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Is undertransfusion a problem in modern clinical practice?
Author(s) -
Hibbs Stephen,
Miles David,
Staves Julie,
Murphy Michael F.
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12893
Subject(s) - medicine , clinical practice , blood transfusion , platelet transfusion , medical record , transfusion medicine , intensive care medicine , emergency medicine , pediatrics , platelet , surgery , family medicine
Background Significant progress has been made in reducing inappropriate transfusion of blood products. However, there is also a need to monitor for their underutilization in patients who would benefit from transfusion. This study aimed to develop a method to monitor for undertransfusion and conduct a preliminary examination of whether it is a problem in modern clinical practice. Study Design and Methods All patients with a hemoglobin ( H b) concentration below 6 g/dL or platelet ( PLT ) count of fewer than 10 × 10 9 /L were identified during a 1‐month period in an academic medical center in the U nited K ingdom. Patients who were transfused within 72 hours of the low reading were excluded from further analysis. For all other patients, records were examined against predefined criteria to ascertain whether the reason for nonadministration of transfusion was justified. Results During the study period there were 63 eligible H b readings and 130 eligible PLT counts in 93 patients. Of these, 36 patients were not transfused within 72 hours of the low reading. The majority of nonadministration (n = 28) was justified by either an additional H b or an additional PLT count on repeat sampling being above the transfusion threshold or the transfusion being medically inappropriate. No documentation was found to indicate that any cases of nonadministration of blood were unjustified. Conclusion This study did not find that patients with low H b readings or PLT counts were inappropriately undertransfused. However, systems similar to those described in this study should be developed to monitor for inappropriate undertransfusion as well as continuing efforts to monitor for and reduce inappropriate overtransfusion.