Blood transfusions: for the thermally injured or for the doctor?
BACKGROUND
Because of the inherent risks of blood transfusions, including the transmission of viral and other infectious diseases, it is important to re-evaluate blood transfusion policies.


METHODS
The present study compared the results of a new selective transfusion policy in which patients were not transfused unless their hemoglobin levels went below 6-6.5 g/dL versus our previous routine transfusion policy in which the hemoglobin levels were routinely maintained at 10 g/dL. The selectively transfused group consisted of 14 patients with a mean +/- SD burn size of 28% +/- 11%, while the routinely transfused group consisted of 38 clinically comparable patients with a mean burn size of 26% +/- 12%.


RESULTS
The patients managed by selective transfusion received fewer transfusions (2.1 +/- 1.7 units) during their hospital stay than patients transfused routinely (7.4 +/- 7.6 units) (p < 0.007) and were less likely to receive maintenance transfusions (4 of 29 total units versus 116 of 282 total units) (p < 0.004). No adverse hemodynamic or other adverse effects related to limiting blood transfusions in the selectively transfused group was noted.


CONCLUSIONS
Routinely transfused patients, on average, received over 5 units more blood than the selective group without any apparent clinical benefit. Thus, the results of this pilot study support a policy of selective blood transfusions in burn patients.
Sittig
K M
KM
Department of Surgery Louisiana State University Medical Center, Shreveport 71130-3932.
Deitch
E A
EA
D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D002056:Burns / Q000097:blood / Q000628:therapy*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D005440:Fluid Therapy; D006291:Health Policy; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies
D006454:Hemoglobins