A randomized controlled clinical trial to compare the clinical outcome of random-based versus formula-based blood transfusion in a tertiary care hospital setting
{"title":"A randomized controlled clinical trial to compare the clinical outcome of random-based versus formula-based blood transfusion in a tertiary care hospital setting","authors":"Prashant Pandey , Supriya Kumari , Gyanendra Agarwal , Shalendra Goel , Divya Setya , Saikat Mandal , Arghyadeep Marik , Mukesh Kumar Singh","doi":"10.1016/j.tracli.2025.02.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objectives</h3><div>Red cell transfusion is the mainstay of therapy for anemia and it is important to transfuse adequate dosage of red cells to maintain tissue oxygen demands. Additionally, it is also important to avoid overload of red cells to prevent adverse effects. Therefore, we compared the rise in hemoglobin and hematocrit for random-Based transfusion (RBT) and formula-based blood transfusion (FBBT) among patients to get a better understanding of differences in clinical outcome between the two methods.</div></div><div><h3>Materials and methods</h3><div>In this study 752 patients were included who were admitted in the hospital and required transfusion of a single unit of PRBC. Patients included in the study were randomized in two categories, RBT and FBBT, using stratified random sampling without any bias. In RBT category, patients received blood transfusion according to standard practice i.e. patient received the full red cell unit without any modifications in volume. All odd number request in cross-match register during the study period who fulfilled the eligibility were included in this group. In FBBT group, even numbered requests in the crossmatch register were randomized to receive FBBT. In this category, patients received transfusion according to the following formula:</div><div>Volume of PRBCs to be transfused = TBV × (Desired Hct − Current Hct of patient)/ Hct of donor unit (where the desired rise of Hct is 3%).</div></div><div><h3>Results</h3><div>In our study we found that the rise in hemoglobin and hematocrit levels were significantly higher for patients receiving FBBT as compared to the patients receiving RBT. Pre-transfusion hemoglobin and hematocrit did not have a significant difference whereas the post transfusion hemoglobin and hematocrit showed a higher rise in the FBBT group as compared to the RBT group. (Welch corrected <em>t</em> = 2.633, <em>p</em> value = 0.0086).</div></div><div><h3>Conclusion</h3><div>This study re-emphasizes the value of FBBT over the routinely used RBT. This study found that FBBT had an edge over RBT, providing significantly higher increase in post-transfusion Hb and Hct. The authors therefore are of the opinion that use of FBBT may be considered in routine clinical practice to optimize transfusions for the patients.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"32 2","pages":"Pages 171-177"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transfusion Clinique et Biologique","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1246782025000308","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives
Red cell transfusion is the mainstay of therapy for anemia and it is important to transfuse adequate dosage of red cells to maintain tissue oxygen demands. Additionally, it is also important to avoid overload of red cells to prevent adverse effects. Therefore, we compared the rise in hemoglobin and hematocrit for random-Based transfusion (RBT) and formula-based blood transfusion (FBBT) among patients to get a better understanding of differences in clinical outcome between the two methods.
Materials and methods
In this study 752 patients were included who were admitted in the hospital and required transfusion of a single unit of PRBC. Patients included in the study were randomized in two categories, RBT and FBBT, using stratified random sampling without any bias. In RBT category, patients received blood transfusion according to standard practice i.e. patient received the full red cell unit without any modifications in volume. All odd number request in cross-match register during the study period who fulfilled the eligibility were included in this group. In FBBT group, even numbered requests in the crossmatch register were randomized to receive FBBT. In this category, patients received transfusion according to the following formula:
Volume of PRBCs to be transfused = TBV × (Desired Hct − Current Hct of patient)/ Hct of donor unit (where the desired rise of Hct is 3%).
Results
In our study we found that the rise in hemoglobin and hematocrit levels were significantly higher for patients receiving FBBT as compared to the patients receiving RBT. Pre-transfusion hemoglobin and hematocrit did not have a significant difference whereas the post transfusion hemoglobin and hematocrit showed a higher rise in the FBBT group as compared to the RBT group. (Welch corrected t = 2.633, p value = 0.0086).
Conclusion
This study re-emphasizes the value of FBBT over the routinely used RBT. This study found that FBBT had an edge over RBT, providing significantly higher increase in post-transfusion Hb and Hct. The authors therefore are of the opinion that use of FBBT may be considered in routine clinical practice to optimize transfusions for the patients.
期刊介绍:
Transfusion Clinique et Biologique, the official journal of the French Society of Blood Transfusion (SFTS):
- an aid to training, at a European level
- the only French journal indexed in the hematology and immunology sections of Current Contents
Transfusion Clinique et Biologique spans fundamental research and everyday practice, with articles coming from both sides. Articles, reviews, case reports, letters to the editor and editorials are published in 4 editions a year, in French or in English, covering all scientific and medical aspects of transfusion: immunology, hematology, infectious diseases, genetics, molecular biology, etc. And finally, a convivial cross-disciplinary section on training and information offers practical updates.
Readership:
"Transfusers" are many and various: anesthetists, biologists, hematologists, and blood-bank, ICU and mobile emergency specialists...