Evaluation of appropriateness of packed red blood cell and fresh frozen plasma transfusion in post-surgical adult patients admitted in ICU and its outcome: a retrospective study in a tertiary care hospital

• Published in: International journal of research in medical sciences Vol. 11; no. 5; pp. 1587 - 1593
• Main Authors: Sahai, Ankit, Verma, Anil Kumar, Sheikh, Firoz, Krishnani, Chandni
• Format: Journal Article
• Language: English
• Published: 29.04.2023
• ISSN: 2320-6071; 2320-6012
• DOI: 10.18203/2320-6012.ijrms20231320

Background: The objective of this study was to evaluate appropriateness of packed red blood cell (PRBC) and fresh frozen plasma transfusion (FFP) in post-surgical adult patients admitted in ICU and its outcome. Methods: A total number of 800 ICU adult patients were enrolled. Out of these 600 patients received PRBC transfusion and 200 received FFP transfusions. Transfusion pattern was analyzed with respect to the number of units transfused, pre and post transfusion hemoglobin levels and coagulation profile. The outcome was measured in terms of mortality, morbidity and length of ICU stay. Transfusions were categorized into appropriate and inappropriate based on transfusion triggers used as per BSH guidelines (British Society for Hematology). The SPSS software was used for analyses. Results: Out of six hundred, 384 were those with appropriate red cell transfusion. In the appropriate transfusion group, majority i.e. 167 (43.49%) underwent more units of PRBC transfusion. The mean duration of mechanical ventilation in appropriate group was 7.43±4.1 days and in inappropriate group was 5.95±3.34 days. (p<0.05). There was significant association found between the high mortality and appropriateness of blood transfusion. Out of 200, One hundred and thirty-seven (137) were those with appropriate FFP transfusion. Majority of the patients underwent two units of FFP transfusion (47%). The mean change in aPTT and INR was comparable in both the groups (p>0.05). Conclusions: Analysis of appropriateness of transfusion according to BSH guidelines shows a high rate of irrational transfusions in Indian subjects. Further studies including large sample size are needed in this context.