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Intraoperative transfusion practices in Europe

Lookup NU author(s): Andrea Bell, Dr Alistair Cain, Dr Ahmed Chishti

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Abstract

© 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold.


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Author(s): Meier J, Filipescu D, Kozek-Langenecker S, Llau Pitarch J, Mallett S, Martus P, Matot I, Accurso G, Ahrens N, Akan M, Akeroy K, Aksoy O, Alanoglu Z, Alfredo M, Alkis N, Almeida V, Alousi M, Alves C, Amaral J, Ambrosi X, Ana I, Anastase D, Andersson M, Andreou A, Anthopoulos G, Apanaviciute D, Arbelaez A, Arcade A-L, Arion-Balescu C, Arun O, Azenha M, Bacalbasa N, Baeten W, Balandin A, Barquero Lopez M, Barsan V, Bascuas B, Basora M, Baumann H, Bayer A, Bell A, Belmonte Cuenca J, Bengisun ZK, Bento C, Beran M, Bermudez Lopez M, Bernardino A, Berthelsen KG, Bigat Z, Bilshiene D, Bilska M, Bisbe Vives E, Biscioni T, Bjorn H, Blom T, Bogdan Prodan A, Bogdanovic Dvorscak M, Boisson M, Bolten J, Bona F, Borg F, Boros C, Borys M, Boveroux P, Boztug Uz N, Brettner F, Brisard L, Britta DW, Browne G, Budow K, Buerkle H, Buggy D, Cain A, Calancea E, Calarasu F, Calder V, Camci AE, Campiglia L, Campos B, Camps A, Carlos D, Carreira C, Carrilho A, Carvalho P, Cassinello C, Cattan A, Cenni L, Cerny V, Ceyda Meco B, Chesov I, Chishti A, Chupin A-M, Cikova A, Cindea I, Cintula D, Ciobanasu R, Clements D, Cobiletchi S, Coburn M, Coghlan L, Collyer T, Copotoiu SM, Copotoiu R, Corneci D, Cortegiani A, Coskunfirat OK, Costea D, Czuczwar M, Davies K, De Baerdemaeker L, De Hert S, Debernardi F, Decagny S, Deger Coskunfirat N, Diana T, Diana GM, Dias S, Dickinson M, Dobisova A, Dragan A, Droc G, Duarte S, Dunk N, Ekelund K, Ekmekci P, Elena C, Ellimah T, Espie L, Everett L, Ferguson A, Fernandes M, Fernandez JA, Ferner M, Ferreira D, Ferrie R, Filipescu D, Flassikova Z, Fleischer A, Font A, Galkova K, Garcia I, Garner M, Gasenkampf A, Gelmanas A, Gherghina V, Gilsanz F, Giokas G, Goebel U, Gomes P, Goncalves Aguiar JM, Gonzalez Monzon V, Gottschalk A, Gouraud J-P, Gramigni E, Grintescu I, Grynyuk A, Grytsan A, Guasch E, Gustin D, Hans G, Harazim H, Hervig T, Hidalgo F, Higham C, Hirschauer N, Hoeft A, Innerhofer P, Innerhofer-Pompernigg N, Jacobs S, Jakobs N, Jamaer L, James S, Jawad M, Jesus J, Jhanji S, Jipa Lavina N, Jokinen J, Jovanovic G, Jubera MP, Kahn D, Karjagin J, Kasnik D, Katsanoulas K, Kelle H, Kelleher M, Kessler F, Kirigin B, Kiskira O, Kivik P, Klimi P, Klucka J, Koers L, Kontrimaviciut E, Koopman-Van Gemert AWMM, Korfiotis D, Kosinova M, Koursoumi E, Kozek Langenecker S, Kranke P, Kresic M, Krobot R, Kropman L, Kulikov A, Kvolik S, Kvrgic I, Kyttari A, Lagarto F, Lance MD, Laufenberg R, Lauwick S, Lecoq J-P, Leech L, Lidzborski L, Liliana H, Linda F, Llau