Effects of a More Restrictive Transfusion Trigger in Trauma Patients

Since the Transfusion Requirements in Critical Care trial, studies have shown that acutely ill patients can drift as a low as 5 g/dL. This study reviews a transfusion trigger change to 6.5 g/dL, which we hypothesize will conserve resources and improve quality of care. This is a retrospective chart r...

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Bibliographic Details
Published in:The American surgeon 2019-04, Vol.85 (4), p.409-413
Main Authors: Garland-Kledzik, Mary, Gaffley, Michaela, Crouse, David, Conrad, Collin, Miller, Preston, Martin, R. Shayn
Format: Article
Language:English
Subjects:
Adult
Aged
Anemia
Blood transfusion
Blood Transfusion - standards
Blood transfusions
Clinical Protocols
Critical care
Critical Care - methods
Critical Care - standards
Female
Hemoglobin
Humans
Male
Middle Aged
Mortality
Patients
Practice Guidelines as Topic
Resource utilization
Retrospective Studies
Transfusion
Trauma
Trauma centers
Treatment Outcome
Ventilators
Wounds and Injuries - therapy
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Summary:Since the Transfusion Requirements in Critical Care trial, studies have shown that acutely ill patients can drift as a low as 5 g/dL. This study reviews a transfusion trigger change to 6.5 g/dL, which we hypothesize will conserve resources and improve quality of care. This is a retrospective chart review at an urban Level I trauma center from January through December 2015 after our trauma service changed the transfusion trigger from 7 to 6.5 g/dL. Outcomes in patients before (TT7) and after (TT6.5) the change in transfusion threshold were then compared. One hundred thirty-one discrete patients were included in this trial, with 285 instances of a hemoglobin of 7 g/dL or less and 178 transfusions. Seventy-two patients were before the change in threshold and 59 after. There was no change in length of hospital stay, ICU stay, ventilator days, mortality, and organ system failure after change in the transfusion threshold. After initiation of a more conservative threshold, 72 units of blood were saved. Decreased transfusion threshold was associated with no worse outcomes associated with decreased resource utilization.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481908500433