Pre-operative routine cross-match for elective thyroid surgery: an appropriate use of blood utility

Authors

  • Nathee Maneewan
  • Waraporn Chau-in
  • Radda Khumhom
  • Kunrisa Boonvarawatthana
  • Duangnade Litu
  • Cattleya Thongrong

Keywords:

routine cross-matched preoperatively, elective thyroid surgery, blood utilization

Abstract

Background: Surgical procedures frequently require blood transfusion. Blood and its components are frequently ordered and cross-matched excessively, without proper analysis of the real needs.

Objective: The purpose of this study was to analyses the actual intraoperative requirement versus the ordering of blood in elective thyroid surgery before implementation of a blood order guideline.

Methods: Consecutively elective thyroid surgeries from January to December 2011 were collected retrospectively using an electronic management information system of Srinagarind
Hospital and anesthetic records. Pre-operative cross-match status and blood transfusion data for each patient were identified from the medical and anesthetic records. The blood utilization parameters include cross-match to transfusion (C/T) ratio; transfusion probability (%T) and transfusion index (Ti) were calculated.

Results: There were 257 patients undergone thyroid surgery. 73 units of pack red blood
cell were prepared for 114 cases. Only 11 units of the prepared blood were used for the 5 patients. The total cost for the blood preparation was 30,780 baht, while the expense of the actual blood used only 2,970 baht. The transfusion utilization indices, C/T ratio, % T and Ti, were 10.36, 6.84 and 0.096, respectively.

Conclusion: This study shows the over-ordering blood by routine pre-operative cross-match for elective thyroid surgery. Blood should be typed and screened preoperatively and cross-matched only when clinically indicated to minimize inappropriate request and expenditure.

Downloads

Published

2017-03-29

How to Cite

Maneewan, N., Chau-in, W., Khumhom, R., Boonvarawatthana, K., Litu, D., & Thongrong, C. (2017). Pre-operative routine cross-match for elective thyroid surgery: an appropriate use of blood utility. Thai Journal of Anesthesiology, 43(1), 49–57. retrieved from https://he02.tci-thaijo.org/index.php/anesthai/article/view/92225

Issue

Vol. 43 No. 1 (2017): January – March

Section

Original articles

License

Copyright
Copyright of all articles published in the Thai Journal of Anesthesiology is held by the Thai Journal of Anesthesiology, the Royal College of Anesthesiologists of Thailand. Submission of a manuscript constitutes the authors' agreement that, upon acceptance for publication, copyright of the work is transferred to the Journal. The content and any opinions expressed in published articles are the sole responsibility of the authors and do not necessarily reflect the views of the editorial board or the Royal College of Anesthesiologists of Thailand.

Licensing
All articles are published open access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). Under this license, anyone may copy and redistribute published articles in any medium or format for non-commercial purposes, provided that appropriate credit is given to the authors and to the Thai Journal of Anesthesiology as the original source of publication, a link to the license is included, and the material is not modified in any way. Requests for commercial use or for adaptation of published material should be directed to the editorial office.

Authors' Rights
Although copyright is held by the Journal, authors retain the right to reuse their own published material in their future scholarly works, theses and dissertations, teaching, and academic presentations, and to deposit the final published version (PDF) in institutional or subject repositories or on personal and institutional websites, without embargo, provided that the Thai Journal of Anesthesiology is clearly acknowledged as the original place of publication.