Predetermined transfusion guidelines, pretransfusion approval, and transfusion audits are useful tools in the education of those ordering blood components, potentially resulting in the reduction of inappropriate use of blood components. Our institution requires mandatory prospective audits for a proportion (10%) of packed red blood cell unit orders and all orders for fresh frozen plasma, platelets, and cryoprecipitate. Cases where the blood bank physician recommends against a transfusion and the ordering physician concurs, or when blood components are released against blood bank's recommendation, are referred to the transfusion committee. Transfusion committee members review the medical records to determine the circumstances surrounding the transfusion request as well as patient outcomes relating to their receiving or not receiving the transfusion. We analyzed 220 transfusion episodes brought before the transfusion committee from 2001 to 2005. The most requested blood component denied or changed was fresh frozen plasma. With only a few exceptions, the denial or change of blood components had no adverse effect on the patient. Nonetheless, these interventions were deemed appropriate by the transfusion committee. In most cases, blood components released based on the demand of the ordering physician, despite the advice of the blood bank physician, were deemed as inappropriate transfusions. This study therefore suggests that prospective audits of blood component orders can help reduce inappropriate transfusions and can be a valuable educational tool for the ordering physicians as well as for residents in training.

中文翻译：

---

确定一家大型大学医院血液成分输血适宜性的前瞻性审核计划：5年经验。

预先确定的输血指南，输血前批准和输血审核是对订购血液成分的人员进行教育的有用工具，有可能减少对血液成分的不当使用。我们的机构要求对包装的红细胞单元订单和所有新鲜冷冻血浆，血小板和冷沉淀的所有订单进行强制性前瞻性审核（10％）。血库医师建议不要输血而订购医师同意的情况，或血液成分违背血库的建议而被释放的情况，请转至输血委员会。输血委员会成员检查医疗记录，以确定围绕输血请求的情况以及与他们接受或不接受输血有关的患者结果。我们分析了2001年至2005年输给输血委员会的220次输血事件。最被要求拒绝或改变的血液成分是新鲜的冷冻血浆。除少数例外，血液成分的拒绝或改变对患者没有不利影响。但是，输血委员会认为这些干预措施是适当的。在大多数情况下，尽管有血库医师的建议，根据订购医师的要求释放的血液成分仍被认为是不适当的输血。