Simeone et al developed a model for predicting blood transfusion requirements during heart surgery. Comparison of predicted to actual blood use can help to identify patients who may have been overtransfused. The authors are from the University of Siena in Italy.
Parameters:
(1) hematocrit on admission
(2) minimum hematocrit during cardiopulmonary bypass (CPB)
(3) cardiopulmonary bypass time in minutes
(4) timing for the surgery
(5) systemic arterial hypertension
(6) preoperative dialysis
(7) cardiogenic shock
(8) age of the patient in years
(9) type of cardiac surgery
|
Parameter |
Finding |
Points |
|
hematocrit on admission |
> 40% |
0 |
|
|
<= 40% |
1 |
|
minimum hematocrit at CPB |
> 20% |
0 |
|
|
<= 20% |
2 |
|
cardiopulmonary bypass |
<= 130 minutes |
0 |
|
|
> 130 minutes |
1 |
|
timing for the surgery |
elective |
0 |
|
|
urgent |
0.5 |
|
|
emergency |
1.5 |
|
systemic arterial hypertension |
absent |
0 |
|
|
present |
0.5 |
|
preoperative dialysis |
no |
0 |
|
|
yes |
4 |
|
cardiogenic shock |
no |
0 |
|
|
yes |
2.5 |
|
age of the patient in years |
<= 70 years |
0 |
|
|
> 70 years |
0.5 |
|
type of cardiac surgery |
isolated CABG |
0 |
|
|
other |
1 |
total predicted blood usage =
= SUM(points for all 9 parameters)
Interpretation:
• minimum predicted blood usage: 0 units of RBCs
• maximum predicted blood usage: 14 units of RBCs
• A patient who got 3 or more units of RBCs above the predicted value was classified as overtransfused.
• A patient who got 3 or more units of RBCs less than the predicted value was classified as under-transfused.
Specialty: Clinical Laboratory, General Surgery, Anesthesiology, Emergency Medicine, Critical Care
