Intraoperative Autologous Blood Storage and Usage in Pediatric Cardiac Surgical Patients Undergoing Cardiopulmonary Bypass
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Authors
Johnsen, Julie
Issue Date
2020-04-07
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Type
Poster
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Abstract
Purpose: The purpose of this quality improvement project was to reduce the use of donor blood by implementing standards that enhance the use of intraoperative autologous blood in post pediatric cardiac surgical patients who undergo cardiopulmonary bypass in a midwestern children’s hospital.|Background: Pediatric donor blood transfusion reactions are underdiagnosed due to similarities with the patient’s underlying condition. Pediatric patients have double the rate of donor blood transfusion reactions when compared to adults. Autologous blood reduces or avoids donor blood transfusion reactions and exposures due to utilizing the patient’s own blood. The American Association of Blood Banks (AABB) recently liberalized the interoperative autologous blood storage standards. The extended intraoperative autologous blood storage time promotes longer patient availability and lessens the patient’s risk for donor blood exposure.|Sample/Setting: 28-bed PICU at a midwestern pediatric hospital. 169 PICU Staff (RNs, Paramedics, CNAs), 11 OR staff, 18 MDs, 8 Nurse Practitioners.|Methods: The staff were educated on the new AABB standards via PowerPoint and were trained on the autologous blood storage and documentation process. A quiz was given at the end of the education to verify understanding of the new process.|Results: Of the 43 pediatric cardiac surgeries, 15 utilized intraoperative autologous blood. Three of those 15 surgeries utilized intraoperative autologous blood greater than 8 hours post collection as a result of the liberalized AABB guidelines. Fourteen that received autologous blood did not require a donor blood RBC transfusion 24 hours post-operatively because they remained hemodynamically stable. The patient cost savings for autologous vs donor blood transfusion was $620.|Conclusion: Implementing the new liberalized AABB standard for intraoperative autologous blood reduces donor RBC exposure thus reducing the risk for adverse reactions to post pediatric cardiac surgical patients. This improved process will lead to increased patient safety and cost savings for the patient.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University