Abstract
Objective:The hemoglobin (Hb) content of packed red blood cells (pRBCs) differs in standard volume units. The pRBC transfusions are based on the number of units routinely. We aimed to use pRBCs according to total Hb content and compare the rates of achieving the target Hb concentration levels with the current transfusion practice.Materials and Methods:Eighty-nine patients (55 males and 34 females) with median age of 46 years (range: 19-75) were enrolled, and of 178 transfusion episodes, 92 were randomized to the Hb content based-study group and 86 to the unit-based control group. Fifty-one patients were evaluated by 1 and rest of the patients by ≥2 episodes (median: 3; range: 1-7). Suitable pRBCs were detected by the Hemosoft Blood Banking Management & Information System. In the Hb content-based study group, to reduce the number of units, the required Hb was calculated by recipients’ height, weight, and Hb levels. When no appropriate units could be found within the inventory, the actual ordered number of units was sent to clinics, as was done for the control group.Results:In the study group totally, 38 units of pRBCs were transfused with a reduction of 19.8% (38/192) from the original order. The success of finding the matched Hb content was statistically increased with low weight and height and high pRBC storage. The Hb content of transfused pRBC units was significantly higher in the study group than the control group. The ratio of achieving the target Hb level was statistically similar in the control and study group (p=0.125), the successful and unsuccessful group (p=0.325), and the control and unsuccessful group (p=0.438). The relation between the shelf-life of the pRBC units and the rate of achieving the target Hb level was found to be similar between groups (p=0.782).Conclusion:The number of pRBC transfusions can be minimized since we clearly demonstrated that the efficacy of Hb content-based transfusion is similar to that of unit-based transfusion.
Highlights
Packed red blood cell concentrates are the major blood components transfused in routine medical practice
The number of packed red blood cells (pRBCs) transfusions can be minimized since we clearly demonstrated that the efficacy of Hb content-based transfusion is similar to that of unit-based transfusion
A total of 178 transfusion episodes occurred in 89 patients, which were randomized into a control group and a study group (Hb content-based, n=92)
Summary
Packed red blood cell (pRBC) concentrates are the major blood components transfused in routine medical practice. The total Hb content of the units does not represent homogeneity due to different Hb concentration levels of donors, Hb losses during component preparation processes (buffy coat isolation, leukofiltration), and storage. It has generally been accepted for many years that pRBC transfusions should be based on the Hb content of the product, instead of units, for practical reasons this has been implemented in few studies [2,3]
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