Rational use of blood components — an audit

Abstract

Objectives The present study was designed to study appropriateness of use of the blood components in pediatric and neonatal wards.Design It was an observational study conducted in a tertiary care institute. The patients were selected from various pediatric subsections over a period of six months. Materials and methodsAll the patients below 12 years of age, who received blood components in any of the pediatric subsections including general pediatric wards, pediatric intensive care unit, pediatric hematology section, neonatal intensive care unit and pediatric surgery ward were included in the study. Each transfusion episode was assessed to decide whether it satisfi ed the predetermined criteria.Results Of the total 184 episodes of blood component transfusions, 153 (83.1%) episodes were appropriate and 31 (16.9%) episodes were inappropriate. Among these, fresh frozen plasma transfusions had highest inappropriate [18/41 (58%)] episodes followed by packed red cell transfusions [11/110 (35.5%)] and platelet transfusions [2/5 (6.45%)].There was no inappropriate episode of cryoprecipitate transfusion.Conclusions The present study reinforces the importance of blood audit in the clinical setting. Judicious implementation of guidelines for use of various blood products may help decrease the inappropriate use of blood components.

Blood Component Transfusion in a Tertiary Care Hospital

“…If the child is stable, alternative measures to increase the hemoglobin can be offered thus reducing the risk of transfusion. An Indian study done in pediatric population by Wade et al found 10% inappropriate whereas, similar study done by Bahadur et al had 39% of inappropriate PRBC transfusions [7,8]. Marti-carvajal et al also found 76% appropriate PRBC transfusions in their study which was comparable to present findings [9].…”

“…Eight out of nine inappropriate transfusions were in patients with platelet count of 20,000 with no bleed and most cases were of Dengue and sepsis. Various studies on pediatric blood transfusion audits done have reported 7% to 33% of platelet transfusions to be inappropriate [7,8,11]. The present study also recorded 71.1% appropriate and 28.9% inappropriate FFP transfusions.…”

Prospective observational study for appropriateness of blood and blood components therapy in children up to 16 years of age admitted in a tertiary care hospital

“…In a study by Wade et al, audit on rational use of blood components found 35.5% PRBC transfusions inappropriate in pediatric patients. 17 Makroo et al found 21.4% of PRBC transfusions to be inappropriate. 18 Earlier studies by Hume et al and Mozes et al found 5.9% and 49.6% of PRBC transfusions to be inappropriate respectively.…”

Long-term audit of the use of fresh frozen plasma in a university hospital

“…Numerous publications have highlighted the need for and proven benefit of auditing the use of blood products as a reliable tool to uncover not only their inappropriate use but also to monitor the extent of the compliance with the set guidelines for the use of these products 5, 6, 7, 8, 10, 11, 12. The guidelines that are frequently followed are mostly from regulatory bodies such as the British Committee for Standards in Haematology (BCSH) Guidelines in the United Kingdom, 16 the American College of Pathologists (CAP) and the American Association of Blood Banks (AABB) in the USA 18 .…”

“…A survey of the literature uncovered numerous studies from developing countries on the trend of the use of FFP, showing a continuous reduction in its use. This reduction was generally attributed to the application of guidelines on the transfusion of blood products, the physicians that were educated on the proper use of FFP, and also the emphasis on the fact that no transfusion is completely free from the infectious and non-infectious risks of blood transfusion 1, 5, 6, 7, 8. Nonetheless, the inappropriate use of FFP is still widespread 8, 9, 10, 11, 12.…”