| Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center. | |
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MedLine Citation:
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PMID: 20930965 Owner: NLM Status: PubMed-not-MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients undergoing elective orthopedic surgeries often incur excess blood loss necessitating transfusion. The preoperative placement of blood requests frequently overshoots the actual need resulting in unnecessary crossmatching. AIMS: Our primary goal was to audit the blood utilization in elective orthopedic surgeries in our hospital over a 1-year period and recommend a blood ordering schedule. MATERIALS AND METHODS: A retrospective analysis of patients who underwent elective orthopedic surgeries over a period of 1 year was done. The data collected include patients' age, sex, type of surgical procedure, pre- and postoperative hemoglobin (Hb) levels, number of units crossmatched, returned, transfused, crossmatch to transfusion ratio (C:T), transfusion indices, estimated blood loss for each surgical procedure, and the actual and predicted fall in Hb. We propose a blood ordering schedule based on surgical blood ordering equation. RESULTS AND CONCLUSIONS: A total of 487 patients with a median age of 37±17 years (mean ± standard deviation) were evaluated. One thousand three hundred and seventy-seven units of blood were crossmatched and only 564 units were transfused to 260 patients. Fifty-nine percent of the units crossmatched were not transfused. Six of the 12 elective procedures had a C:T ratio higher than 2.5. Ten of the 12 procedures (83.3%) had a low transfusion index (TI < 0.5). The calculated red blood cell units were less than 0.5 in 5 of the 12 elective procedures, and hence we recommend a group and save policy for these procedures. Blood ordering schedule based on patient and surgical variables would provide an efficient way of blood utilization and management of resources. |
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Authors:
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Arulselvi Subramanian; Kanchana Rangarajan; Sudeep Kumar; Vijay Sharma; Kamran Farooque; Mahesh Chandra Misra |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of emergencies, trauma, and shock Volume: 3 ISSN: 0974-519X ISO Abbreviation: J Emerg Trauma Shock Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-10-08 Completed Date: 2011-07-14 Revised Date: 2012-01-09 |
Medline Journal Info:
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Nlm Unique ID: 101493921 Medline TA: J Emerg Trauma Shock Country: India |
Other Details:
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Languages: eng Pagination: 225-30 Citation Subset: - |
Affiliation:
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Blood Bank & Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, AIIMS, New Delhi, India. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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