Vnitr Lek 2025, 71(1):E1-E7 | DOI: 10.36290/vnl.2025.013
Analysis of indications for blood components in the Regional Hospital Liberec, as
- 1 Transfuzní oddělení, Krajská nemocnice Liberec, a. s.
- 2 Fakulta zdravotnických studií, Technická univerzita v Liberci
Aim: Correct indications of blood components (BC) are the key to effective and safe haemotherapy. The aim of this study was to evaluate the indication criteria of BC, to compare the changes in BC indications between two periods and to improve the quality of haemotherapy at the Regional Hospital Liberec, as (KNL).
Materials and methods: The study population consisted of all BCs (erythrocytes, platelets, plasma) administered in the KNL in the period from 1 October 2020 to 30 September 2021 and from 1 August 2022 to 31 July 2023. From the database of the laboratory information system, the laboratory results of BC recipients were matched to each BC: haemoglobin (Hb), platelet count, and prothrombin time - ratio (PT-R). These results were matched if they were tested before the administration of the BC within the previous calendar day, i.e., within 48 hours before the issue of the BC.
Results: In 2020/21, 35% of red blood cells, leucocyte-depleted in additive solution (ED) were administered to patients with Hb > 80 g/l, and in 2022/23, 32% of ED. Comparison of mean Hb values revealed no statistically significant difference between the periods (p = 0.61), and the approach to ED indications did not change. In 2020/2021, 29% of platelet BCs were administered to patients with platelet counts > 50 × 109/l, and in 2022/2023, 16% of platelet BCs. Platelet BCs were issued to patients with lower platelet counts in 2022/23 than in 2020/21 (p < 0.001). Whether this was a rationalization of indications or a different patient make-up, cannot be assessed. In 2020/2021, 52% of plasma, fresh frozen (P) was administered to patients with a PT-R ≤ 1.5, and in 2022/2023, 47% of P. When comparing mean PT-R values, there was no statistically significant difference between the evaluated periods (p = 0.45).
Conclusion: The approach to erythrocyte and plasma BC indications was consistent. A more considered approach was taken for plasma BCs for borderline indications, when compared with the literature. For platelet BCs, indications were rationalized or patient make-up was different. In general, BCs were rationally indicated. We will continue to work with the results of the study.
Keywords: analysis, blood components, indications.
Accepted: February 11, 2025; Published: February 18, 2025 Show citation
References
- Doporučení České hematologické společnosti - "Život ohrožující krvácení". [cit. 2024-07-25]. Available from: .
- Doporučení České hematologické společnosti ČLS JEP - "Diagnostika a léčba akutního peripartálního život ohrožujícího krvácení". [cit. 2024-07-25]. Available from: .
- Řeháček V. Indikace podání transfuzních přípravků. In: Řeháček V, Masopust J (eds), et al. Transfuzní lékařství. 1. vyd. Grada Publishing, a.s.: Praha 2013:85-102. ISBN 978-80-247-4534-3.
- Estcourt LJ, Birchall J, Lowe D, et al. Platelet transfusions in haematology patients: are we using them appropriately? Vox Sang. 2012;103(4):284-93. doi: 10.1111/j.1423-0410.2012.01627.x.
Go to original source...
Go to PubMed...
- Edwards J, Morrison C, Mohiuddin M, et al. Patient blood transfusion management: discharge hemoglobin level as a surrogate marker for red blood cell utilization appropriateness. Transfusion. 2012;52(11):2445-51. doi: 10.1111/j.1537-2995.2012.03591.x.
Go to original source...
Go to PubMed...
- Barr PJ, Donnelly M, Cardwell CR, et al. The appropriateness of red blood cell use and the extent of overtransfusion: right decision? Right amount? Transfusion. 2011;51(8):1684-94. doi: 10.1111/j.1537-2995.2011.03130.x.
Go to original source...
Go to PubMed...
- Galuszkova D, Galuszka J. Hemotherapy analysis: the teaching hospital Olomouc in 2006. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007, 151(2):349-351. doi: 10.5507/bp.2007.060.
Go to original source...
Go to PubMed...
- Carson JL, Stanworth SJ, Guyatt G, et al. Red Blood Cell Transfusion: 2023 AABB International Guidelines. JAMA. 2023 21;330(19):1892-1902. doi: 10.1001/jama.2023.12914.
Go to original source...
Go to PubMed...
- Carson JL, Kleinman S. Indications and hemoglobin thresholds for RBC transfusion in adults. [cit. 2024-09-10]. Available from: .
- Hébert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med. 1999 11;340(6):409-17. doi: 10.1056/NEJM199902113400601.
Go to original source...
Go to PubMed...
- Estcourt LJ, Birchall J, Allard S, et al. Guidelines for the use of platelet transfusions. Br J Haematol. 2017; 176(3):365-394. doi: 10.1111/bjh.14423.
Go to original source...
Go to PubMed...
- Blood transfusion, NICE guideline. [cit. 2024-07-25]. Available from: .
- Green L, Bolton-Maggs P, Beattie C, et al. British Society of Haematology Guidelines on the spectrum of fresh frozen plasma and cryoprecipitate products: their handling and use in various patient groups in the absence of major bleeding. Br J Haematol. 2018;181(1):54-67. doi: 10.1111/bjh.15167.
Go to original source...
Go to PubMed...
- Gašová Z. Terapeutické hemaferézy. In: Řeháček V, Masopust J (eds), et al. Transfuzní lékařství. 1. vyd. Grada Publishing, a.s.: Praha 2013:119-134. ISBN 978-80-247-4534-3.
- Triulzi DJ, Jansen N. Seheult JN, et al. Patient blood management. In: Simon TL, Gehrie EA, McCullough J (eds), et al. Rossi's Principles of Transfusion Medicine. Sixth Edition. John Wiley & Sons Ltd.: Hoboken, NJ 2022: 293-305. ISBN 9781119719755.
Go to original source...
- Hunt BJ, Allard S, Keeling D, et al. A practical guideline for the haematological management of major haemorrhage. Br J Haematol. 2015 Sep;170(6):788-803. doi: 10.1111/bjh.13580.
Go to original source...
Go to PubMed...
- Carson JL, Stanworth SJ, Dennis JA, et al. Transfusion thresholds for guiding red blood cell transfusion. Cochrane Database Syst Rev. 2021 Dec 21;12(12):CD002042. Dostupné z DOI: .
Go to original source...
Go to PubMed...