Red cell transfusion practice following the transfusion requirements in critical care (TRICC) study: prospective observational cohort study in a large UK intensive care unit

Chohan, Sanjiv; McArdle, Fiona; McClelland, D. B. L.; Mackenzie, Simon J; Walsh, Timothy

doi:10.1046/j.1423-0410.2003.00284.x

Cited by 78 publications

(71 citation statements)

References 17 publications

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“…[9][10][11][12][13][14] Nonetheless, surveys on transfusion practices have shown that more than 90% of physicians currently transfuse two RBC units simultaneously showing that they have not yet implemented this new transfusion policy. [15][16][17][18] Since data suggest that single-unit transfusions may considerably reduce the total RBC requirements we changed our policy for hospitalized patients without active bleeding from double-to single-unit RBC transfusions. The current study analyzed the effect of the new RBC transfusion policy with regards to the overall RBC requirements and the transfusion efficiency, the adherence to the transfusion policy, as well as safety aspects including bleeding risk and the number of transfused platelets.…”

Section: Introductionmentioning

confidence: 99%

Significant reduction of red blood cell transfusion requirements by changing from a double-unit to a single-unit transfusion policy in patients receiving intensive chemotherapy or stem cell transplantation

Berger¹,

Gerber²,

Arn³

et al. 2011

Haematologica

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BackgroundTraditionally, single-unit red blood cell transfusions were believed to be insufficient to treat anemia, but recent data suggest that they may lead to a safe reduction of transfusion requirements. We tested this hypothesis by changing from a double-to a single-unit red blood cell transfusion policy. Design and MethodsWe performed a retrospective cohort study in patients with hematologic malignancies receiving intensive chemotherapy or hematopoietic stem cell transplantation. The major end-points were the reduction in the total number of red blood cell units per therapy cycle and per day of aplasia. The study comprised 139 patients who received 272 therapy cycles. Overall 2212 red blood cell units were administered in 1548 transfusions. ResultsDuring the periods of the double-and single-unit policies, one red blood cell unit was transfused in 25% and 84% of the cases and the median number of red blood cell units per transfusion was two and one, respectively. Single-unit transfusion led to a 25% reduction of red blood cell usage per therapy cycle and 24% per aplasia day, but was not associated with a higher outpatient transfusion frequency. In multivariate analysis, single-unit transfusion resulted in a reduction of 2.7 red blood cell units per treatment cycle (P=0.001). The pre-transfusion hemoglobin levels were lower during the single-unit period (median 61 g/L versus 64 g/L) and more transfusions were administered to patients with hemoglobin values of 60 gl/L or less (47% versus 26%). There was no evidence of more severe bleeding or more platelet transfusions during the single-unit period and the overall survival was similar in both cohorts. ConclusionsImplementing a single-unit transfusion policy saves 25% of red blood cell units and, thereby, reduces the risks associated with allogeneic blood transfusions.Key words: red blood cells, transfusion, single-unit, acute leukemia, hematopoietic stem cell transplantation. 2012;97(1)116-122. doi:10.3324/haematol.2011 This is an open-access paper. Citation: Berger MD, Gerber B, Arn K, Senn O, Schanz U, and Stussi G. Significant reduction of red blood cell transfusion requirements by changing from a double-unit to a single-unit transfusion policy in patients receiving intensive chemotherapy or stem cell transplantation. Haematologica

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Section: Introductionmentioning

confidence: 99%

Significant reduction of red blood cell transfusion requirements by changing from a double-unit to a single-unit transfusion policy in patients receiving intensive chemotherapy or stem cell transplantation

Berger¹,

Gerber²,

Arn³

et al. 2011

Haematologica

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“…Acute blood loss following trauma, gas-trointestinal hemorrhage, surgery, among other causes of anemia, are contributing factors for red blood cells transfusion indication in critically ill patients. (4,5) In the last decade, the red blood cells transfusion practice in critically ill patients has been subject to seve ral investigations. Relevant studies in the USA found that the mortality risk increases proportionally to the number of transfused packed red blood cells units, usually above two units.…”

