Intraoperative transfusion practices in Europe

J Meier, D Filipescu, S Kozek-Langenecker, J Llau Pitarch, S Mallett, P Martus, I Matot, ETPOS collaborators, Kim Ekelund (Member of study group)

44 Citations (Scopus)

Abstract

BACKGROUND: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe.

METHODS: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013.

RESULTS: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl(-1) and increased to 9.8 (1.8) g dl(-1) after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2).

CONCLUSION: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl(-1)), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold.

CLINICAL TRIAL REGISTRATION: NCT 01604083.

Original languageEnglish
JournalBritish Journal of Anaesthesia
Volume116
Issue number2
Pages (from-to)255-61
Number of pages7
ISSN0007-0912
DOIs
Publication statusPublished - Feb 2016

Keywords

  • Blood Transfusion
  • Cohort Studies
  • Europe
  • Female
  • Hospitals
  • Humans
  • Intraoperative Care
  • Male
  • Middle Aged
  • Prospective Studies
  • Journal Article
  • Observational Study
  • Research Support, Non-U.S. Gov't

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