Abstract
In this study, we retrospectively carried out a survey on trigger values of hemoglobin concentration for red cell concentrates (RCC) transfusion, prothrombin time for fresh frozen plasma (FFP) transfusion, and platelet counts for platelet concentrates (PC) transfusion at Matsuyama Red Cross Hospital in 2006. Trigger values were then compared with the blood usage guidelines revised in 2005 in Japan. Actual rates of trigger value assessment on the day of transfusion were 78.1% in cases with RCC transfusion, 54.8% with FFP, and 77.5% with PC. The rate of appropriate RCC usage was high in patients with hematological disease (76.7%), but low in perioperative patients (41.0%) and those with chronic hemorrhage (33.3%). Concerning FFP, the rate of trigger value assessment remained low, and the rate of appropriate usage remained at lower levels in all patients (7.7∼22.7%). The rate of appropriate PC usage was high in patients with hemorrhage or disseminated intravascular coagulation syndrome (92.6%), perioperative patients (67.4%), and in those with acute leukemia or malignant lymphoma (85.0%). On the contrary, the rate of appropriate PC usage was low in patients with aplastic anemia or myelodysplastic syndrome (37.6%), and solid tumors or miscellaneous diseases (18.5%). Concerning patients with hematological disease, the rate of appropriate PC usage increased just after the reservation system was introduced. This was because doctors recognized trigger platelet counts used for PC, and then medical technologists checked the platelet counts of patients before transfusion and confirmed the clinical decision made by the doctor. In conclusion, the checking system used by medical technologists and reconsideration of the trigger values by doctors were useful for the appropriate usage of blood products.