Pitarch JV, Lopes A, Lopez L, Lopez Alvarez A, Lorenzi I, Lorre G, Lucian H, Lupis T, Lupu MN, Macas A, Macedo A, Maggi G, Mallett S, Mallor T, Manoleli A, Manolescu R, Manrique S, Maquoi I, Marios-Konstantinos T, Markovic Bozic J, Markus HW, Marques M, Martinez R, Martinez E, Martinez E, Martinho H, Martins D, Martires E, Martus P, Matias F, Matot I, Mauff S, Meale P, Meier J, Merz H, Meybohm P, Militello MG, Mincu N, Miranda ML, Mirea L, Moghildea V, Moise A, Molano Diaz P, Molto L, Monedero P, Moral V, Moreira Z, Moret E, Mulders F, Munteanu AM, Nadia Diana K, Nair A, Neskovic V, Ninane V, Nitu D, Oberhofer D, Odeberg-Wernerman S, Oganjan J, Omur D, Orallo Moran MA, Ozkardesler S, Pacasova R, Paklar N, Pandazi A, Papaspyros F, Paraskeuopoulos T, Parente S, Paunescu MA, Pavicic Saric J, Pereira F, Pereira E, Pereira L, Perry C, Petri A, Petrovic U, Pica S, Pinheiro F, Pinto J, Pinto F, Piwowarczyk P, Platteau S, Poeira R, Popescu R, Popica G, Poredos P, Prasser C, Preckel B, Prospiech A, Pujol R, Raimundo A, Raineri SM, Rakic D, Ramadan M, Ramazanoglu A, Rantis A, Raquel F, Ratsep I, Real C, Reikvam T, Reis L, Rigal J-C, Rohner A, Rokk A, Roman Fernandez A, Rosenberger P, Rossaint R, Rozec B, Rudolph T, Saeed Y, Safonov S, Saka E, Samama CM, Sanchez Lopez O, Sanchez Perez D, Sanchez Sanchez YE, Sandeep V, Sandu MN, Sanll S, Saraiva A, Scarlatescu E, Schiraldi R, Schittek G, Schnitter B, Schuster M, Seco C, Selvi O, Senard M, Serra S, Serrano H, Shmigelsky A, Silva L, Simeson K, Singh R, Sipylaite J, Skitek K, Skok I, Smekalova O, Smirnova N, Sofia M, Soler Pedrola M, Sondergaard S, Sormus A, Sorvoll IH, Soumelidis C, Spindler Yesel A, Stefan M, Stevanovic A, Stevikova J, Stivan S, Stourac P, Striteska J, Strys L, Suljevic I, Tania M, Tareco G, Tena B, Theodoraki K, Tifrea M, Tikuisis R, Tolos R, Tomasi R, Tomescu D, Tomkute G, Tormos P, Trepenaitis D, Troyan G, Unic-Stojanovic D, Unterrainer A, Uranjek J, Valsamidis D, Van Dasselaar N, Van Limmen J, Van Noord P, Van Poorten JF, Vanderlaenen M, Varela Garcia O, Velasco A, Veljovic M, Vera Bella J, Vercauteren M, Verdouw B, Verenkin V, Veselovsky T, Vieira H, Villar T, Visnja I, Voje M, Von Dossow-Hanfstingl V, Von Langen D, Vorotyntsev S, Vujanovic V, Vukovic R, Watt P, Werner E, Wernerman J, Wittmann M, Wright M, Wunder C, Wyffels P, Yakymenko Y, Ylldlrlm C, Yllmaz H, Zacharowski K, Zahorec R, Zarif M, Zielinska-Skitek E, Zsisku L

Publication type: Article

Publication status: Published

Journal: British Journal of Anaesthesia

Year: 2016

Volume: 116

Issue: 2

Pages: 255-261

Online publication date: 19/01/2016

Acceptance date: 24/11/2015

ISSN (print): 0007-0912

ISSN (electronic): 1471-6771

Publisher: Oxford University Press

URL: http://doi.org/10.1093/bja/aev456

DOI: 10.1093/bja/aev456


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