Homologous blood transfusion practices in patients scheduled for major elective surgery in Mulago Hospital in 2005

Abstract

Homologous blood transfusion is taking of blood from one individual and inserting it in to the circulatory system of another and it is considered a form of organ transplant. It is performed as a treatment of various medical conditions with decreased oxygen carrying capacity in circulation such as anaemia. The main objective of the study is to describe the current homologous blood transfusion practices in patients aged 12 years and above scheduled for major elective surgery in Mulago Hospital. It is a cross-sectional descriptive study for patients aged 12 years and above who were consecutively recruited and for whom blood were ordered as they were scheduled for elective surgery in Mulago Hospital. The data were collected using questionnaires. The ASA classification and the diagnosis as well as the persons responsible for ordering the blood and how much was ordered were noted from the file. In the theatre, blood lost during surgery, duration of surgery, types of anaesthesia, and the techniques used to reduce blood loss were recorded. The patients were followed up in the wards for the first 24 hours and noted whether transfusion had been done. The data was analysed using EPI- Info program Computer. The study covered 152 patients and 268 units of blood were ordered and only 22 units (14.47%) were used. The mean blood loss intra-operatively was 450.3mls and the cross-matched to transfusion ration was 12.18: 1 P – Value of the test statistics is 0.08 hence it is significant. In conclusion most of the blood (77.6%) was ordered by the surgeon. The general condition of the patient, duration of surgery, the procedure type of anaesthesia and the techniques to reduce blood loss affects the transfusion needs of the patient. Recommendation: The surgeon and the anesthetist should take full responsibility and assess the patients for elective surgery together. The patients should be normally prepared in an optimal physiological state. Appropriate type of anaesthesia, technique to reduce blood toss should be used.