The safety of red-blood cell transfusion triggers of perioperative transfusion trigger score
JIN Xia;LIAO Ren;LIU Jin;Department of Anesthesiology,West China Hospital of Sichuan University;
Objective To investigate the application of Perioperative Transfusion Trigger Score( POTTS) in directing transfusion in non-cardiac selective surgeries and evaluate its safety in clinical applications. Methods We selected 270 intraoperative packed red blood cell( RBC) transfused patients from the multicenter study following " The safety and effectiveness of POTTS" protocol out of 1 213 patients from 2012 to 2016. 78 of the 270 patients followed POTTS strategy( P group,n =78,evaluated the patients' intraoperative minimum Hb level basing on their cardiac function,respiratory,temperature and angina history) while the rest 192 patients used restrictive strategy for intraoperative transfusion( R group,n = 192,Hb70 g/L as transfusion parameter,anesthesiologists should evaluate whether to start transfusion when Hb 70—100 g/L). We retrospective analyze and compare the incidence of low Hb transfusion,physiological transfusion trigger,acute hemorrhage and comorbidity,evaluated blood loss volume and Hb before transfusion,postoperative 30 d mortality and morbidity. Results When compared with R group,P group had higher incidence of low Hb related transfusion and physiological transfusion trigger( low Hb : 87. 18% vs 52. 08%; physiological transfusion trigger : 59. 90% vs 83. 33; P0. 05). The incidence of hypotension before transfusion in P group was obviously higher than that in R group( 74. 36% vs 51. 56%,P 0. 05). In P group,Hb before transfusion was lower than that in R group( 68 g/L vs 78 g/L,P0. 05). There were no statistically significant differences in 30 d mortality and morbidity between the two groups( mortality: 3. 85% vs 2. 08%; morbidity: 12. 82%vs 8. 85%; P0. 05). Conclusion In non-cardiac elective operations,POTTS strategy is stricter but safer than the restrictive transfusion strategy.
【CateGory Index】： R457.1