Document Detail


Removing the Need for Crossmatched Blood in Elective EVAR.
MedLine Citation:
PMID:  22182351     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The unit cost for crossmatching blood is £137.22 (€158.94). A maximum surgical blood order schedule for elective EVAR does not exist. We studied the crossmatch to transfusion ratio in our series to establish this recommendation. MATERIALS AND METHODS: A single centre retrospective study of consecutive EVAR cases between October 2001 and December 2010. Blood loss, units transfused and indication for transfusion per case were analysed. RESULTS: 203 elective EVAR cases were studied. Median blood loss was 200 ml with a mean of 288 ml (range 50-8400 ml). A total of twelve patients (6%) required blood transfusion. Six cases (3%) for postoperative Hb <8 g/dL and three patients (1.5%) for medical complications. Three patients required a massive transfusion; two had peri-procedural haemorrhage and one patient developed a large groin haematoma. The crossmatch to transfusion ratio was 11.1. CONCLUSIONS: The maximum surgical blood order for elective EVAR should be a group and save (type and screen) sample because of the high crossmatch to transfusion ratio. Intraoperative transfusion is rarely required (<1%) but often necessitates large transfusion quantities. In this circumstance each hospital is required to have an emergency protocol to manage massive blood loss. Applying these principles across all surgical specialities may lead to significant financial savings, improve efficiency and reduce wastage.
Authors:
K Mann; I Sim; T Ali; P Chong; P Leopold; A Hatrick; D Gerrard
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-17
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  -     ISSN:  1532-2165     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Frimley Park Hospital NHS Foundation Trust, Portsmouth Road, Frimley, Surrey GU16 7UJ, UK.
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