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

Seminars in Cardiothoracic and Vascular Anesthesia
Kelly Graham UralHeather Scuderi-Porter

Abstract

Background. Excess ordering of blood products for surgical cases is expensive and wasteful. Evidence has shown that institution-specific versions of the Maximum Surgical Blood Order Schedule (MSBOS) lead to better ordering practices. Most MSBOSs recommend a crossmatch for a minimum of 2 units of packed red blood cells (PRBCs) for cardiac surgical cases; however, studies have shown that >50% of these patients receive no transfusions. Our aim was to create a blood order algorithm for cardiac surgical cases that would decrease unnecessary crossmatching. Methods. Retrospective data was collected for 264 patients from January 2011 through April 2012. The crossmatch-to-transfusion ratio (C:tx), transfusion probability (%T), and transfusion index (TI) were calculated for each type of procedure. Results. All 264 patients were crossmatched and 98 patients were transfused, resulting in an overall transfusion probability (%T) of 37.12% (95% confidence interval 31.52-43.09). A total of 1175 units of blood were crossmatched, but only 370 units of blood were transfused, resulting in a C:tx of 3.17 (95% confidence interval 2.61-4.03). The average number of units transfused per procedure (transfusion index) was 1.40. C:tx was highest and TI wa...Continue Reading

References

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Citations

Jun 28, 2015·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Abdel Galil M Abdel GaderMotasim Badri
May 24, 2018·Seminars in Cardiothoracic and Vascular Anesthesia·Kelly UralMariella Gastañaduy
Dec 5, 2018·Acta Clinica Belgica·Amir ShamshirianSoheil Azizi
Feb 16, 2019·Seminars in Cardiothoracic and Vascular Anesthesia·J Mauricio Del RioMiklos D Kertai

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Methods Mentioned

BETA
coronary artery bypass

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