Related Experiment Video
Updated: Jun 25, 2026
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
An audit of transfusion of red blood cell units in pediatric anesthesia
Charlotte Y Keung1, Katherine R Smith, Helen F Savoia
1Department of Anaesthesia, Royal Children's Hospital, Melbourne, Australia.
Insights
Pediatric surgery significantly impacts red blood cell (RBC) usage, with specific procedures like cardiac surgery and liver transplants requiring the most transfusions. Understanding these patterns aids resource allocation and patient counseling.
Area of Science:
- Pediatric Surgery
- Transfusion Medicine
- Healthcare Resource Management
Background:
- Red blood cell (RBC) transfusions are critical in surgery, yet pediatric data on usage is limited.
- Informed consent and resource allocation necessitate understanding RBC transfusion likelihood.
- Current knowledge gaps exist regarding perioperative RBC utilization in pediatric populations.
Purpose of the Study:
- To quantify and describe RBC use during the perioperative period in a large pediatric hospital.
- To identify specific surgical procedures with high RBC transfusion rates in children.
Main Methods:
- A 2-year retrospective analysis merging operating theatre, trauma registry, and blood bank databases.
- Calculation of RBC transfusion incidence associated with various surgical procedures.
- Identification of RBC units transfused perioperatively.
Main Results:
- Over 21,000 patients underwent over 32,000 anesthetics, with 41% of released RBC units transfused perioperatively.
- Cardiac surgery was the largest consumer of RBC units (2359 units).
- High transfusion rates observed in liver transplants (87%), cardiac surgery (on bypass 79%, off bypass 55%), and cranioplasty (61%).
Conclusions:
- Perioperative transfusion accounts for a significant portion of total RBC consumption in pediatric surgery.
- Specific high-risk procedures drive the majority of pediatric RBC transfusions.
- Findings support targeted strategies for RBC management in pediatric surgical settings.
Background:
Patients undergoing surgery are an important user of red blood cells (RBC). Increasingly, medical staff and patients wish to know the likelihood of RBC transfusion for appropriate resource allocation and to inform preoperative discussions regarding risk. Although some adult data are available, little is known about RBC use in children.
Aim:
The aim of this study was to describe RBC use in the perioperative period in a large pediatric hospital.
Methods:
Over a 2-year period the hospital operating theatre database and trauma registry was merged with the blood bank database to identify episodes where RBC units were transfused in association with anesthesia. Incidence of transfusion of RBC units associated with particular procedures was then calculated.
Results:
A total of 21 441 patients underwent 32 511 anesthetics from January 1, 2006 to December 31, 2007, and 9838 units of RBC were released from the hospital blood bank of which 4070 (41%) were transfused in the perioperative period. Cardiac surgery was the greatest user of RBC units (2359 units). Acute major trauma accounted for only 159 units. Overall 6.3% of anesthetics were associated with a RBC transfusion. The procedures with the greatest frequency of RBC transfusion were cardiac surgery on bypass (79%), cardiac off bypass (55%), liver transplant (87%) and cranioplasty (61%).
Conclusion:
In a tertiary pediatric hospital surgery accounts for a substantial proportion of total RBC use, with particular procedures accounting for the majority of transfusions.
Related Concept Videos
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...