Transfusão sanguínea em um hospital de urgências e emergências

Transfusão sanguínea em um hospital de urgências e emergências

• Autor
• Martha Cavalcanti dos Santos
• Co-autores
• Bianca Cansian , Raul Garre Climent Rocha , João Carlos Pina Faria , Camila Augusta Victorino , Roseli Oselka Saccardo Sarni
• Resumo

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  Blood transfusion in an urgency and emergency hospital 

  Abstract:

  Objective: To evaluate the adequacy of the prescription of red blood cells concentrates by emergency physicians.

  Methods: A Cross-sectional study by survey of transfusion requisition records completed by emergency physicians, from May/2018 to April/2019, in an emergency hospital. Adequacy in the indication, volume and subtype (filtered, irradiated and washed) of prescribed erythrocytes were evaluated. To compare the qualitative data, we used the ?2 test. The significance level adopted was 5%.

  Results: One thousand and twenty two transfusions were evaluated. The indication, volume and subtypes were correct in 72.7%, 45.9% and 81.6% respectively. Transfusion in symptomatic patients presented superior adequacy when compared to asymptomatic individuals with significant statistical difference (indication: 79,6% vs 67.2%, p <0.001; Volume: 63.5% vs 31.7%, p <0.001; subtype: 85.3% vs 78.7%, p 0.006). Among clinical situations, there were more errors in sepsis (39.7%) and pneumonia (36.3%). More than half of the prescriptions presented excessive volume, raising the risk of circulatory overload, observing that the mean age was 60.6 years. The specific analysis of the prescribed subtypes showed adequacy of 17.9% in the filtrated, 1.7% in the irradiated and none of the washed. Thirty transfusions should have been filtered, but the prescriber did not request the subtype.

  Conclusion: One hypothesis for the observed inaccuracies is inadequate medical training on the subject, both in undergraduate and medical residency, associated with a lack of updating in transfusion protocols. The transfusion Committee received the results of this study with a proposal for continuing education measures on transfusion hemotherapy.

  Key words: Erythrocyte Transfusion, Emergency Treatment, Prescriptions, Transfusion Medicine.

   

• Palavras-chave
• Transfusão de Eritrócitos, Tratamento de Emergência, Prescrições, Medicina transfusional.
• Área Temática
• Clínica Médica

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