Post-transfusion hemoglobin values and patient blood management

Abstract

Objectives The objective of this retrospective study was to evaluate the added value of communicating post-transfusion hemoglobin values to clinicians as a strategy to improve RBC utilization in a 500-bed hospital. Methods The total number of RBC transfusions, the mean number of RBC units transfused per patient, the mean pre- and post-transfusion hemoglobin values, the ratio of patients transfused and the ratio of patients with a post-transfusion hemoglobin > 10.5 g/dL were calculated per service and per department for six months. The data were reported to each service and compared with the data of the department as peer group. The impact of this communication strategy was evaluated in the following six months. Results In the six months pre-intervention, the mean post-transfusion hemoglobin value was 9.2 g/dL. Post-transfusion hemoglobin was > 10.5 g/dL in 13.4% of patients (112/835). Following communication of these data, RBC consumption decreased 21.0% (p < 0.01) and 21% (p < 0.01) fewer patients received transfusions despite an increase in mean post-transfusion hemoglobin value to 9.4 g/dL (p < 0.01). Conclusion Providing feedback on post-transfusion hemoglobin data and the global consumption of RBC units to prescribing physicians can be an additional, feasible and effective strategy to encourage self-assessment and to improve blood utilization.

Epidemiology and Associated Factors in Transfusion Management in Intensive Care Unit

“…These values are in agreement with the literature: it is estimated that the increase in haemoglobin concentration after the transfusion of a unit of red blood cells is approximately 1 g/dL, but it depends on the volume of the unit of red blood cells and the clinic. In addition, factors such as body mass index, sex, haemoglobin value prior to transfusion or continuous blood loss and diuresis secondary to fluid replacement can modify the Hb level increase [ 48 ]. On the other hand, guided exclusively by the pre-transfusion Hb values, we can think that some of the polytraumatized patients with Hb values above the 75th percentile (Hb > 10.4) could not have received a transfusion if the hospital in which they were treated had had a PBM programme.…”