[Rational transfusion therapy. A study of transfusion practice and possibilities of optimization in elective coronary...

The objective of the study was to evaluate the effect of intervention on physicians' transfusion behavior in elective coronary artery bypass grafting (CABG). We analyzed transfusion data on 176 patients who underwent primary elective CABG during two periods, either before (phase one, n = 102) or after (phase two, n = 74) intervention. The intervention was based on cooperation with the involved department of cardiac surgery, interviews of the surgeons and anaesthesiologists ordering blood, and concurrent audit of transfusion practice using a blood order form. The proportion af patients receiving allogenic transfusions decreased from 90% in phase one to 58% in phase two and the total use of blood components was reduced from an average of 6.3 units/patient to 2.7 units/patient, p < 0.01. Indications for transfusion documented in the medical record increased from 19% in phase one to 63% in phase two. It is concluded that intervention on physicians' transfusion behavior can improve the transfusion therapy in patients who undergo elective CABG.