Anesthesia & Clinical Research
Open Access

Abstract

Changes in the Transfusion Practice in Cerebral Aneurysm Clipping Surgery: A Center Experience

Filipa Pereira, Angela Carmezim Mota, Manuela Casal, Cidalia Silva, Jorge Coutinho and Humberto Machado

Objective: Blood use in the perioperative period has been changing over time. The increasing costs of transfusions led to a transformation in the clinical practice.

In our institution until April 2012 all patients who underwent cerebral aneurysm clipping surgery had at least 2 units of RBCs (red blood cells) cross-matched before surgery and from then on only type and screen is performed.

This study assesses the policy changes and the costs associated with blood use in cerebral aneurysm clipping surgery.

Methods: Records of 206 patients who underwent cerebral aneurysm clipping surgery at Centro Hospitalar do Porto in Portugal were retrospectively reviewed between January 2011 and July 2014.

Results: A total of 206 patients underwent cerebral aneurysm clipping surgery during the reviewed period. The patients were separated in two groups: cross-match group and type and screen group.104 patients had its blood cross-matched and 102 had it typed and screened. There was a trend to transfuse less when the blood was typed and screened (6% vs 13%). The cross-match group presented average losses of 1,8 units of blood per surgery which represented 188 units of blood that were not used. In this group all the 104 patients had blood prepared, and only 13 (12,5%) used the blood. In the type and screen group the blood was prepared in 13 cases and used only in 6 cases (46%).

The financial analyses revealed that typing and screening cost about 48% less than cross-matching. This means that if the type and screen method was used since the beginning of the period under analysis, the hospital would have had a saving of 1022€.

Conclusion: Routine type and screen should be made for every patients proposed for aneurysm clipping surgery. Financial benefits with the reduction of transfusion costs would lead to a better management of our blood products.