Provider uptake of the anemia protocol across different intensive care units over 5 years in urban medical center.

Abstract

Background: Anemia is a common condition among critically ill patients. To address this, patient blood management (PBM) programs have been introduced to enhance anemia treatment while reducing the need for transfusions. This study assesses the implementation and effectiveness of an anemia management protocol across multiple intensive care units (ICUs), with a particular emphasis on its impact within the trauma ICU (TICU).

Methods: We retrospectively reviewed ICU patients at AGH from 2016 to 2020. Adult patients (≥18 years) with an admission hemoglobin <12 g/dL were included. Statistical analyses compared patients receiving the anemia protocol management (AP) versus those receiving standard of care (nonanemia protocol [N-AP]).

Results: Out of 28,420 ICU admissions, 32% of TICU patients met the inclusion criteria, with 43% managed using the AP-significantly higher than in other ICUs (p < .001). Within the TICU, patients receiving the protocol had fewer daily blood draws (p = .04), lower transfusion rates (p = .001), and higher average hemoglobin levels (p = .03) compared to those not managed with the protocol. Over time, protocol use in the TICU increased from 15% in 2016 to 41% in 2020 (p < .001), which correlated with reductions in transfusions and blood draws.

Conclusion: The adoption of a structured AP was linked to enhanced anemia management, decreased transfusion requirements, and fewer blood draws in ICU patients. The TICU showed the highest rate of protocol adoption and the most notable improvements. These results support the broader implementation of protocol-driven PBM approaches to optimize outcomes in ICU settings.