Maximum surgical blood order schedule in a newly set-up tertiary care hospital

ABSTRACT

Limited availability and supply necessitates the rational use of blood and blood products and avoidance of unnecessary transfusion. A study was carried out in our tertiary care hospital over a period of two years to determine the usage of blood during different surgical procedures. Therefore, the ratio of units cross-matched to units transfused and transfusion probability were calculated. In this study, besides identifying the cases in which blood wastage was present, different factors and circumstances which affect Maximum Surgical Blood Order Schedule [MSBOS] were also noted. After ethical committee approval and informed consent, 305 patients, ASA I and II, were inducted who were scheduled for elective surgical procedures. Parameters recorded were age, sex, hemoglobin, hematocrit, number of blood units crossmatched, duration of surgery, blood loss, type of anesthesia, cross-match to transfusion ratio [C/T], transfusion probability and transfusion index. Among 305 patients, in the Obstetrics and Gynecology group the C/T ratio was 2.4 in cesarean section, in Surgery group it was maximum in open cholecystectomy [11], in the Urology group it was 6 in carcinoma bladder, in the spine surgeries it was 2.6 and in PDA ligation it was 7. By a team approach involving the surgeon, anesthesiologist and hematologist we can reduce the number and pattern of ordering blood for various surgeries