Section: Introductionmentioning

confidence: 99%

Transfusão de concentrado de hemácias na unidade de terapia intensiva

Volpato¹,

Ferreira²,

Ferreira³

et al. 2009

Rev. bras. ter. intensiva

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“…Bu konuyla ilgili pek çok çalışma bildirilmiştir (14)(15)(16)(17)(18)(19)(20)(21)(22) Bilindiği gibi dokulara oksijen sunumu; Hb konsantrasyonu, Hb değerinin saturasyon yüzdesi ve kalp debisine bağlıdır. Oksijen sunumundaki düşüş; dokudaki oksidatif metabolizmayı engeller ve anaerobik metabolizmaya kaymaya neden olur.…”

Section: Discussionunclassified

“…Oksijen sunumundaki düşüş; dokudaki oksidatif metabolizmayı engeller ve anaerobik metabolizmaya kaymaya neden olur. Aktif kanama olmayan hastalarda Hb 7 g/dL'ye kadar tolere edilebilir (15). Son yıllarda hastanın kliniği ile birlikte dokunun oksijen ihtiyacının karşılanmasının esas alınması gerektiği vurgulanmaktadır (22).…”

Section: Discussionunclassified

Uludag University Medical Faculty Research Hospital Emergency Service an Epidemiological Investigation into Blood and Blood Product Transfusion

Esen¹,

Aydın²,

Özdemir³

et al. 2012

JAEM

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Objective: This study was designed prospectively to investigate the demographic data of patients (n=434) who received blood and blood products at the Uludag University Medical Faculty Research Hospital Emergency Service between June 2009 and December 2009. The indications for the blood products used, the amount and the type of products used and the documentation of reactions were investigated and compared with data in the literature. Materials and Methods: 83.0% patients had normal vital parameters, 3.4% had hypotension, 2.1% had tachycardia, 1.1% had fever, 9.7% had hypotension and tachycardia and 0.7% had hypotension, tachycardia and fever. In terms of hemoglobin levels, 40.6% of patients had a level below 7 g/dL, 13.1% were between 7-8 g/dL, 26.7% were between 8-10 g/dL and 19.6% were above 10 g/dL. The patients who were transfused with an erythrocyte suspension were mostly the group who had a hemoglobin level below 7 g/ dL. Platelets were transfused mostly for thrombocytopenia in patients with a platelet count between 10-20 x 10 3 /mm 3 . Results:Of all transfused patients, 3.9% had an acute complication related to transfusion. 1.2% of these were acute febrile non-hemolytic reactions (FNHR), 1.1% were heart failure, 0.9% were allergic reactions and 0.7% were both FNHR and allergic reactions. 76.5% of all transfused patients were discharged from the emergency department, 19.4% were hospitalized, 2.5% were sent to other hospitals and 1.6% died in the emergency department. Conclusion: In light of our findings, it can be seen that many transfusions are performed in the emergency department, transfusion protocols are not normally followed and most transfusions are performed to support the outpatient clinic. (JAEM 2012; 11: 61-7)

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Red cell transfusion practice following the transfusion requirements in critical care (TRICC) study: prospective observational cohort study in a large UK intensive care unit

Cited by 78 publications

References 17 publications

Significant reduction of red blood cell transfusion requirements by changing from a double-unit to a single-unit transfusion policy in patients receiving intensive chemotherapy or stem cell transplantation

Significant reduction of red blood cell transfusion requirements by changing from a double-unit to a single-unit transfusion policy in patients receiving intensive chemotherapy or stem cell transplantation

Transfusão de concentrado de hemácias na unidade de terapia intensiva

Uludag University Medical Faculty Research Hospital Emergency Service an Epidemiological Investigation into Blood and Blood Product Transfusion

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