Where did my O units go? Assessing a Month of O RBC Utilization in a Level 1 Trauma Center

Abstract

Abstract Introduction/Objective The availability of red blood cells (RBCs) can be unpredictable and influenced by various factors affecting inventory levels. Anticipating future requirements can prove difficult, particularly in medical facilities catering to both trauma and chronically ill patients. By analyzing the fluctuation in blood indications, we can improve our planning and promote the responsible use of O RBCs. Methods/Case Report O units transfused in December 2023 in a level 1 trauma center were reviewed for transfusion indication, which was categorized into symptomatic anemia (SA), bleeding, sickle cell-related transfusion (SCRT), and surgery-related transfusion (SRT). Results (if a Case Study enter NA) During this month, our institution transfused 320 O units, of which 79% (254/320) were D positive. Most RBCs were given to patients with bleeding (43%,136/320) and SA (36%, 115/320). About half of the units used for acutely bleeding patients had massive transfusion protocol (MTP) activated (48%, 51/105), with 2/3 of those units used for trauma patients. Because most of our patients are African Americans, SCRT was also evaluated. Only 17/320(5%) of the units were given to our sickle cell disease patients. Lastly, we evaluated SRT because of our busy surgical service. We noted that 46 (14%) are SRT units, with 20% used prophylactically on the same admission and 50% used post-operatively. Conclusion It’s important to note that while patients with acute bleeding can cause a sudden depletion in the blood supply, patients with chronic anemia and bleeding can still make up a significant portion of those who require RBCs in a level 1 trauma hospital. In such a setting, where cases requiring MTP can be unpredictable, managing inventory levels can be challenging, and it requires careful monitoring to ensure that the appropriate blood units are used.