Use of red blood cells concentrates at the General Hospital of Mexico

BackgroundBlood transfusion is a valuable therapeutic tool for massive bleeding in spite of inherent risks and makes the difference between life and death. Rational use of blood components and particularly of red blood cells concentrates (RBC) request for surgery could minimize the transfusional reactions and financial burden for blood banks.ObjectiveTo know the transfusion practice and the relationship between the request and use of RBC in programmed surgeries at the General Hospital of Mexico.Materials and methodsA retrospective study was conducted and data analysis based in the number of RBC units required from the blood bank were compared with the number of RBC units transfused. Medical records, surgical notes, anesthesia worksheets, nursing and laboratory reports from a 6 months period, were reviewed.ResultsDuring the studied period, 354 RBC were requested from the blood bank from different surgical specialties; with a total of 680 units. From these only 63 (9.2%) were transfused vs 617 (90.7%) that were not used and were returned to the blood bank.ConclusionsRBC requests were excessive compared to the real demand; this represents inadequate blood requests and elevated costs for the blood bank and the health system. There is a need to promote strategies through the institutional Transfusion Medicine Committee.

ResumenAntecedentesLa transfusión sanguínea es una herramienta terapéutica valiosa para la hemorragia masiva; a pesar de sus riesgos, marca la diferencia entre la vida y la muerte. La solicitud racional de los concentrados eritrocitarios en cirugía, podría reducir al mínimo las reacciones transfusionales y el gasto financiero para los bancos de sangre.ObjetivoConocer la práctica transfusional y la relación entre la solicitud y el uso de sangre en cirugías programadas del Hospital General de México.Material y métodosSe realizó un estudio retrospectivo y análisis de datos basado en el número de unidades de sangre requeridas al banco de sangre comparándolas con el número de unidades transfundidas. Se revisaron notas médicas y quirúrgicas, hojas de anestesia y reportes de enfermería y laboratorio, en un periodo de 6 meses.ResultadosSe analizaron 354 solicitudes de concentrado eritrocitario al banco de sangre; lo que equivale a un total de 680 unidades. De esta cifra, sólo 63 (9.2%) unidades se transfundieron y 617 (90.8%) que no se utilizaron y fueron devueltas al banco de sangre.ConclusionesLa solicitud de concentrados eritrocitarios fue excesiva en relación a la demanda real requerida; esto representa una inadecuada solicitud de sangre y costos elevados tanto para el banco de sangre como para el sistema de salud. Es necesario promover estrategias a través del Comité de Medicina Transfusional institucional.