian study from our group (Shortt et al, 2009). It is associated with mortality, morbidity and increased costs (Campbell et al, 2015), and accounts for a substantial proportion of red blood cells (RBCs) transfusedapproximately 12% in an Australian study from our group (Shortt et al, 2009).…”

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confidence: 99%

Fibrinogen concentration and use of fibrinogen supplementation with cryoprecipitate in patients with critical bleeding receiving massive transfusion: a bi‐national cohort study

et al. 2017

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We aimed to compare hypofibrinogenaemia prevalence in major bleeding patients across all clinical contexts, fibrinogen supplementation practice, and explore the relationship between fibrinogen concentrations and mortality. This cohort study included all adult patients from 20 hospitals across Australia and New Zealand who received massive transfusion between April 2011 and October 2015. Of 3566 patients, 2829 (79%) had fibrinogen concentration recorded, with a median first and lowest concentration of 2·0 g/l (interquartile range [IQR] 1·5-2·7) and 1·8 g/l (IQR 1·3-2·4), respectively. Liver transplant (1·7 g/l, IQR 1·2-2·1), trauma (1·8, IQR 1·3-2·5) and vascular surgery (1·9 g/l, IQR 1·4-2·5) had lower concentrations. Total median fibrinogen dose administered from all products was 7·3 g (IQR 3·3-13·0). Overall, 1732 (61%) received cryoprecipitate and 9 (<1%) fibrinogen concentrate. Time to cryoprecipitate issue in those with initial fibrinogen concentration <1 g/l was 2·5 h (IQR 1·2-4·3 h). After adjustment, initial fibrinogen concentration had a U-shaped association with in-hospital mortality [adjusted odds ratios: fibrinogen <1 g/l, 2·31 (95% confidence interval (CI) 1·48-3·60); 1-1·9 g/l, 1·29 (95% CI 0·99-1·67) and >4 g/l, 2·03 (95% CI 1·35-3·04), 2-4 g/l reference category]. The findings indicate areas for practice improvement including timely administration of cryoprecipitate, which is the most common source of concentrated fibrinogen in Australia and New Zealand.

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“…TKA can result in substantial perioperative blood loss, rendering patients at increased risk of requiring allogenic blood transfusion12). Total knee and hip arthroplasty and fracture surgery is the number one reason for transfusion in patients undergoing surgery and accounts for 9.8% of all transfused red blood cell units3). Complications of allogenic blood transfusion include the risk of disease transmission, hemolytic reaction, fluid and hemodynamic overload, acute lung injury, coagulopathy, allergic reaction and febrile non-hemolytic reaction4).…”

Section: Introductionmentioning

confidence: 99%

Blood Management Strategies in Total Knee Arthroplasty

Liu¹,

Dan

Martos³

et al. 2016

Knee Surg Relat Res

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A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods and can be employed in various combinations. Recent literature has highlighted the importance of preoperative Hb optimization, minimizing blood loss and evidence-based transfusion guidelines. Given TKA is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal.

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Assessment of the urgency and deferability of transfusion to inform emergency blood planning and triage: the Bloodhound prospective audit of red blood cell use

Abstract: The majority of RBCs are transfused with a high degree of clinical urgency, with only a minor proportion required to support elective surgery.

Cited by 45 publications

References 17 publications

An evaluation of intra- and post-operative blood loss in total hip arthroplasty at the national orthopaedic hospital, Lagos

An evaluation of intra- and post-operative blood loss in total hip arthroplasty at the national orthopaedic hospital, Lagos

Fibrinogen concentration and use of fibrinogen supplementation with cryoprecipitate in patients with critical bleeding receiving massive transfusion: a bi‐national cohort study

Blood Management Strategies in Total Knee Arthroplasty

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