IJCRR - 7(22), November, 2015
Pages: 01-07
UTILISATION OF BLOOD COMPONENTS IN A TERTIARY CARE HOSPITAL
Author: Mohammad Zubair Qureshi, Vijay Sawhney, Humiara Bashir, Meena Sidhu, Peer Maroof
Category: Healthcare
[Download PDF]
Abstract:
Background: Transfusion of blood components such as Packed Red Cell (PRC), Fresh Frozen Plasma (FFP) and platelet concentrates (PC) play an important role as a supportive therapy. This study was performed to study the utilisation and appropriateness of blood components in clinical practice at a tertiary care hospital–based blood bank at GMC, Jammu. Materials and Methods: A prospective analysis of blood components was conducted over a period of one year from November 2012 to October 2013. The usage of different types of blood component were recorded and correlated with the patient’s diagnosis and indications for transfusion. The appropriate use of blood components were assessed by DGHS guidelines. Results: Of the total 17634 units of blood components issued over a period of 1 year, 58.14% were Packed Red Cells (PRC), 29.43% were Fresh Frozen Plasma (FFP), 12.25% were Platelet Concentrate (PC) and 0.18% were Cryoprecipitate. The appropriate use of Packed Red Cells was 90.33% whereas inappropriate use was 9.67%. Inappropriate use of PRC was mostlyseen in patients with minor bleeding without significant changes in hemoglobin level and in patients with asymptomatic chronic anemia with Hb > 7g/dl. For Fresh Frozen Plasma 80.66% usage was appropriate and 19.34% were used inappropriately. Use of FFP for volume expansion was the most frequent form of inappropriate use followed by cases of bleeding without derang of coagulation tests. For Platelet Concentrate 93.29% transfusions were utilized appropriately and 6.71% inappropriately. Inappropriate use of PC was mostly seen in patients who had received platelets prophylactically with platelet count above 10,000/μl. Conclusion: Periodic review of blood component usage is very important to access the blood utilization pattern and judicious implementation of guidelines for use of blood components would decrease their inappropriate use.
Keywords: Packed red cell, Platelet concentrates, Fresh frozen plasma, Appropriate
Citation:
Mohammad Zubair Qureshi, Vijay Sawhney, Humiara Bashir, Meena Sidhu, Peer Maroof. UTILISATION OF BLOOD COMPONENTS IN A TERTIARY CARE HOSPITAL International Journal of Current Research and Review. 7(22), November, 01-07
References:
1. Luk C et al. Prospective audit of the use of fresh-frozen plasma. Based on Canadian Medical Association transfusion guidelines. Canadian Medical Association Journal, 2002; 166:1539–1540.
2. Dushyant Singh Gaur, Gita Negi, Neena Chauhan, et al. Utilization of blood and components in a tertiary care hospital. Indian Journal of Hematology and Blood Transfusion. 2009; 25(3):91- 95.
3. Alving B, Alcorn K. How to improve transfusion medicine, a treating physician’s perspective. Arch Path Med 1999; 123:492– 5.
4. Zimmerman R, Buscher M, Linhardt C, et al. A survey of blood Component use in a German university hospital Transfusion 1997; 37:1075-1083.
5. Hawkins TE, Carter JM, Hunter PM. Can mandatory post transfusion approval programme be improved Transfusion Medicine 1994; 4: 45-50.
6. Joshi GP et al. Audit in transfusion practice. 19. Journal of Evaluation in Clinical Practice, 1998, 4:141–146.
7. Cheng G, Wong HF, Chan A, et al. The effects of a self-educating blood component request form and enforcements of transfusion guidelines on FFP and platelet usage. Clin Lab Haem 1996; 18: 83-87.
8. Metz J, McGrath KM, Copperchini ML, et al, Appropriateness of transfusion of red cells, platelets and fresh frozen plasma. An audit in a tertiary care teaching hospital. Med J Aust. 1995; 162:572–3.
9. Mozes B, Epstein M, Ben Bassat I, et al. Evaluation of appropriateness of blood and blood products transfusion using present criteria Transfusion 1989; 29: 473-476.
10. Tinmouth A, MacDougall L, Fergusson D, et al. Reducing the amount of blood transfused. Arch Intern Med. 2005; 165:845– 52.
11. Greene E, McCullough J, Weisdrof D. Platelet utilization and the transfusion trigger: A prospective analysis. Transfusion 2007; 47:201-205.
12. Blumberg N, Laczin J, Mellican A, et al. A critical survey of fresh-frozen plasma use. Transfusion 1986; 26: 511-513.
13. Makroo RN, Raina V, Kumar P, et al. A prospective audit of transfusion requests in a tertiary care hospital for the use of fresh frozen plasma Asian Journal of Transfusion Science 2007; (1)2: 59-61.
14. Pratibha R, Jayaranees S, Ramesh JC, et al. An audit of fresh frozen plasma Usage in a tertiary referral centre in a developing country Malays J.Pathol 2001; 23: 41-46.
15. Chaudhary R, Singh H, Verma A, et al. Evaluation of fresh frozen plasma usage at tertiary Care hospital in north India ANZ. J. Surgery 2005; 75: 573-576.
16. Kakkar N, Kaur R and Dhanoa J. Improvement in fresh frozen plasma /transfusion transfusion practice: results of an outcome audit. Transfus Med 2004; 14:231-5.
17. Schofield WN, Rubin GL, Dean MG. Appropriateness of platelet, fresh frozen plasma and cryoprecipitate transfusion in New South Wales public hospitals. Med J Aust 2003; 178:117-21.
18. Beloeil H, Brosseau M,Benhamou D. Transfusion of fresh frozen plasma (FFP): audit of prescriptions. Ann Fr Anesth Reanim 2001; 20: 686-92.
19. Hameedullah, Khan FA and Kamal RS. Improvement in intra operative fresh frozen plasma transfusion practice-impact of medical audits and providing education. J Pak Med Assoc 2000; 50:253-6.
20. Makroo RN, Mani RK, Raina V, et al. Use of blood components in critically ill patients in the medical intensive care unit of a ter- tiary care hospital. Asian J Transfus Sci. 2009 July; 3(2): 82–85.
21. Estcourt LJ, Stanworth SJ, Murphy MF. Platelet transfusions for patients with haematological malignancies: who needs them? Br J Haematol 2011; 154(4):425–40.
22. Estcourt L.J, Birchall J, Lowe D. Platelet transfusions in haematology patients: are we using them appropriately? Vox Sanguinis a International Society of Blood Transfusion 2012; 10:1-10.
23. Schiffer CA. Prophylactic platelet transfusion. Transfusion 1992; 32: 295-8.
24. Slichter SJ. Controversies in platelet transfusion therapy. Annu Rev Med 1980; 3 1: 509-40.
25. Wallace EL, Churchill WH, Surgenor DM, et al. Collection and transfusion of blood and blood components in the United States, 1994. Transfusion 1998; 38:625-36.
26. Freireich EJ. Supportive care for patients with blood disorders. Br J Haematol 2000; 111:68-77.
|