Red Blood Cell Transfusion Practices

Abstract

Background and Objectives. High-intensity ICU staffing model is associated with quality and outcome improvements. Restrictive red blood cell (RBC) transfusion strategies have been shown to have equivalent mortality to a more liberal strategy in the ICU. We examined the effect of high-intensity staffing on pretransfusion hemoglobin levels, RBC transfusion rates and length of ICU stay. Materials and Methods. The study was a retrospective chart review (n = 196) of all patients admitted to the adult medical/surgical ICU for more than 24 hours one year prior to and after institution of the high-intensity staffing model. Results. Matched for demographics and diagnosis, RBC transfusion rates pre- versus postinstitution of the high-intensity staffing model was 42% versus 27%, respectively, and pretransfusion hemoglobin levels were lower (8.94 to 7.39 g/dL). Length of stay was 4.1 days pre–high-intensity staffing and 4.0 days post–high-intensity staffing. Conclusions. High-intensity ICU staffing resulted in fewer RBC transfusions and lower transfusion thresholds. This restrictive RBC transfusion strategy had no adverse effects on patient ICU length of stay.