Transfusion practice and guidelines in Australian and New Zealand intensive care units

Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To describe the relationship between clinical practice and national guidelines for the transfusion of red blood cells (RBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate in Australian and New Zealand intensive care units (ICUs). Setting: Forty-seven ICUs over a 5-week period from August to September 2008. Design: Prospective, observational, multicentre, cohort study. Patients: A total of 874 patients receiving any type of blood transfusion. Methods: All patients who were transfused at least one unit of any blood component were included. Patient-specific and blood-component specific data were gathered. Pre-transfusion haemoglobin, platelet count, international normalised ratio (INR), and fibrinogen levels were compared to national guidelines. Results: Of all 874 patients, 757 received RBCs (86.6%), 231 (26.4%) received platelets, 340 (38.9%) received FFP, and 78 (8.9%) received cryoprecipitate. Bleeding was the reason for administration of RBCs in 46%, FFP in 55%, and platelets in 47% of transfusions. The mean (SD) pre-transfusion haemoglobin was 77.6 (9.5) g/l, while the geometric means (95% CI) for platelet count, INR, and fibrinogen were 67.0 (59.7–75.3) × 109/l, 1.84 (1.76–1.93), and 1.4 (1.1–1.8) g/l, respectively. The proportions of transfusions not adherent to guidelines were 2% for RBC, but 53% for platelets, 29% for FFP, and 88% for cryoprecipitate (RBC vs. other transfusion p < 0.001 for all). Conclusions: Transfusion practice of RBCs in Australian and New Zealand ICUs is restrictive and is concordant with guidelines. However, the transfusion of other blood components is not.
Original languageEnglish
Pages (from-to)1138 - 1146
Number of pages9
JournalIntensive Care Medicine
Volume36
Issue number7
DOIs
Publication statusPublished - 2010

Cite this

Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group (2010). Transfusion practice and guidelines in Australian and New Zealand intensive care units. Intensive Care Medicine, 36(7), 1138 - 1146. https://doi.org/10.1007/s00134-010-1867-8
Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group. / Transfusion practice and guidelines in Australian and New Zealand intensive care units. In: Intensive Care Medicine. 2010 ; Vol. 36, No. 7. pp. 1138 - 1146.
@article{31cedb71448e48cdbc8c4766d0818062,
title = "Transfusion practice and guidelines in Australian and New Zealand intensive care units",
abstract = "Objective: To describe the relationship between clinical practice and national guidelines for the transfusion of red blood cells (RBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate in Australian and New Zealand intensive care units (ICUs). Setting: Forty-seven ICUs over a 5-week period from August to September 2008. Design: Prospective, observational, multicentre, cohort study. Patients: A total of 874 patients receiving any type of blood transfusion. Methods: All patients who were transfused at least one unit of any blood component were included. Patient-specific and blood-component specific data were gathered. Pre-transfusion haemoglobin, platelet count, international normalised ratio (INR), and fibrinogen levels were compared to national guidelines. Results: Of all 874 patients, 757 received RBCs (86.6{\%}), 231 (26.4{\%}) received platelets, 340 (38.9{\%}) received FFP, and 78 (8.9{\%}) received cryoprecipitate. Bleeding was the reason for administration of RBCs in 46{\%}, FFP in 55{\%}, and platelets in 47{\%} of transfusions. The mean (SD) pre-transfusion haemoglobin was 77.6 (9.5) g/l, while the geometric means (95{\%} CI) for platelet count, INR, and fibrinogen were 67.0 (59.7–75.3) × 109/l, 1.84 (1.76–1.93), and 1.4 (1.1–1.8) g/l, respectively. The proportions of transfusions not adherent to guidelines were 2{\%} for RBC, but 53{\%} for platelets, 29{\%} for FFP, and 88{\%} for cryoprecipitate (RBC vs. other transfusion p < 0.001 for all). Conclusions: Transfusion practice of RBCs in Australian and New Zealand ICUs is restrictive and is concordant with guidelines. However, the transfusion of other blood components is not.",
author = "Westbrook, {Andrew John} and Pettila, {Ville Yrjo Olavi} and Nichol, {Alistair Dualta} and Bailey, {Michael John} and Syres, {Gillian Ann} and Murray, {Lynnette Joy} and Rinaldo Bellomo and Erica Wood and Phillips, {Louise Elizabeth} and Street, {Alison M} and French, {Craig J} and Neil Orford and John Santamaria and Cooper, {David James} and {Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group}",
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pages = "1138 -- 1146",
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Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group 2010, 'Transfusion practice and guidelines in Australian and New Zealand intensive care units', Intensive Care Medicine, vol. 36, no. 7, pp. 1138 - 1146. https://doi.org/10.1007/s00134-010-1867-8

Transfusion practice and guidelines in Australian and New Zealand intensive care units. / Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group.

