Acil Serviste Kan Ürünü İstemlerinin Değerlendirilmesi: Prospektif Gözlemsel Bir Çalışma

Yıl 2024, Cilt: 6 Sayı: 2, 178 - 185, 30.06.2024

Yasemin Özdamar , Mehmet Cihat Demir , İlter Ağaçkıran , Nalan Metin Aksu

https://doi.org/10.52827/hititmedj.1399940

Öz

Amaç: Acil servis kan ürünü istemleri artıyor, ancak aşırı olup olmadığı belirsizdir. Acil hekimleri tarafından yapılan kan ürünü istemlerini ve kullanım oranlarını inceleyerek kan ürünleri istemlerinin aşırı olup olmadığını tespit etmeyi amaçladık.
Gereç ve Yöntem: Bu prospektif, gözlemsel ve tek merkezli çalışma, beş ay içinde üçüncü basamak bir yetişkin acil servisine başvuran 18 yaş ve üzeri hastaların demografik verilerini, kan transfüzyonu endikasyonlarını ve transfüzyon oranlarını incelemiştir.
Bulgular: Bin dört yüz yetmiş beş kan ürünü istemi (hasta başına ortalama 6,92 ünite) incelendi. Bu istemlerin %63,1’i kullanılmadı. Transfüzyon oranları eritrosit süspansiyonu için %40,89, trombosit süspansiyonu için %25,61 ve taze donmuş plazma için %44,34 idi. Kan ürünleri istemenin ana endikasyonları gastrointestinal kanama ve anemiydi. Gastrointestinal kanaması olan hastalarda spesifik olarak eritrosit süspansiyonlarının %30,04’ü, trombosit süspansiyonlarının %31,9’u ve taze donmuş plazmaların %60,56’sı kullanıldı. Travma hastalarında istenen eritrosit süspansiyonlarının %12,75’i, trombosit süspansiyonlarının %0,083’ü ve taze donmuş plazmaların %13,89’u kullanıldı.
Sonuç: Acil serviste kan ürünlerine yönelik aşırı istemler, kaynakların yanlış kullanılmasına neden olabilir. Transfüzyon komitesi, gereksiz istekleri azaltmak ve kaynak kullanımını optimize etmek için özel stratejiler geliştirmeli ve hekim farkındalığını arttırmalıdır.

Anahtar Kelimeler

Eritrosit süspansiyonu, kan ürünleri, kaynak kullanımı, taze donmuş plazma, transfüzyon, trombosit süspansiyonu

Evaluation of Blood Product Requests in the Emergency Department: A Prospective Observational Study

Öz

Objective: Emergency department (ED) blood product requests are rising, but it is unclear if they are excessive. We aimed to examine the blood product requests and usage rates made by emergency physicians to determine whether the requests for blood products are excessive.
Material and Method: This prospective, observational, and single-center study analyzed demographic data indications for blood transfusion, and transfusion rates of patients aged 18 years and older admitted to a tertiary adult emergency department in five months.
Results: One thousand four hundred seventy-five blood product requests (with a mean of 6.92 units per patient) were examined. Of 63.1%, these requests were not used. The transfusion rates were 40.89 % for erythrocyte suspension, 25.61% for thrombocyte suspension, and 44.34% for fresh frozen plasma. The main indications for requesting blood products were gastrointestinal bleeding and anemia. Specifically, 30.04% of erythrocyte suspensions, 31.9% of thrombocyte suspensions, and 60.56% of fresh frozen plasma were used for patients with gastrointestinal bleeding. In trauma patients, 12.75% of requested erythrocyte suspensions, 0.083% of thrombocyte suspensions, and 13.89% of fresh frozen plasma were utilized.
Conclusion: Excessive requests for blood products in the emergency department can misuse resources. The transfusion committee should develop specialized strategies and increase physician awareness to reduce unnecessary requests and optimize resource utilization.

Anahtar Kelimeler

Erythrocyte suspension, blood products, fresh frozen plasma, resource utilization, transfusion, thrombocyte suspension

Etik Beyan

This study was initiated in the emergency department of a university hospital following the ethics committee's approval. (Hacettepe University Non-Invasive Clinical Research Ethics Committee, approval ID: GO 18/498-21, dated June 5, 2018.). No human rights were violated during this study, and the study was in accordance with the Declaration of Helsinki.

Destekleyen Kurum

None

Teşekkür

None

Kaynakça

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