Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand

CONTEXT: Preoperative blood bank testing should optimize the trade-off between intraoperative transfusion delay and blood wastage. AIMS: This study aims to develop a maximal surgical blood order schedule (MSBOS) for elective neurosurgery. SETTINGS AND DESIGN: Prospective data in University Teaching...

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Autores principales: Saringcarinkul, Ananchanok, Chuasuwan, Siriwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898101/
https://www.ncbi.nlm.nih.gov/pubmed/29682030
http://dx.doi.org/10.4103/ajns.AJNS_104_16
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author Saringcarinkul, Ananchanok
Chuasuwan, Siriwan
author_facet Saringcarinkul, Ananchanok
Chuasuwan, Siriwan
author_sort Saringcarinkul, Ananchanok
collection PubMed
description CONTEXT: Preoperative blood bank testing should optimize the trade-off between intraoperative transfusion delay and blood wastage. AIMS: This study aims to develop a maximal surgical blood order schedule (MSBOS) for elective neurosurgery. SETTINGS AND DESIGN: Prospective data in University Teaching Hospital, Northern Thailand. SUBJECTS AND METHODS: Blood transfusion data were collected on all adult patients satisfying inclusion/exclusion criteria in 2015. Patients were assigned to ten procedure groups (G): vascular: (1) Aneurysm/arteriovenous malformation, (2) Cerebrovascular bypass; tumor resection: (3) Meningioma, (4) Other, (5) Cerebellopontine angle, (6) Pituitary/craniopharyngioma, (7) Endoscopic pituitary; and miscellaneous: (8) Cranioplasty, (9) Spine, (10) Other. The crossmatch-transfusion ratio (C/T), transfusion probability (%T), and transfusion index (Ti) were calculated. MSBOS was generated by applying published criteria, subjected to clinical neurosurgical judgment. STATISTICAL ANALYSIS USED: Statistical Package for the Social Sciences, Vision 20. RESULTS: Of 377 patients, 95% underwent preoperative cross-and-match (C and M) testing for 1422 red blood cell (RBC) units, while 3% had no type and screen (T and S) nor C and M, and 2% had T and S only. Overall C/T was 6.6, with range from 4 for G3-53 for G8. Intraoperative %T was 27%. Intraoperative Ti was 0.6. Our MSBOS recommended T and S only for G2, G7, G8, G9, G10; C and M of 2 RBC units for G1, G4, G5, G6; and C and M 2-to-4 for G3. If this were followed in 2015, intraoperative blood needs would have been satisfied for ≥82% of patients, and substantial reductions achieved in blood banking fees. CONCLUSIONS: Our MSBOS may help optimize blood ordering and serve as an example for similar efforts for other surgical specialties.
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spelling pubmed-58981012018-04-20 Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand Saringcarinkul, Ananchanok Chuasuwan, Siriwan Asian J Neurosurg Original Article CONTEXT: Preoperative blood bank testing should optimize the trade-off between intraoperative transfusion delay and blood wastage. AIMS: This study aims to develop a maximal surgical blood order schedule (MSBOS) for elective neurosurgery. SETTINGS AND DESIGN: Prospective data in University Teaching Hospital, Northern Thailand. SUBJECTS AND METHODS: Blood transfusion data were collected on all adult patients satisfying inclusion/exclusion criteria in 2015. Patients were assigned to ten procedure groups (G): vascular: (1) Aneurysm/arteriovenous malformation, (2) Cerebrovascular bypass; tumor resection: (3) Meningioma, (4) Other, (5) Cerebellopontine angle, (6) Pituitary/craniopharyngioma, (7) Endoscopic pituitary; and miscellaneous: (8) Cranioplasty, (9) Spine, (10) Other. The crossmatch-transfusion ratio (C/T), transfusion probability (%T), and transfusion index (Ti) were calculated. MSBOS was generated by applying published criteria, subjected to clinical neurosurgical judgment. STATISTICAL ANALYSIS USED: Statistical Package for the Social Sciences, Vision 20. RESULTS: Of 377 patients, 95% underwent preoperative cross-and-match (C and M) testing for 1422 red blood cell (RBC) units, while 3% had no type and screen (T and S) nor C and M, and 2% had T and S only. Overall C/T was 6.6, with range from 4 for G3-53 for G8. Intraoperative %T was 27%. Intraoperative Ti was 0.6. Our MSBOS recommended T and S only for G2, G7, G8, G9, G10; C and M of 2 RBC units for G1, G4, G5, G6; and C and M 2-to-4 for G3. If this were followed in 2015, intraoperative blood needs would have been satisfied for ≥82% of patients, and substantial reductions achieved in blood banking fees. CONCLUSIONS: Our MSBOS may help optimize blood ordering and serve as an example for similar efforts for other surgical specialties. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5898101/ /pubmed/29682030 http://dx.doi.org/10.4103/ajns.AJNS_104_16 Text en Copyright: © 2018 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Saringcarinkul, Ananchanok
Chuasuwan, Siriwan
Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand
title Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand
title_full Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand
title_fullStr Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand
title_full_unstemmed Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand
title_short Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand
title_sort maximum surgical blood order schedule for elective neurosurgery in a university teaching hospital in northern thailand
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898101/
https://www.ncbi.nlm.nih.gov/pubmed/29682030
http://dx.doi.org/10.4103/ajns.AJNS_104_16
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