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Blood transfusion in critically ill patients in an Intensive Care Unit of a Tertiary Hospital in Nigeria
Abstract
Objective: To evaluate the use of whole blood and blood products in our ICU to determine patterns and outcome after transfusion.
Design: A retrospective, case-control study.
Setting: The Intensive care unit (ICU) of the University of Benin Teaching Hospital, a seven-bed open unit for the management of surgical, medical and paediatric patients.
Subjects: Patients who received blood transfusion in the ICU. Every patient who received blood transfusion was matched for a similar case without blood transfusion. Patients’ socio-demographic characteristics, number of units of blood transfused, length of stay and outcomes were determined.
Result: Approximately 30% of all patients admitted during the study period were transfused with blood. Majority of these patients (83.2%) had one to three units of blood. Obstetrics and neuro-surgical patients had more blood transfused than others. Whole blood constituted >85% of blood transfused while packed cells and fresh frozen plasma constituted 11.8% and 2.8% respectively. Blood transfusion did not have any significant impact on patients’ length of stay and mortality. The number of units of blood transfused appears to be associated with poor outcome (P=0.006).
Conclusion: Obstetric and neuro-surgical patients utilised blood and blood products in the ICU more than any other patients. The number of units of blood transfused was more predictive of mortality than the blood transfusion per se. A judicious use of blood and blood products, giving patients what they need and the development of transfusion guideline in the ICU is expedient.
Design: A retrospective, case-control study.
Setting: The Intensive care unit (ICU) of the University of Benin Teaching Hospital, a seven-bed open unit for the management of surgical, medical and paediatric patients.
Subjects: Patients who received blood transfusion in the ICU. Every patient who received blood transfusion was matched for a similar case without blood transfusion. Patients’ socio-demographic characteristics, number of units of blood transfused, length of stay and outcomes were determined.
Result: Approximately 30% of all patients admitted during the study period were transfused with blood. Majority of these patients (83.2%) had one to three units of blood. Obstetrics and neuro-surgical patients had more blood transfused than others. Whole blood constituted >85% of blood transfused while packed cells and fresh frozen plasma constituted 11.8% and 2.8% respectively. Blood transfusion did not have any significant impact on patients’ length of stay and mortality. The number of units of blood transfused appears to be associated with poor outcome (P=0.006).
Conclusion: Obstetric and neuro-surgical patients utilised blood and blood products in the ICU more than any other patients. The number of units of blood transfused was more predictive of mortality than the blood transfusion per se. A judicious use of blood and blood products, giving patients what they need and the development of transfusion guideline in the ICU is expedient.
