Evidence map›Paper›PMID 41244186›Full record

ArticleAsian journal of transfusion science

Preoperative cross-matching in major elective surgical procedures in children: An audit of department's transfusion practices.

Rajkiran Srinivas Raju, Shubha Attibele Mahadevaiah, Shanthala A M Devi

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Article in Asian journal of transfusion science. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Rajkiran Srinivas RajuDepartment of Paediatric Surgery, St. Johns National Academy of Health Sciences, Bengaluru, Karnataka, India.
Shubha Attibele MahadevaiahDepartment of Paediatric Surgery, St. Johns National Academy of Health Sciences, Bengaluru, Karnataka, India.
Shanthala A M DeviDepartment of Transfusion Medicine and Immuno-Hematology, St. Johns National Academy of Health Sciences, Bengaluru, Karnataka, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo determine the utilization of cross-matched packed red blood cell (PRBC) concentrate in children posted for major elective operative procedures. To evaluate the efficacy of a simple preoperative "screening criteria" for ordering preoperative cross-match. MATERIALS AND

methodsData were retrieved from online surgery scheduling system prospectively over a 4-month period (January-April 2022). The number of units cross-matched and those utilized were assessed. A screening criterion was devised in consultation with stakeholders for ordering blood. The utilization of PRBCs was reassessed after implementation of these criteria and reaudited (July-October 2022). A subset analysis of A1 (tunneled catheter placements) and A2 (core pediatric surgical procedures) groups was done to analyze blood utilization.

resultsInitial audit showed poor PRBC utilization with 46 units unused of the 54 cross-matched units, and most of these were from A1 group (3 of 29 units and 5 out of 25 units utilized in A1 and A2 groups, respectively). Reaudit after introducing cutoff criteria showed sharp decline (79.3%) in the number of cross-matched units and the number of units returned (84.6% decrease) in A1 group and the number of units returned unused dropped by 50% in the A2 group. There was visible reversal of indicators of utilization (cross-match to transfusion ratio dropped from 6.75 to 1.73 and TI increased from 0.163 to 0.613), indicating optimal utilization.

conclusionThis pilot audit clearly demonstrates the gap between requisition and utilization of cross-matched PRBCs. Formulating an effective screening criterion avoids unnecessary cross-matching and wastage of resources and maximizes utilization.

Indexed as

Blood product utilizationcross-match to transfusion ratioelective cross-matchingtransfusion index

Identifiers

PMID41244186
PMCPMC12614711

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