Tailoring the Blood Ordering Process for Cardiac Surgical Cases Using an Institution-Specific Version of the Maximum Surgical Blood Order Schedule

Ural, Kelly; Volpi-Abadie, Jacqueline; Owen, Garrett; Gilly, George; Egger, Allison; Scuderi-Porter, Heather

doi:10.1177/1089253215573327

Cited by 12 publications

(7 citation statements)

References 22 publications

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“…Recently, programmed implementation of more restrictive transfusion policies, such as Patient Blood Management (PBM) [28] and Maximum Surgical Blood Order Schedule (MSBOS), would result in a significant reduction in overall consumption of red cells. [29]…”

Section: Discussionmentioning

confidence: 99%

Audit of clinical use of blood products in a tertiary care hospital

Chandrasekar

Balakrishnan

Ponnaiyan

et al. 2021

JHAS

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Objectives: Blood and its components are an important part of patient management treatment protocols and like drugs have property to cause adverse reactions in the recipients. To maximize the effectiveness, safety and utility clinicians and intravenous therapists should be knowledgeable about the potential risk of blood component therapy. Hence, regular audit of blood and its component usage is essential to access the blood utilization pattern and set ideal policies in all the blood using specialties. Material and Methods: This is a prospective Study conducted in department of Transfusion Medicine at Vinayaka Mission Kirupananda Variyar Medical College & Hospital for a period of one year. Source of data was blood bank requisition forms and blood bank registers of patients who underwent elective or emergency procedures in the hospital, for which blood was ordered. Results: The mean age of the study subjects was 41.8 years. The male : female ratio was 1.6 : 1. Majority of the study subjects were in the surgery department followed by Ortho and OBG. Majority of the study subjects belong to B+ve blood group followed by O+ve group and only 20% of the subjects belong to negative blood group. 70% of the subjects required blood transfusion for some kind of surgical intervention and only 28% had required blood transfusion related to medical causes. Majority required four units of PRC transfusion. Majority of the subjects had the haemoglobin levels in the range of 6–7 and the mean level was 6.56 gms%. Majority of the packed red cell was stored for 2 weeks or 5 weeks and the mean duration of storage was 4.3 weeks. A statistical significant improvement was observed in the mean haemoglobin levels in the post-transfusion period compared to the pre-transfusion haemoglobin. Only 5% of the times the reaction related to fever or anaphylaxis had occurred among the entire study subjects. 50% had completed the entire blood transfusion in less than 4 hrs and the mean duration was 4.3 hrs. 65.9% of the patients had appropriate blood transfusion based on the guideline and the remaining 34% had inappropriate blood transfusion. It is inferred from the table that the CTR, transfusion probability and the transfusion index was found to be above the guideline value to be considered as effective blood utilisation. Conclusion: Regular audit of blood components is crucial so that appropriate measures can be taken for proper usage. Continuous medical education regarding the transfusion services for the clinicians and staff nurses have major role in improvement for the clinical transfusion practices in the hospitals.

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Section: Discussionmentioning

confidence: 99%

Audit of clinical use of blood products in a tertiary care hospital

Chandrasekar

Balakrishnan

Ponnaiyan

et al. 2021

JHAS

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“…Tabela 5-Análise do índice de pacientes transfundidos nos procedimentos cirúrgicos realizados no Hospital Ophir Loyola. Estudos sugerem a realização de compatibilização de pelo menos dois concentrados de hemácias (Ural et al, 2016;Moghaddamahmadi et al, 2021), de fato, notou-se, que a maioria dos procedimentos realizados no hospital necessita de cerca de dois concentrados de hemácias (Figura 5). Acredita-se, ainda, que a perda média estimada de sangue na maioria dos procedimentos cirúrgicos seja de 100-600 mL (Sharingcarinkul & Chuasuwan, 2018), o que corresponde em média a um volume comportado normalmente por um a dois concentrados de hemácias.…”

Section: Patologiaunclassified

Análise das reservas cirúrgicas de concentrados de hemácias em um hospital oncológico

