Intraoperative transfusion practices in Europe

TY - JOUR

T1 - Intraoperative transfusion practices in Europe

AU - Meier, J

AU - Filipescu, D

AU - Kozek-Langenecker, S

AU - Llau Pitarch, J

AU - Mallett, S

AU - Martus, P

AU - Matot, I

AU - Accurso, G

AU - Adelmann, D

AU - Ahrens, N

AU - Akan, M

AU - Åkeröy, K

AU - Aksoy, O

AU - Alanoglu, Z

AU - Alfredo, M

AU - Alkis, N

AU - Almeida, V

AU - Ekelund, Kim

AU - ETPOS collaborators

N1 - © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - 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). Conclusions: 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.

AB - 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). Conclusions: 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.

KW - Blood Transfusion

KW - Cohort Studies

KW - Europe

KW - Female

KW - Hospitals

KW - Humans

KW - Intraoperative Care

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Journal Article

KW - Observational Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1093/bja/aev456

DO - 10.1093/bja/aev456

M3 - Journal article

C2 - 26787795

SN - 0007-0912

VL - 116

SP - 255

EP - 261

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

IS - 2

ER -