Knowledge of appropriate blood product use in perioperative patients among clinicians at a tertiary hospital

Background: Blood products are an expensive and scarce resource with inherent risks to patients. The current knowledge of rational blood product use among clinicians in South Africa is unknown.Purpose of research: To describe the level of clinicians' knowledge related to all aspects of the ordering and administration of blood products from the South African Blood Services for peri-operative patients at a tertiary hospital.Method: A self-administered survey was distributed to 210 clinicians of different experience levels from the departments of Anaesthesiology, General Surgery and Trauma, Orthopaedic Surgery and Obstetrics and Gynaecology at the study hospital. The questions related to risks, cost, ordering procedures and transfusion triggers for red cell concentrate (RCC), fresh frozen plasma (FFP) and platelets.Results: A total of 172 (81.90%) surveys were returned. The overall mean for correctly answered questions was 16.76 (±4.58). The breakdown by specialty was: Anaesthesiology 19.98 (±3.84), General Surgery and Trauma 16.28 (±4.05), Orthopaedic Surgery 13.83 (±4.17) and Obstetrics and Gynaecology 15.63 (±3.51). Anaesthesiology performed better than other disciplines (p < 0.001) and consultants out-performed their junior colleagues (p < 0.001). Seventy percent correctly identified triggers for RCC transfusion and 50% for platelets. Administration protocols were correctly defined by 80% for RCC and FFP just over 50% for platelets. Thirty eight percent of respondents deemed infectious and non-infectious risk sufficient to obtain informed consent. Knowledge of costs and ordering was below 30%.Conclusion: Clinician's knowledge of risks, resources, costs and ordering of blood products for perioperative patients is poor. Transfusion triggers and administration protocols had an acceptable correct response rate.

Download Full-text

Predictive Factors for High Blood Product Use in Patients with Acute Stanford Type A Dissection

10.1055/s-0040-1705504 ◽

2020 ◽

Author(s):

M. J. Schafigh ◽

M. Hamiko ◽

W. Schiller ◽

H. Treede ◽

C. Probst

Keyword(s):

Predictive Factors ◽

Blood Product ◽

Type A ◽

Product Use ◽

Type A Dissection

Download Full-text

Faculty Opinions recommendation of Blood product use in trauma resuscitation: plasma deficit versus plasma ratio as predictors of mortality in trauma (CME).

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13091956.14415058 ◽

2011 ◽

Author(s):

Mike Murphy ◽

Nikki Curry

Keyword(s):

Blood Product ◽

Trauma Resuscitation ◽

Plasma Ratio ◽

Predictors Of Mortality ◽

Product Use

Download Full-text

Abnormal Calcium Levels During Trauma Resuscitation Are Associated With Increased Mortality, Increased Blood Product Use, and Greater Hospital Resource Consumption

Anesthesia & Analgesia ◽

10.1213/ane.0000000000002312 ◽

2017 ◽

Vol 125 (3) ◽

pp. 895-901 ◽

Cited By ~ 19

Author(s):

Emily J. MacKay ◽

Michael D. Stubna ◽

Daniel N. Holena ◽

Patrick M. Reilly ◽

Mark J. Seamon ◽

...

Keyword(s):

Blood Product ◽

Resource Consumption ◽

Hospital Resource ◽

Trauma Resuscitation ◽

Product Use

Download Full-text

The Impact of Perioperative Viscoelastic Test Application on Blood Product Usage and Outcome in Cardiac Surgery; Regional Cardiac Surgery Center Experience

Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society ◽

10.5222/gkdad.2021.78557 ◽

2021 ◽

Author(s):

Murat Aksun ◽

Saliha Aksun ◽

Mehmet Ali Çoşar ◽

Elif Neziroğlu ◽

Senem Girgin ◽

...

Keyword(s):

Cardiac Surgery ◽

Clinical Experience ◽

Heart Surgery ◽

Blood Product ◽

Open Heart Surgery ◽

Control Group ◽

Open Heart ◽

Blood Products ◽

Product Use ◽

The Impact

Objective: Thromboelastography (TEG) is a diagnostic modality that gives information about coagulation. Despite all blood-preserving precautions in open heart surgery there are blood losses and the use of blood and blood products becomes inevitable. TEG is mostly not available in every center and habits, trends and clinical experience in blood use create the possibility of causing unnecessary use of blood and blood products. In this study, it was aimed to determine the effect of the use of thromboelastography on the use of blood and blood products in cardiac surgery. Methods: Two hundred patients between 18-70 years old who underwent open heart surgery were included in the study. After the cardiopulmonary bypass (CPB), the cases were confirmed to have an Activated Clotting Time (ACT) value in the range of 120-150 sec after protamine administration. In 100 patients in the TEG group, the coagulation status was evaluated with TEG and it was decided how to apply blood and blood product use. Blood and blood product use was applied to 100 patients in the control group based on clinical experience and foresight. The total amount of blood and blood product used, fluid balance, need for inotropics, mechanical ventilator time, complications, duration of intensive care and discharge times were recorded. Results: Use of Fresh Frozen Plasma (FFP) at the after CPB in the TEG group was statistically significantly lower than that of the control group FFP (p<0.05). Postoperative FFP and postoperative platelet use in the study group were statistically significantly lower than in the postoperative FFP and postoperative platelet values of the control group (p <0.05). Conclusion: The use of thromboelastography is a very useful monitoring in terms of reducing FFP use after CPB and reducing FFP and platelet usage in the postoperative period. In this way, the unnecessary use of blood and blood products can be prevented.

Download Full-text

Comparison of blood product use and costs with use of 3-factor versus 4-factor prothrombin complex concentrate for off-label indications

American Journal of Health-System Pharmacy ◽

10.2146/ajhp180076 ◽

2018 ◽

Vol 75 (15) ◽

pp. 1103-1109 ◽

Cited By ~ 3

Author(s):

Jessica DeAngelo ◽

Daniel H. Jarrell ◽

Richard Cosgrove ◽

James Camamo ◽

Christopher J. Edwards ◽

...

Keyword(s):

Prothrombin Complex Concentrate ◽

Blood Product ◽

Factor Versus ◽

Off Label ◽

Product Use

Download Full-text

Blood product support

Oxford Handbook of Cancer Nursing ◽

10.1093/med/9780198569244.003.0039 ◽

2007 ◽

pp. 501-510

Keyword(s):

Blood Product ◽

Intensive Chemotherapy ◽

Blood Products ◽

Product Use ◽

Remission Rates ◽

Nurses Role ◽

British Committee

Blood products 502 The nurses' role in blood product transfusions 508 The introduction of safe, reliable blood products has enabled the development of intensive chemotherapy programmes for a variety of malignancies. This has led to significantly improved remission rates. It must be remembered however that blood product use is not without risks, and that these are a very expensive resource. The pool of acceptable donors is also diminishing because of more stringent screening. Blood products should only be used in appropriate situations in consultation with national and local guidelines. (See British Committee for Standards in Haematology, BCSH...

Download Full-text