ABSTRACT
Background: Since the beginning of the COVID-19 pandemic in April 2020 the supply with blood products was largely stable and the demand for red blood cell concentrates (RBCC) could be covered. From June 2021, a blatant undersupply of RBCC occurred and rescheduling elective interventions depending on the patient's blood group was required. A well-considered restrictive blood bank management approach for RBCC provision became imperative and the analysis of its effects is presented here. Method(s): Data was analyzed to show the influence of the COVID-19 pandemic on the RBCC distribution management in the blood bank. Therefore, RBCC cross-matches, delivery, return and transfusions of RBCC were analyzed, so the crossmatch-to-transfusion ratio (CTR: ratio of cross-matched to transfused RBCC) as an efficiency marker could be calculated. In consideration of the CTR the consequences of minimizing the number of RBCC provided for elective surgeries in direct consultation with clinical decision makers on blood bank management efficiency were statistically described in the context of inpatient admissions and operations. Result(s): The availability on demand and consumption of RBCC were stable from April 2020 to May 2021 (mean value per month, fig. 1). However, the significant drop in RBCC supply from June 2021 was intercepted by a change of the RBCC management strategy as the number of transfusions remained unchanged (fig. 1): for elective operations the amount of RBCC provided was drastically reduced (from 48% to 23%). As a result, the overall CTR decreased from 3.0 on annual average (January 2019 to June 2021) to 1.7 from July 2021 to December 2021 (fig. 2). The number of operations was stable on a monthly average, as well as the inpatient admissions per month from 2019 to 2021 (2512) were only interrupted temporarily in April 2020 (1689). Conclusion(s): Regarding constant inpatient admissions and performed surgeries, the amount of transfused RBCC was stable. With drastically decreasing the number of RBCC provided for elective interventions a more efficient blood bank management led to a uncompromised patient care and even the target CTR of 1.7 in the surgical field (Gombotz, Patient Blood Management, Anesthesiologist 2013, 62:519-527) could be reached. Therefore, we consider this proceeding worth maintaining for the future. (Figure Presented).