The use of blood products in the Intensive Therapy Unit
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 Aims – This audit was undertaken to establish whether use of packed red cell (PRC) transfusions in the Intensive Therapy Unit (ITU) was in line with best clinical evidence. It aimed to help optimise the use of blood transfusions, thereby improving patient safety and reducing costs. Methods – This retrospective audit examined blood transfusions administered in the ITU over a six month period. The indication for transfusion was identified from the requesting database or medical notes in order to assess whether the transfusion was appropriate. The data was used to establish the number of transfusions administered inappropriately, average number of units administered per session and average haemoglobin at which PRC were transfused. Results – 131 units of PRC were transfused in ITU during the 6 month period. 25 units (19.1%) administered in 13 transfusion sessions were deemed ‘inappropriate.’ Excluding cases of acute bleeding, 2 units of PRC were transfused in 38 (79.2%) sessions, whilst single units were transfused in 10 (20.8%) sessions. The mean haemoglobin at which patients were transfused was: 7.4g/dL (transfusions within guidelines); 6.7g/dL (within guidelines but excluding acute bleeding and cardiac history); 7.9g/dL (outside guidelines but clinically justified); 7.7g/dL (not justified). Inappropriate transfusions exposed a minimum of 6 patients to unnecessary risk, and were associated with a cost of £4245.24. Conclusions – 77% PRC transfusions were given appropriately; a relatively conservative transfusion strategy was evident, however, there was still a tendency to transfuse multiple units. Increasing awareness of the available evidence may help to reduce the number of inappropriate transfusions and consequently reduce unnecessary risk to patients and costs of treatment.