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Scientific Articles

Rationale for blood request: cross match versus group and screen

Authors:

Chanika A Gamage ,

Department of Surgery, Faculty of Medicine, University of Colombo, LK
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P Pratheepan,

Professorial Surgical Unit, National Hospital of Sri Lanka, LK
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S Sivaganesh

Department of Surgery, Faculty of Medicine, University of Colombo and Professorial Surgical Unit, National Hospital of Sri Lanka, LK
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Abstract

Introduction Adherence to guidelines for the cross-matching and reservation of blood for surgical procedures will optimize the utilization of resources. The objective of this study was to evaluate the practice of cross-match and utilization of blood for elective surgeries in a tertiary Sri Lankan surgical unit using the following criteria: cross-match to transfusion ratio (C/T ratio) ≤ 3.0, transfusion probability (%T) ≥30 and transfusion index (TI) ≥0.5.

Material and methods A retrospective analysis of 104 patients who underwent elective surgical procedures at the Professorial Surgical Unit, Colombo during the period of January-September 2011 was done. Data was obtained from patient records. Blood utilization was evaluated using the following indices: C/T ratio, %T and TI.

Results Of the 104 patients, 96(92.3%) had a cross-match and 8 (7.69%) had only a group and screen. The cumulative non-utilisation of cross-matched blood was 107/126 (84.9%).All procedures studied had a CT ratio > 3 and a TI < 0.5 i.e. beyond the criteria of justification for a crossmatch. Large bowel surgeries, mastectomies and oesophagectomies marginally matched the criteria justifying a crossmatch only in respect to the %T, with values just above 30%.

Conclusion This data suggests that unwarranted cross-matching of blood is done in most procedures, especially cholecystectomies, fundoplications and thyroidectomies where a group and screen is adequate. We recommend further study of this issue and the development of evidence based blood ordering schedules in each hospital.

Sri Lanka Journal of Surgery 2013; 31(3): 24-27

DOI: http://dx.doi.org/10.4038/sljs.v31i3.6225

How to Cite: Gamage, C.A., Pratheepan, P. & Sivaganesh, S., (2014). Rationale for blood request: cross match versus group and screen. Sri Lanka Journal of Surgery. 31(3), pp.24–27. DOI: http://doi.org/10.4038/sljs.v31i3.6225
Published on 24 Jan 2014.
Peer Reviewed

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