Siqueira¹,

Neto

Santos³

et al. 2022

RSD

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O sangue possui um papel fundamental da manutenção da sobrevida de pacientes durante a realização de procedimentos cirúrgicos eletivos. A transfusão de concentrados de hemácias é capaz de corrigir rapidamente o estado anêmico e melhorar a oxigenação, no entanto, sua realização está associada a desfechos adversos. Em pacientes oncológicos está ligada a pior sobrevida e maior risco de recidiva. Dessa forma, buscou-se analisar as reservas de concentrado de hemácias e avaliar o perfil dos pacientes submetidos as cirurgias eletivas, em um hospital oncológico. Foi um estudo do tipo observacional, descritivo com delineamento transversal, com análise de todas as fichas de solicitações de concentrado de hemácias para reserva cirúrgica, com uma amostra de 1386 solicitações. As mulheres e a faixa etária entre 40 e 79 anos foram o público mais transfundido com concentrados de hemácias, as cirurgias eram de grande porte, os setores responsáveis pela maior número de transfusão foram cirurgia oncoabdominal e oncoginecologia, assim como as patologias desses setores câncer de estômago e câncer do colo do útero; procedimentos com excesso de compatibilização foram tratamento cirúrgico para epilepsia, traquelectomia, arteriografia e esplenectomia; a maioria dos procedimentos apresentou um índice de pacientes transfundidos > 10% para os quais é necessário a reserva do hemocomponente, já na análise do Maximal Blood Order Schedule, notou-se que uma ampla gama de procedimentos necessita de duas unidades de concentrados de hemácias. Isso gerou subsídios para estimular o uso racional do sangue na instituição de saúde.

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“…However, recent studies have indicated that about 50% of people undergoing cardiac surgery did not receive any blood units. 5 …”

Section: Introductionmentioning

confidence: 99%

Survey of Maximum Blood Ordering for Surgery (MSBOS) in elective general surgery, neurosurgery and orthopedic surgery at the Poursina Hospital in Rasht, Iran, 2017

Moghaddamahmadi¹,

Khoshrang²,

Khatami

et al. 2021

Hematology, Transfusion and Cell Therapy

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Introduction Blood is a valuable life resource that depends on the donation of blood by the community. As a result, it is crucial that the manner in which this expensive resource is used be correct and reasonable. Objective The purpose of this study was to investigate the Maximum Blood Ordering for Surgery (MSBOS) in general, orthopedic and neurosurgical elective surgeries at the Poursina Hospital in Rasht in 2017. Methods According to the patient file number information, such as gender, age, type of surgery, number of blood units requested, number of cross-matched blood units, number of blood units transfusion, number of patients undergoing transfusion, number of patients who were cross-matched, initial hemoglobin and the underlying disease, was extracted from the HIS (Hospital Information System). Based on the collected data, a descriptive report of the cross-match to transfusion ratio (C/T), transfusion index (TI) and transfusion probability (%T) was performed, using average and standard deviation, by using the SPSS 16. Results In the present study, 914 patients from the neurosurgery, orthopedic and general surgery wards of the Poursina Hospital were studied. Of these, 544 were male (59.5%) and 370 were female (40.5%), aged 1–99 years, with a mean age of 43 years. The frequency distribution of C/T in this study was 1.29 in neurosurgery, 1.95 in orthopedic surgery and 1.96 in general surgery. This study indicated that the C/T index was above the normal standard level in four different kinds of surgery, including leg fracture (2.71), cholecystectomy(2.71), forearm fracture (2.70), and skin graft (2.62).The C/T index was at the maximum normal level in thyroidectomy surgery (2.5). The other surgeries had the normal C/T index. Conclusion Overall, all of the MSBOS indices were at the standard level in this study, although C/T indices were higher than the standard level in the surgeries for cholecystectomy, leg fracture, forearm fracture, hand fracture and skin graft.

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Tailoring the Blood Ordering Process for Cardiac Surgical Cases Using an Institution-Specific Version of the Maximum Surgical Blood Order Schedule

Abstract: Using the gold standard C:tx of >2:1 as an indicator of inappropriate blood utilization, our analysis confirmed that excessive crossmatching occurred for several procedures. Now a subset of cardiac surgical cases only requires a type and screen order prior to surgery.

Cited by 12 publications

References 22 publications

Audit of clinical use of blood products in a tertiary care hospital

Audit of clinical use of blood products in a tertiary care hospital

Análise das reservas cirúrgicas de concentrados de hemácias em um hospital oncológico

Survey of Maximum Blood Ordering for Surgery (MSBOS) in elective general surgery, neurosurgery and orthopedic surgery at the Poursina Hospital in Rasht, Iran, 2017

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