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Br J Anaesth. 2016 Feb;116(2):255-61. doi: 10.1093/bja/aev456.

Intraoperative transfusion practices in Europe.

Collaborators (415)

Accurso G, Ahrens N, Akan M, Åkeröy K, Aksoy O, Alanoğlu Z, Alfredo M, Alkis N, Almeida V, Alousi M, Alves C, Amaral J, Ambrosi X, Ana I, Anastase D, Andersson M, Andreou A, Anthopoulos G, Apanaviciute D, Arbelaez A, Arcade AL, Arion-Balescu C, Arun O, Azenha M, Bacalbasa N, Baeten W, Balandin A, Barquero López M, Barsan V, Bascuas B, Basora M, Baumann H, Bayer A, Bell A, Belmonte Cuenca J, Bengisun ZK, Bento C, Beran M, Bermudez Lopez M, Bernardino A, Berthelsen KG, Bigat Z, Bilshiene D, Bilska M, Bisbe Vives E, Biscioni T, Björn H, Blom T, Bogdan Prodan A, Bogdanovic Dvorscak M, Boisson M, Bolten J, Bona F, Borg F, Boros C, Borys M, Boveroux P, Boztug Uz N, Brettner F, Brisard L, Britta de W, Browne G, Budow K, Buerkle H, Buggy D, Cain A, Calancea E, Calarasu F, Calder V, Camci AE, Campiglia L, Campos B, Camps A, Carlos D, Carreira C, Carrilho A, Carvalho P, Cassinello C, Cattan A, Cenni L, Cerny V, Ceyda Meço B, Chesov I, Chishti A, Chupin AM, Cikova A, Cindea I, Cintula D, Ciobanasu R, Clements D, Cobiletchi S, Coburn M, Coghlan L, Collyer T, Copotoiu SM, Copotoiu R, Corneci D, Cortegiani A, Coskunfirat OK, Costea D, Czuczwar M, Davies K, De Baerdemaeker L, De Hert S, Debernardi F, Decagny S, Deger Coskunfirat N, Diana T, Diana GM, Dias S, Dickinson M, Dobisova A, Dragan A, Droc G, Duarte S, Dunk N, Ekelund K, Ekmekçi P, Elena C, Ellimah T, Espie L, Everett L, Ferguson A, Fernandes M, Fernández JA, Ferner M, Ferreira D, Ferrie R, Filipescu D, Flassikova Z, Fleischer A, Font A, Galkova K, Garcia I, Garner M, Gasenkampf A, Gelmanas A, Gherghina V, Gilsanz F, Giokas G, Goebel U, Gomes P, Gonçalves Aguiar JM, Gonzalez Monzon V, Gottschalk A, Gouraud JP, Gramigni E, Grintescu I, Grynyuk A, Grytsan A, Guasch E, Gustin D, Hans G, Harazim H, Hervig T, Hidalgo F, Higham C, Hirschauer N, Hoeft A, Innerhofer P, Innerhofer-Pompernigg N, Jacobs S, Jakobs N, Jamaer L, James S, Jawad M, Jesus J, Jhanji S, Jipa Lavina N, Jokinen J, Jovanovic G, Jubera MP, Kahn D, Karjagin J, Kasnik D, Katsanoulas K, Kelle H, Kelleher M, Kessler F, Kirigin B, Kiskira O, Kivik P, Klimi P, Klučka J, Koers L, Kontrimaviciut E, Koopman-van Gemert AW, Korfiotis D, Kosinová M, Koursoumi E, Kozek Langenecker S, Kranke P, Kresic M, Krobot R, Kropman L, Kulikov A, Kvolik S, Kvrgic I, Kyttari A, Lagarto F, Lance MD, Laufenberg R, Lauwick S, Lecoq JP, Leech L, Lidzborski L, Liliana H, Linda F, Llau Pitarch JV, Lopes A, Lopez L, Lopez Alvarez A, Lorenzi I, Lorre G, Lucian H, Lupis T, Lupu MN, Macas A, Macedo A, Maggi G, Mallett S, Mallor T, Manoleli A, Manolescu R, Manrique S, Maquoi I, Marios-Konstantinos T, Markovic Bozic J, Markus W H, Marques M, Martinez R, Martinez E, Martínez E, Martinho H, Martins D, Martires E, Martus P, Matias F, Matot I, Mauff S, Meale P, Meier J, Merz H, Meybohm P, Militello MG, Mincu N, Miranda ML, Mirea L, Moghildea V, Moise A, Molano Diaz P, Moltó L, Monedero P, Moral V, Moreira Z, Moret E, Mulders F, Munteanu AM, Nadia Diana K, Nair A, Neskovic V, Ninane V, Nitu D, Oberhofer D, Odeberg-Wernerman S, Oganjan J, Omur D, Orallo Moran MA, Ozkardesler S, Pacasová R, Paklar N, Pandazi A, Papaspyros F, Paraskeuopoulos T, Parente S, Paunescu MA, Pavičić Šarić J, Pereira F, Pereira E, Pereira L, Perry C, Petri A, Petrovic U, Pica S, Pinheiro F, Pinto J, Pinto F, Piwowarczyk P, Platteau S, Poeira R, Popescu R, Popica G, Poredos P, Prasser C, Preckel B, Prospiech A, Pujol R, Raimundo A, Raineri SM, Rakic D, Ramadan M, Ramazanoğlu A, Rantis A, Raquel F, Rätsep I, Real C, Reikvam T, Reis L, Rigal JC, Rohner A, Rokk A, Roman Fernandez A, Rosenberger P, Rossaint R, Rozec B, Rudolph T, Saeed Y, Safonov S, Saka E, Samama CM, Sánchez López Ó, Sanchez Perez D, Sanchez Sanchez YE, Sandeep V, Sandu MN, Sanlı S, Saraiva A, Scarlatescu E, Schiraldi R, Schittek G, Schnitter B, Schuster M, Seco C, Selvi O, Senard M, Serra S, Serrano H, Shmigelsky A, Silva L, Simeson K, Singh R, Sipylaite J, Skitek K, Skok I, Smékalová O, Smirnova N, Sofia M, Soler Pedrola M, Söndergaard S, Sõrmus A, Sørvoll IH, Soumelidis C, Spindler Yesel A, Stefan M, Stevanovic A, Stevikova J, Stivan S, Štourač P, Striteska J, Strys L, Suljevic I, Tania M, Tareco G, Tena B, Theodoraki K, Tifrea M, Tikuisis R, Tolós R, Tomasi R, Tomescu D, Tomkute G, Tormos P, Trepenaitis D, Troyan G, Unic-Stojanovic D, Unterrainer A, Uranjek J, Valsamidis D, van Dasselaar N, Van Limmen J, van Noord P, van Poorten JF, Vanderlaenen M, Varela Garcia O, Velasco A, Veljovic M, Vera Bella J, Vercauteren M, Verdouw B, Verenkin V, Veselovsky T, Vieira H, Villar T, Visnja I, Voje M, von Dossow-Hanfstingl V, Von Langen D, Vorotyntsev S, Vujanovič V, Vukovic R, Watt P, Werner E, Wernerman J, Wittmann M, Wright M, Wunder C, Wyffels P, Yakymenko Y, Yıldırım Ç, Yılmaz H, Zacharowski K, Záhorec R, Zarif M, Zielinska-Skitek E, Zsisku L.

