Research spotlight: When it comes to blood tranfusions, less is more
Approximately 36,000 pints of blood are used in transfusions every single day in the United States, saving the lives of countless patients who have endured trauma, surgery, or illness. But in recent years, evidence has emerged that these transfusions all come with more risk than doctors originally thought. Studies have shown patients who receive more blood are subject to a variety of negative outcomes, longer hospital stays, more trouble breathing, more time in intensive care, and higher infection rates relative to similar patients who did not receive as many transfusions. Some doctors have even begun calling them “liquid organ transplants” to underscore the care that should be taken when administering them.
Golisano Children’s Hospital physicians are doing their part to contribute to this growing field of research by studying outcomes of children who have undergone cardiac surgery. Led by Jill Cholette, M.D., Associate Professor of Pediatrics, the group has conducted four clinical trials and published the bulk of the research done on the subject. Most recently, a paper in the Annals of Thoracic Surgery — the official journal of The Society of Thoracic Surgeons — described how infants recovering from cardiac surgery are best managed with a conservative approach to blood transfusions.
It’s an approach employed at Golisano Children’s Hospital as well, which subscribes to quality-not-quantity, when considering a transfusion.
“It’s a joint effort between the surgeons, anesthesiologists, and the ICU, and others to reduce the volume and number of blood transfusions we give,” said Cholette. “The other portion is improving the quality of blood we give to patients. There are ways to modify blood — to wash it, clean it, store it — that make for safer and more effective transfusions.”
Cholette is also working with a group of PICU physicians nationally that is putting together formal guidelines for blood transfusions in PICU patients, an initiative supported by the National Institutes of Health.
“It’s an important topic,” said Cholette. “I’m glad it’s getting more attention.”