Volume 7 Issue 5
Sep.  2016
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Chan MENG, Jia GAN, Xue-jun ZENG, Wei-gang FANG, Wei-guo ZHU, Jia-lin CHEN, Lian-jun BAI. Clinical Characteristics of Patients with Hemoglobin Level before Red Blood Cell Transfusion Higher than Recommended Threshold in Non-surgical Departments of Peking Union Medical College Hospital[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(5): 357-361. doi: 10.3969/j.issn.1674-9081.2016.05.007
Citation: Chan MENG, Jia GAN, Xue-jun ZENG, Wei-gang FANG, Wei-guo ZHU, Jia-lin CHEN, Lian-jun BAI. Clinical Characteristics of Patients with Hemoglobin Level before Red Blood Cell Transfusion Higher than Recommended Threshold in Non-surgical Departments of Peking Union Medical College Hospital[J]. Medical Journal of Peking Union Medical College Hospital, 2016, 7(5): 357-361. doi: 10.3969/j.issn.1674-9081.2016.05.007

Clinical Characteristics of Patients with Hemoglobin Level before Red Blood Cell Transfusion Higher than Recommended Threshold in Non-surgical Departments of Peking Union Medical College Hospital

doi: 10.3969/j.issn.1674-9081.2016.05.007
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  • Corresponding author: ZENG Xue-jun Tel: 010-69155645, E-mail:zxjpumch@126.com
  • Received Date: 2016-07-19
  • Publish Date: 2016-09-30
  •   Objective  To investigate the clinical characteristics of patients with hemoglobin level higher than the recommended threshold by guidelines before receiving red blood cell (RBC) transfusion in non-surgical departments of Peking Union Medical College Hospital (PUMCH).  Methods  One thousand patients were randomly selected from hospitalized patients who received RBC transfusion at PUMCH between January and December in 2013. Among them, those in non-surgical departments and with hemoglobin ≥ 70 g/L before transfusion were identified, and their hemoglobin level before RBC transfusion, proportion in non-surgical patients receiving RBC transfusion, symptoms and signs related to anemia before transfusion were described.  Results  Of the 1000 patients, 270 were from non-surgical departments, and their average hemoglobin before RBC transfusion was (63.7±11.5)g/L. Seventy-four of the 270 (27.4%) patients had hemoglobin ≥ 70 g/L before RBC transfusion, including 60 (22.2%) patients with homoglobin ≥ 70 g/L and < 80 g/L, 10 (3.7%) patients with homoglobin ≥ 80 g/L and < 90 g/L, and 4 (1.5%) patients with hemoglobin ≥ 90 g/L. Among the 74 patients, symptoms and signs related to anemia and decision-making of the transfusion were identified in 59(79.7%) patients' medical records, the other 15(20.3%) patients with missing data were those with more severe conditions, multiple co-morbidities, multi-organ involvement, unstable conditions, or poor tolerance to decreasing hemoglobin level.  Conclusions  The hemoglobin threshold for RBC transfusion in non-surgical departments of PUMCH was consistent with the recommendations of both international and Chinese guidelines. Given specific conditions, RBC transfusion in those patients with hemoglobin level higher than the recommended threshold is clinically appropriate, but the decision-making process regrading RBC transfusion should be recorded in detail.
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  • [1] Carson JL, Carless PA, Hebert PC. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion[J]. Cochrane Database Syst Rev, 2012, 4:CD002042.
    [2] Carson JL, Terrin ML, Noveck H, et al. Liberal or restrictive transfusion in high-risk patients after hip surgery[J]. N Engl J Med, 2011, 365:2453-2462. doi:  10.1056/NEJMoa1012452
    [3] Carson JL, Carless PA, Hébert PC. Outcomes using lower vs higher hemoglobin thresholds for red blood cell transfusion[J]. JAMA, 2013, 309:83-84. doi:  10.1001/jama.2012.50429
    [4] Roubinian NH, Escobar GJ, Liu V, et al. Trends in red blood cell transfusion and 30-day mortality among hospitalized patients[J]. Transfusion, 2014, 54:2678-2686. doi:  10.1111/trf.12825
    [5] Carson JL, Sieber F, Cook DR, et al. Liberal versus restrictive blood transfusion strategy:3-year survival and cause of death results from the FOCUS randomised controlled trial[J]. Lancet, 2015, 385:1183-1189. doi:  10.1016/S0140-6736(14)62286-8
    [6] 卫生部.临床输血技术规范[S].北京: 卫生部办公厅, 2000.
    [7] Carson JL, Grossman BJ, Kleinman S, et al. Red blood cell transfusion:a clinical practice guideline from the AABB[J]. Ann Intern Med, 2012, 157:49-58. doi:  10.7326/0003-4819-157-1-201206190-00429
    [8] Murphy MF, Wallington TB, Kelsey P, et al. Guidelines for the clinical use of red cell transfusions[J]. Br J Haematol, 2001, 113:24-31. doi:  10.1046/j.1365-2141.2001.02701.x
    [9] Practice Guidelines for blood component therapy: A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy[J]. Anesthesiology, 1996, 84: 732-747.
    [10] Hebért PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trail of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Trails Group[J]. N Engl J Med, 1999, 340:409-417. doi:  10.1056/NEJM199902113400601
    [11] Rouette J, Trottier H, Ducruet T, et al. Red blood cell transfusion threshold in postsurgical pediatric intensive care patients:a randomized clinical trial[J]. Ann Surg, 2010, 251:421-427. doi:  10.1097/SLA.0b013e3181c5dc2e
    [12] Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding[J]. N Engl J Med, 2013, 368:11-21. doi:  10.1056/NEJMoa1211801
    [13] Karam O, Tucci M, Ducruet T, et al. Red blood cell transfusion thresholds in pediatric patients with sepsis[J]. Pediatr Crit Care Med, 2011, 12:512-518. doi:  10.1097/PCC.0b013e3181fe344b
    [14] Holst LB, Haase N, Wetterslev J, et al. Lower versus higher hemoglobin threshold for transfusion in septic shock[J]. N Engl J Med, 2014, 371:1381-1391. doi:  10.1056/NEJMoa1406617
    [15] Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock[J]. N Engl J Med, 2001, 345:1368-1377. doi:  10.1056/NEJMoa010307
    [16] CSCO肿瘤相关性贫血专家委员会.肿瘤相关行输血临床实践指南(2012-2013版)[S/OL].http//:www.medlive.cn.
    [17] Rodgers GM 3rd, Becker PS, Blinder M, et al. Cancer- and chemotherapy-induced anemia[J]. J Natl Compr Canc Netw, 2012, 10:628-653. doi:  10.6004/jnccn.2012.0064
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