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Intensive Care Medicine

, Volume 36, Issue 7, pp 1138–1146 | Cite as

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

  • The Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials GroupEmail author
Original

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.

Keywords

Transfusion Red blood cells Fresh frozen plasma Platelets Cryoprecipitate Indication 

Notes

Acknowledgements

We would like to thank Australian Red Cross Blood Service and the New Zealand Blood Service for excellent collaboration during this study, and the Executive Committee of ANZICS Clinical Trials Group for review and publication endorsement of this study. An unrestricted grant was provided from the Australian Red Cross Blood Service, and the Australian and New Zealand Intensive Care Research Centre.

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Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • The Blood Observational Study Investigators on behalf of the ANZICS-Clinical Trials Group
    • 1
    Email author
  1. 1.MelbourneAustralia

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