HHS: Hospitals need management programs for blood transfusions

U.S. hospitals need to develop "patient blood management" programs to reduce the number of unneeded blood transfusions given across the country, according to a recent Associated Press story.

The problem: There is a wide variability in when and how physicians choose to provide transfusions, with patients in the South most likely to receive one, and patients out West least likely. As a result, "there is both excessive and inappropriate use of blood transfusions in the U.S. Improvements in rational use of blood have lagged," the HHS Advisory Committee on Blood Safety and Availability said earlier this month. Blood use in the U.S. has skyrocketed in the past decades--rising more than 40 percent between 1994 and 2008, committee advisors report. And the U.S. uses far more blood--49 units for every 1,000 patients--when compared to other countries like Britain and Canada, which use only 30 units for every 1,000 patients, on average.

The cause is two-fold, committee members say: U.S. physicians too often use transfusions as a first-line treatment on minor problems like mild anemia; and U.S. hospitals aren't employing new strategies to reduce blood-loss during surgeries or other invasive procedures.

Committee members are pushing HHS to develop new, tighter standards for when transfusions are appropriate, and encouraged hospitals to voluntarily develop blood management programs to the same end. One example: Eastern Maine Medical Center has instituted just such a program and cut its blood use in half since 2006, according to the AP.

The hospital has developed clear guidelines for using transfusions on anemic patients, implemented re-circulating technology during surgery to capture and re-use the patient's own blood, and instituted new rules for physicians ordering multiple transfusions on the same patient.

Harvey Klein, head of the National Institutes of Health's Division of Transfusion Medicine, encouraged more of a management approach than a strict attempt to reduce overall transfusion use, according to coverage in the America's Blood Centers', ABC Newsletter.

To learn more:
- read the AP story in the San Jose Mercury News
- get more details from America's Blood Center's commentary