Efficiency of Packed Red Cell Utilization and Establishment of Effective Maximum Surgical Blood Order Schedule in Elective Coronary Artery Bypass Graft Surgery in a Specialized Tertiary Care Center

• DOI: 10.4103/pja.pja_8_24
• Publication Date: 2024-12-31T05:00:09Z
• Authors: Joanna Marie Dali...

ABSTRACT

Background: Implementation of blood conservation protocol may increase the efficiency of blood utilization and optimize the maximum surgical blood ordering schedule (MSBOS) in our institution. The primary objectives of this study are to evaluate the efficient utilization of a fixed blood request of 4 units of packed red blood cells (PRBCs) and to establish an effective MSBOS on primary isolated elective coronary artery bypass graft (CABG).

Methodology: This was a retrospective, analytical, observational, cohort type of study conducted through chart review of CABG patients from January 2018 to December 2019. Indices used to evaluate blood utilization efficiency were crossmatch to transfusion (C/T) ratio, transfusion probability (T%), and transfusion index (TI). MSBOS was computed based on the data gathered.

Results: A total of 77 patients were included in this study. Blood transfusion based on C/T ratio was associated with body surface area <1.75 m2 (P = 0.006) and involvement of distal grafts >3 vessels (P = 0.042). Overall, C/T ratio was 2.44, T% was 70.1%, and TI was 1.69. Unutilized blood was measured at 59%. The computed MSBOS for elective CABG was at 2 units (2.53).

Conclusion: There is efficient PRBC utilization in primary elective CABG when the blood indices were used. Evidence-based MSBOS is established and the previous 4 units PRBC can be reduced to 2 units to promote C/T ratio <2 as evidence of an optimal blood utilization.