Quality, Regulation and Governance: Winning Abstract 2017
Review of blood product management for an ECLS programme
M. Williams & C. Nolan
Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
Introduction:
The Extra Corporeal Life Support (ECLS) programme at Our Lady’s Children’s Hospital commenced in 2007. The Blood Transfusion laboratory provides significant support to patients while they are on ECLS. Laboratory management works closely with the clinical teams to minimise exposure to blood components for these patients.
Patients are categorised into ‘bleeding’ and non-bleeding’ patients. Their category influences the blood components held on standby while the patient is on ECLS. To assess the success of blood minimising strategies a review of blood component usage, by patients while on ECLS, was performed.
Data from 2009 to 2016 was analysed.
Method:
The list of patients on ECLS is provided regularly by the ECLS Coordinator to facilitate monitoring of blood component usage. Data for each patient was compiled from the Laboratory Information Management System (LIMS) and is maintained on Excel spreadsheets.
Total usage, usage of each component, costs per patient and per day was calculated from this data.
Results:
123 patients were placed on ECLS during the review period with a total of 608 days on ECLS over the eight years (range 53-104 days per year). There was an overall reduction in blood component usage from a high in 2009 to its lowest level in 2016.
Since 2011 there was an annual increase in the use of pedipacks for patients under four months of age, with the exception of 2016. An annual reduction in the average number of platelets, red cells and plasma used per patient on ECLS was identified. This was confirmed by the reduced cost per day on ECLS from €1588 in 2009 to €836 in 2016.
Conclusion:
Close co-operation between the Blood Transfusion laboratory and clinical teams facilitates the reduction in donor exposure for patients on ECLS and contributes to the overall reduction in costs associated with ECLS. Continued monitoring is required to ensure blood minimising strategies, like the use of pedipacks, are maintained.