In: Intensive Care Medicine, Vol. 36, No. 7, 2010, p. 1138 - 1146.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Transfusion practice and guidelines in Australian and New Zealand intensive care units

AU - Westbrook, Andrew John

AU - Pettila, Ville Yrjo Olavi

AU - Nichol, Alistair Dualta

AU - Bailey, Michael John

AU - Syres, Gillian Ann

AU - Murray, Lynnette Joy

AU - Bellomo, Rinaldo

AU - Wood, Erica

AU - Phillips, Louise Elizabeth

AU - Street, Alison M

AU - French, Craig J

AU - Orford, Neil

AU - Santamaria, John

AU - Cooper, David James

AU - Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group

PY - 2010

Y1 - 2010

N2 - Objective: To describe the relationship between clinical practice and national guidelines for the transfusion of red blood cells (RBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate in Australian and New Zealand intensive care units (ICUs). Setting: Forty-seven ICUs over a 5-week period from August to September 2008. Design: Prospective, observational, multicentre, cohort study. Patients: A total of 874 patients receiving any type of blood transfusion. Methods: All patients who were transfused at least one unit of any blood component were included. Patient-specific and blood-component specific data were gathered. Pre-transfusion haemoglobin, platelet count, international normalised ratio (INR), and fibrinogen levels were compared to national guidelines. Results: Of all 874 patients, 757 received RBCs (86.6%), 231 (26.4%) received platelets, 340 (38.9%) received FFP, and 78 (8.9%) received cryoprecipitate. Bleeding was the reason for administration of RBCs in 46%, FFP in 55%, and platelets in 47% of transfusions. The mean (SD) pre-transfusion haemoglobin was 77.6 (9.5) g/l, while the geometric means (95% CI) for platelet count, INR, and fibrinogen were 67.0 (59.7–75.3) × 109/l, 1.84 (1.76–1.93), and 1.4 (1.1–1.8) g/l, respectively. The proportions of transfusions not adherent to guidelines were 2% for RBC, but 53% for platelets, 29% for FFP, and 88% for cryoprecipitate (RBC vs. other transfusion p < 0.001 for all). Conclusions: Transfusion practice of RBCs in Australian and New Zealand ICUs is restrictive and is concordant with guidelines. However, the transfusion of other blood components is not.

AB - Objective: To describe the relationship between clinical practice and national guidelines for the transfusion of red blood cells (RBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate in Australian and New Zealand intensive care units (ICUs). Setting: Forty-seven ICUs over a 5-week period from August to September 2008. Design: Prospective, observational, multicentre, cohort study. Patients: A total of 874 patients receiving any type of blood transfusion. Methods: All patients who were transfused at least one unit of any blood component were included. Patient-specific and blood-component specific data were gathered. Pre-transfusion haemoglobin, platelet count, international normalised ratio (INR), and fibrinogen levels were compared to national guidelines. Results: Of all 874 patients, 757 received RBCs (86.6%), 231 (26.4%) received platelets, 340 (38.9%) received FFP, and 78 (8.9%) received cryoprecipitate. Bleeding was the reason for administration of RBCs in 46%, FFP in 55%, and platelets in 47% of transfusions. The mean (SD) pre-transfusion haemoglobin was 77.6 (9.5) g/l, while the geometric means (95% CI) for platelet count, INR, and fibrinogen were 67.0 (59.7–75.3) × 109/l, 1.84 (1.76–1.93), and 1.4 (1.1–1.8) g/l, respectively. The proportions of transfusions not adherent to guidelines were 2% for RBC, but 53% for platelets, 29% for FFP, and 88% for cryoprecipitate (RBC vs. other transfusion p < 0.001 for all). Conclusions: Transfusion practice of RBCs in Australian and New Zealand ICUs is restrictive and is concordant with guidelines. However, the transfusion of other blood components is not.

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U2 - 10.1007/s00134-010-1867-8

DO - 10.1007/s00134-010-1867-8

M3 - Article

VL - 36

SP - 1138

EP - 1146

JO - Intensive Care Medicine

JF - Intensive Care Medicine

SN - 0342-4642

IS - 7

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Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group. Transfusion practice and guidelines in Australian and New Zealand intensive care units. Intensive Care Medicine. 2010;36(7):1138 - 1146. https://doi.org/10.1007/s00134-010-1867-8