Evaluation of the appropriateness of red blood cell suspension replacements in patient blood management

"Patient Blood Management (PBM)" is a multidisciplinary, evidence-based treatment model aimed at providing the most appropriate care for the patient by optimizing the patient's own blood, thereby reducing the need for blood and blood component transfusions while managing an acceptable level of anemia risk. The aim of our study is to evaluate red blood cell (RBC) transfusions performed in a university hospital from the perspective of PBM principles. This study included 1000 patients aged 18 and over who were hospitalized or followed up in outpatient clinics for various reasons and received RBC transfusions between March 1, 2023, and May 1, 2023, at Eskişehir Osmangazi University Hospital. It was observed that a total of 1217 units of RBC transfusions were administered to these 1000 patients. The highest rate of transfusions was in the hematology department at 18.5%, followed by the medical oncology department at 15.1%. In our study, it was noted that the most common indication for RBC transfusions was low hemoglobin levels. The mean hemoglobin level of these patients before transfusion was found to be 7.647 ± 1.1067 g/dL. It was observed that the second most common indication for RBC transfusion was in patients who underwent major postoperative surgeries. The mean hemoglobin level of these patients before transfusion was calculated to be 8.302 ± 1.1969 g/dL, and this value was found to be statistically significantly higher than the other indications (p<0.001). Among those with a pre-transfusion hemoglobin (PTH) level ≥ 10 g/dL, the most common indication for transfusion was postoperative low hemoglobin, with a rate of 54.2%. The PTH value was not recorded for 29 patients, and the vast majority of these patients (69%) were transfused due to postoperative low hemoglobin. A statistically significant relationship was found between the number of transfusion units administered at one time and the PTH level (p<0.001). In total, 76 transfusions out of 1217 showed blood group incompatibility. However, no transfusion reactions were observed in any of the transfusions performed during the study. Key Words: Patient Blood Management, Red Blood Cell Suspension