RED CELL TRANSFUSION

TRIGGERS USED IN OPERATING ROOM

Abstract

Objective: The purpose of this study was to determine and quantify those factors that anesthetist’s use when deciding to transfuse blood in operating room. Setting: CMH abbottabad Period: Nov to Dec 2008 Design: Survey report. Patients and Methods: Prospective cross-sectional descriptive from operation theatre of Combined Military Hospital Abbottabad a tertiary care hospital. With consent from the local ethics committee, an audit was carried out using a questionnaire designed to examine some of the factors that could be important in the decision-making process surrounding blood transfusion during intermediate and major surgery. Anesthetists were asked to fill in the audit forms and to indicate whether they were going to give blood or not. Fifty two audit forms, completed during intermediate or major surgery, were
analyzed to determine the strengths of certain factors in the decision-making process related to transfusion. Result: Fifty one forms had a satisfactorily complete data set with hemoglobin concentrations Hb between 6.6 and 15.0 g/dL. This study demonstrates that, of the physiological factors, the hemoglobin concentration was the most important factor used for red cell transfusion, and the presence of ongoing bleeding an important contextual factor. Peer pressure to transfuse became apparent at a [Hb] of about 8.5 g/dL. Conclusion: The patients were transfused at the average Hb value of 10.8 g/dL. This average Hb of transfused patients is much higher than current Hb trigger thresholds of 7.0–8.0 g/dL.