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A REVIEW OF BLOOD TRANSFUSION PRACTICES IN BURNS PATIENTS ATTENDING THE NATIONAL BURNS CENTRE, NEW ZEALAND
Author(s) -
Guiney A.M.,
Stapelberg F. H.,
She R. W.,
Moazzam A.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04914_5.x
Subject(s) - medicine , blood transfusion , red blood cell transfusion , immunosuppression , adverse effect , intensive care unit , total body surface area , red blood cell , packed red blood cells , blood loss , retrospective cohort study , emergency medicine , surgery , intensive care medicine
Purpose: Blood loss and high rates of transfusion in the intensive care unit and burn centre is an area of ongoing concern. Many studies report that patients receiving red blood cell transfusions in the ICU/burn centre setting are more likely to experience complications. Blood use brings the risk of infection, adverse reaction and immunosuppression and more recently evidence for tumour progression. The purpose of this study was to review blood transfusion practices in burns patients attending the national burn centre over a 2 year period and to assess transfusion policies over this timeframe. Methodology: A retrospective chart review from 2006 to 2008 was performed. All patients with >10% total body surface area burns who underwent surgery were included in the study. Variables examined were packed red blood cells transfused during and after surgery, preoperative and postoperative haemoglobin and cross‐match to transfusion ratios. Results: Of the 146 patients reviewed, 79 required multiple transfusions which were administered in the majority of cases via a traditional red blood cell transfusion approach. There was a high cross‐match to transfusion ratio. Conclusion: A traditional blood transfusion policy is administered in this unit however in those patients that were treated using a more restrictive policy, a lower haemoglobin was well tolerated. There is scope for the implementation of a more restrictive transfusion policy.