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A1295
October 26, 2005
9:00:00 AM - 11:00:00 AM
Hall C4
A Traceability Tool for Perioperative Blood Salvage To Evaluate and Improve Our Practice in an Orthopedic Surgery Setting
Caroline Hell, R.D., Caroline Forestier, M.D., Barth Calon, M.D., Thomas Breining, M.D., Elise Gaertner, M.D.
Anesthesiology, Hautepierre Hospital, Strasbourg, France
INTRODUCTION:

Current French hospital legislation demands that public health institutions guarantee quality of care by a policy of professional practice evaluation. In order to evaluate and improve our practice in per and postoperative blood salvage, we studied a new tool, the traceability software Smart-Card ™ (Sorin Group, Mirandola, Italy).

METHODS:

Since July 2004, autologous per and postoperative transfusion data are saved from the blood salvage apparatus (Electa™, Sorin Group, Mirandola, Italy) to an electronic card (Smart card™, Sorin Group, Mirandola, Italy). Blood salvage management data of all patients scheduled for elective total hip or knee arthroplasty were transferred from the Electa™ via the Smart-Card™ through an Excel ™ (Microsoft, USA) database.

We evaluated data before (group 1) and after modification of our cell salvage policy (group 2), The analysis concerned the Processed Volumes (A column), hematocrites in the bowls (B), the number of treated bowls (C), wash volumes (D), waste volumes (E), collected red blood cells (F) and final hematocrite of the retransfused red blood cells = hematocrite out of the apparatus (G)

ANALYSIS : Results of this preliminary study were compared by non parametric tests of Mann-Witney and Wilcoxon. (significance p<0.05).

RESULTS : Group 1 (136 patients, July to December) and group 2 (39 patients, December to March) were compared in the following table. Volumes are given in mL.

CONCLUSIONS: This study showed that care personal (anesthesiologists and nurses) did not use the apparatus optimally, resulting in premature washing of several bowls, inadequate use of concentration function, and a low retransfusion hematocrite. After several sessions of utilizer training, data (group 2) showed a definite improvement of the results: hematocrites of the retransfused red blood cells were higher. Furthermore, a non significant decrease of wash and waste volumes was observed, which could result in cost containment. Beyond its benefits for traceability, this tool, in the current quality –insurance approach, allowed us to evaluate and improve our blood management practice in our orthopedic setting.[table1]

Anesthesiology 2005; 103: A1295
Table 1
ABCDEFG
Gr119976.4%33013497938034.6%
Gr220877.6%22713462132740.9%
P0.0080.1NSNSNSNS0.004