Re-establishment of Blood Ordering Practice for Elective Surgery

Park, Yongjung; Kim, Moon Jung; Kim, Jin Ju; Kim, Sinyoung; Kim, Jong Hoon; Kim, Hyun Ok

Abstract

BACKGROUND: The amount of blood components "on hold" preoperatively is usually determined by the surgeon's experiences or habits, and is often an amount in excess of the amount actually transfused. This method could diminish the effective use of blood components and result in an excessive workload for the blood bank, a shortage of blood products, and an increase in the quantity of discarded blood products. We quantified the amount of RBC components transfused during surgeries to establish the maximal surgical blood order schedule (MSBOS).
METHODS
We analyzed the number of RBC component units transfused to patients >17 years of age who underwent elective surgeries performed at a university hospital between November 2005 and February 2007.
RESULTS
There were 48,007 elective surgeries performed during the investigated period. The Departments of Surgery, Ophthalmology, Otolaryngology, and Urology carried out 8,317, 7,407, 5,928, and 5,268 surgical cases, respectively. The MSBOS values for 60 types of surgeries categorized into 7 surgical fields are listed.
CONCLUSION
In the current study, we analyzed a greater number of surgical cases than previous studies in an effort to generate accurate and practical data. The mean amount of transfused RBC units was less in most types of surgeries compared to previous studies; this finding is presumed to be the result of improvements in surgical techniques and advances in medical science. A regular and comprehensive revision of the MSBOS is required to correspond to the changes in the medical environment and the shifting characteristics of patients, and to maximize the utility of blood products. A committee to supervise transfusion practices is also essential to coordinate different policies of the laboratory, surgical,and anesthesiology departments.