Establishing transfusion needs in burn patients.
BACKGROUND
Despite blood-conservation techniques, hemorrhage during burn excision remains substantial. It is difficult to predict the blood loss that will occur per operation and how many units the patient will require during surgery. This may result in high cross-match-to-transfusion ratios (CMTRs).


METHODS
A retrospective chart review from 2001 to 2003 was performed. All adult patients with >20% total body surface area burns who underwent surgery were included in the study. Variables examined were centimeters excised, estimated blood loss, packed red blood cells transfused during surgery, preoperative and postoperative hematocrit, and CMTR.


RESULTS
There were 273 operations. The average estimated blood loss was 820 mL, and; the median posttransfusion hematocrit was 27. Based on the area excised and units transfused, a ratio of packed red blood cells/cm excised was determined. A total of 1.78 U blood were transfused/1000 cm(2) excised to keep hematocrit between 25 and 31; P = 0.02.


CONCLUSIONS
Estimation of excision area can predict transfusion need, which at our institution yields a low CMTR.
Criswell
Kara K
KK
The Burn and Shock Trauma Institute, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. kkcriswellmd@yahoo.com
Gamelli
Richard L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data*; D001810:Blood Volume; D001830:Body Surface Area; D002056:Burns / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate