Optimized management of transfusion of hemocomponents in a pediatric surgical block
Background and Goal of Study: Tolerance to hypovolemia is physiologically lower in the pediatric patient compared to the adult. In addition, due to their lower blood volume, bleeding volumes of minor importance in an adult, can be critical in the child. For this reason, it is not uncommon to request blood components from the operating room in surgical procedures in which it is not certain that it will be transfused but, if necessary, will require it immediately. Frequently these blood components have to be discarded in case of non-transfusion.
The aim of our study was to analyze the impact of a new transport and storage protocol of blood components in portable coolers with controlled temperature, between the Blood Bank (BB) and the operating room.
Materials and Methods: An analysis of the number of blood components returned to the BB from the operating room over a period of 7 years (2009-2015) was carried out. These units had to be discarded for remaining outside the transfusion service for a period of more than 30 minutes. We also analyze the economic cost of these discarded packages.
During the first 7 months, the impact of the implementation of a protocol for the delivery of blood components to the operating room in portable coolers with controlled temperature was evaluated, both in the number of blood components that were reused and the savings that this entailed.
Results and Discussion: Discarded units in the previous 7 years were: 277 in 2009, 163 in 2010, 146 in 2011, 108 in 2012, 129 in 2013, 110 in 2014 and 110 in 2015 with a total cost of € 161,119.
The provisional results of the first 7 months since its implementation showed 108 sent portable coolers, with a total of 405 Units of blood components (243 CH, 146 FFP and 16 PC).
The number of units of blood components returned to BB and reused was 74 (52 CH, 18 PFC, 4 PQT). Only 2 units of CH and 2 of PFC have been rejected by BB.
The savings calculated at the official price of the Community of Madrid in these 7 months was € 8,700.
The Transfusion committee allowed the detection of an easily avoidable expense through the purchase of 3 portable coolers, accumulators and temperature control systems, which were amortized in a single month.
Conclusions: The development of a protocol for sending portable coolers with blood components to the children´s surgical block will allow an estimated annual savings to the hospital and the Community of Madrid of € 15,000.