Blood Use in Surgical Patients with Red Blood Cell Transfusion of Over 20 Units during Single Hospital Stay

  Objective  To assess the blood use in surgical patients with red blood cell(RBC) transfusion of over 20 U during single hospital stay in Peking Union Medical College Hospital (PUMCH) in order to help develop strategy for rational blood use.

  Methods  We collected 27 surgical patients which received RBC transfusion of over 20 U during single hospital stay between January and October 2015 in PUMCH, and analyzed the data of these patients in aspects of baseline characteristics, blood use in perioperative period and during surgery, and treatment outcome.

  Results  There were 22 males and 5 females in the 27 patients. A total of 867 U RBCs, 124 800 ml blood plasma, and 50 U platelets were transfused in them. Fifteen patients (55.6%) received 20~29 U RBCs in perioperative period, and the maximum volume of RBCs use per person was 92 U. Three hundred and thirty-four U RBCs were transfused during surgery, accounted for 38.5% of the total use; 32 000 ml blood plasma was transfused during surgery, accounted for 25.6% of the total volume used in perioperative period. The mean length of hospital stay was 43 days, with 1 patient hospitalized for less than 7 days (2.3%) and 3 for more than 60 days (11.1%). Sixteen patients (59.3%) were discharged after successful treatment, 5 patients (18.5%) gave up treatment, and 6 patients died (22.2%).

  Conclusions  It is very important to perform preoperative assessment and cross-department consultation for rational blood transfusion strategy and disease severity evaluation. In order to reduce the volume of blood transfusion, conducting prompt hemostasis in the cases of major bleeding during surgery and seizing the appropriate timing for blood transfusion is essential. Management of blood use should also be strengthened for better use of blood product.