Analysis of Immediate-Spin Crossmatched Blood for Emergency Transfusions

Abstract

Background : To evaluate the appropriateness for the requests for the emergency transfusions, we reviewed 3 year experiences in the use of the immediate-spin crossmatched blood (ISMB) for emergency transfusions in a tertiary hospital.

Methods : Low-isotonic salt solution was used for cell suspension and crossmatchings were con￢tinued including antiglobulin phase after issuing of the ISMB. The number of cases, the issuing time, sex, age, reasons for emergency transfusions and vital signs of the patients were retrospec￢tively reviewed. Only cases of massive transfusions and classes III and IV according to the Advanced Trauma Life Support (ATLS) classification were considered appropriate.

Results : 1. The total number of emergency transfusions was 614 and 0.53 cases per day. The average age of the patients was 44.7±17.8 and male to female ratio was 2:1. And 357 cases (58.2%) were performed during off hours when the hospital was not fully staffed. 2. Six hundred thirteen cases (99.8%) were transfused with compatible blood. However, one case (0.2%) was found to have anti-E antibody during the emergency transfusion. 3. Massive transfusion were per￢formed only in 32% of the total cases and the reasons for emergency transfusions in remaining cases were upper gastrointestinal bleeding (53%), trauma (19.2%) and for obstetrical problems (16.8%), 4. Of the total 519 cases reviewed, 392 cases (75.5%) were considered appropriately, and 127 cases (24.5%) were considered inappropriately selected for emergency transfusions.

Conclusions : One fourth of emergency transfusions were found to be inappropriate. We believe that the physicians and educational programs should carefully request the ISMB for emergency transfusions and that the use of ISMB is clearly indicated for emergency transfusion management.