Appropriateness of red blood cell transfusion in Australasian intensive care practice.
OBJECTIVE
To determine the incidence and appropriateness of use of allogenic packed red blood cell (RBC) transfusion in Australian and New Zealand intensive care practice.


METHODS
Intensive care units of 18 Australian and New Zealand hospitals: March 2001.


METHODS
Prospective, observational, multicentre study.


METHODS
All admissions to participating intensive care units were screened and all patients who received a transfusion of RBC were enrolled. The indications for transfusion were recorded and compared with Australian National Health and Medical Research Council guidelines. Transfusions conforming to these guidelines were deemed appropriate.


METHODS
RBC transfusion in intensive care and transfusion appropriateness.


RESULTS
1808 admissions to intensive care units were screened: 357 (19.8%) admissions (350 patients) received an RBC transfusion while in intensive care. Overall, 1464 RBC units were administered in intensive care on 576 transfusion days. The most common indications for transfusion were acute bleeding (60.1%; 880/1464) and diminished physiological reserve (28.9%; 423/1464). The rate of inappropriate transfusion was 3.0% (44/1464). Diminished physiological reserve with haemogloblin level > or = 100 g/L was the indication in 50% (22/44) of inappropriate transfusions; no indication was provided for 31% (15/44).


CONCLUSIONS
The rate of inappropriate transfusion in Australian and New Zealand intensive care units in 2001 was remarkably low.
French
Craig J
CJ
Department of Intensive Care, Western Health, Melbourne, VIC, Australia. craig.french@wh.org.au
Bellomo
Rinaldo
R
Finfer
Simon R
SR
Lipman
Jeffery
J
Chapman
Marianne
M
Boyce
Neil W
NW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001803:Blood Transfusion / Q000592:standards* / Q000706:statistics & numerical data; D003422:Critical Care / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006302:Health Services Research; D006454:Hemoglobins / Q000032:analysis; D006470:Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009520:New Zealand; D010343:Patient Admission / Q000706:statistics & numerical data; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D014600:Utilization Review
D006454:Hemoglobins