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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

A massive transfusion protocol to decrease blood component use and costs.

Terence O'Keeffe¹, Majed Refaai, Kathryn Tchorz

¹Departments of Surgery, Division of Burn, Trauma, and Critical Care, University of Texas Southwestern Medical School, Dallas 75390, USA.

Archives of Surgery (Chicago, Ill. : 1960)

|July 23, 2008

Summary

This summary is machine-generated.

Implementing a massive transfusion protocol (MTP) significantly reduced blood component use and improved turnaround times, leading to cost savings. Mortality rates remained unchanged, and recombinant factor VIIa did not increase complications.

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Area of Science:

Trauma care
Transfusion medicine
Hemorrhage management

Background:

Massive transfusion protocols (MTPs) are critical in managing severe hemorrhage.
Optimizing blood component use and transfusion efficiency is a key challenge in trauma care.

Purpose of the Study:

To evaluate the impact of implementing a massive transfusion protocol (MTP) on blood component utilization, transfusion turnaround times, costs, and patient outcomes.
To assess the safety of using recombinant factor VIIa within the MTP, specifically regarding thromboembolic complications.

Main Methods:

A retrospective before-and-after cohort study was conducted at an academic Level I urban trauma center.
Blood component use, transfusion turnaround times, costs, and mortality were compared between 132 patients treated under an MTP and 46 historical control patients.
The MTP involved the use of recombinant factor VIIa for patients with exsanguinating hemorrhage.

Main Results:

Following MTP implementation, there was a significant decrease in the use of packed red blood cells, plasma, and platelets.
Transfusion turnaround times improved, with the first shipment under 10 minutes and reduced time between shipments (18 vs. 42 minutes).
Significant cost savings of $2270 per patient were achieved, despite the addition of recombinant factor VIIa, and no increase in thromboembolic complications was observed.

Conclusions:

The MTP effectively reduced blood component consumption and improved transfusion efficiency, resulting in substantial cost savings.
Patient mortality rates were not significantly affected by the MTP implementation.
The use of recombinant factor VIIa within the MTP did not lead to an increase in thromboembolic complications.