Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov;46 Suppl 5(Suppl 5):S90-S96.
doi: 10.1016/j.htct.2024.05.008. Epub 2024 Aug 21.

Optimizing O red blood cell concentrate usage in the emergency department in the era of patient blood management

Louisiane Courcelles  1 , Marie Pouplard  1 , Orla Braun  2 , Corentin Streel  1 , Véronique Deneys  3
Affiliations

Optimizing O red blood cell concentrate usage in the emergency department in the era of patient blood management

Louisiane Courcelles et al. Hematol Transfus Cell Ther. 2024 Nov.

Abstract

Background: Emergency transfusion may require the availability of O-negative red blood cell concentrates without pre-transfusion testing. At the Cliniques Universitaires Saint-Luc, the emergency department was used to having access to two decentralized O-negative red blood cell concentrates. This study aims to analyze the consumption of O-negative red blood cell concentrates in emergency situations both before and after the implementation of a novel strategy aiming at optimizing stocks. This strategy provides a combined allocation of one unit of O-positive red blood cell concentrate and one unit of O-negative red blood cell concentrate decentralized in the emergency department and reserve the transfusion of the negative unit only to under 45-year-old women and under 20-year-old men.

Materials and methods: A retrospective study was conducted of the transfusion and medical records of all patients who received immediate transfusions in the emergency department without pre-transfusion testing between 2008 and 2022.

Results: A total of 193 patients received O red blood cell concentrates without pre-transfusion testing in emergency situations between 2008 and 2022. During the first 24 h of hospitalization, 354 O-negative units were transfused. Mean ratios of number of O-negative bags between 2008 and 2020 was 1.98 unit/patient. After implementation of the new strategy, the ratio in 2021 was 1.46 unit/patient and drastically decreased in 2022 to 0.79 unit/patient.

Conclusion: In situations of emergency, allocating O-negative units only for women younger than 45 years and men younger than 20 years could have saved 85% of O-negative red blood cell concentrates transfused (303/354) yet balancing the immunological risk. Limiting the number of delocalized units of O-negative red blood cell concentrates in the emergency department seems to lower O-negative consumption. With this strategy, the units spared could have been transfused to patients with greater needs (e.g., sickle cell patients or chronically transfused patients).

Keywords: Emergency department; O-negative red blood cells; Patient blood management; Uncrossmatched transfusion.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest The authors affirm that they have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1
Population pyramid of patients transfused with O-negative RBC units at the emergency department between 2008 and 2022 (n = 193).
Figure 2:
Figure 2
Evolution of distribution of O-negative units transfused to 193 patients in the emergency department between 2008 and 2022.
See this image and copyright information in PMC

References

    1. Standards for Blood Banks and Transfusion Services, 33rd edition—Print. (n.d.). Aabb.Org. Retrieved July 25, 2023, from https://www.aabb.org/aabb-store/product/standards-for-blood-banks-and-tr...
    1. Virk M.S., Lancaster D., Quach T., Lim A., Shu E., Belanger G., Pham T.D. Optimizing O-negative RBC utilization using a data-driven approach. Transfusion. 2020;60(4):739–746. doi: 10.1111/trf.15713. - DOI - PubMed
    1. Shreffler D.C., Sing C.F., Neel J.V., Gershowitz H., Napier J.A. Studies on genetic selection in a completely ascertained caucasian population. I. Frequencies, age and sex effects, and phenotype associations for 12 blood group systems. Am J Hum Genet. 1971;23(2):150–163. - PMC - PubMed
    1. Zatta A.J., McQuilten Z.K., Mitra B., Roxby D.J., Sinha R., Whitehead S., Dunkley S., Kelleher S., Hurn C., Cameron P.A., Isbister J.P., Wood E.M., Phillips L.E., Massive Transfusion Registry Steering Committee Elucidating the clinical characteristics of patients captured using different definitions of massive transfusion. Vox Sang. 2014;107(1):60–70. doi: 10.1111/vox.12121. - DOI - PubMed
    1. Streel, C., Pouplard, M., Laporte, F., Bertrand, O., Luyten, U., Pirlet, C., Khaouch, Y., & Deneys, V. (2023). There is an urgent need to adopt a pull-flow logic for the supply of RBCs to meet patients’ needs: A single center study. Transfusion Clinique Et Biologique: Journal De La Societe Francaise De Transfusion Sanguine, S1246-7820(23)00073-3. 10.1016/j.tracli.2023.06.008 - DOI - PubMed

LinkOut - more resources