Author information

1
Clinic of Anesthesiology and Intensive Care Medicine, Faculty of Medicine of the Kepler University Linz, Linz, Austria jens.meier@gmail.com.
2
Emergency Institute of Cardiovascular Disease, University Bucharest, Bucharest, Romania.
3
Department of Anesthesiology and Intensive Care Medicine, EKH Evangelic Hospital Vienna, Vienna, Austria.
4
Department of Anesthesiology and Intensive Care Medicine, Hospital Clínico Universitario de Valencia, Valencia, Spain.
5
Department of Anesthesiology, Royal Free Hospital Hampstead NHS Trust, London, UK.
6
Clinical Epidemiology, Eberhard Karls University Tübingen, Tübingen, Germany.
7
Department of Anesthesiology & Intensive Care Medicine & Pain, Tel Aviv Medical Centre, Tel Aviv, Israel.

Abstract

BACKGROUND:

Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe.

METHODS:

We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013.

RESULTS:

The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl(-1) and increased to 9.8 (1.8) g dl(-1) after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2).

CONCLUSION:

Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl(-1)), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold.

CLINICAL TRIAL REGISTRATION:

NCT 01604083.

KEYWORDS:

anaemia; anesthesia; blood transfusion; surgery; transfusion trigger

PMID:
26787795
PMCID:
PMC4718146
DOI:
10.1093/bja/aev456
[Indexed for MEDLINE]
Free PMC Article

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