Maximum Surgical Blood Ordering Schedule in Common Pediatric Cardiac Surgeries in a Tertiary Center

Background & Objective: Unnecessary pre-operative ordering of red blood cells (RBCs) in elective surgeries increases costs and waste of blood inventory. Maximum surgical blood order schedule (MSBOS) is a helpful strategy in the estimation of blood units needed for surgery and the prevention of overconsumption. In this study, an MSBOS for pediatric cardiac surgeries is designed.Methods: In this cross-sectional study, we included all pediatric patients who underwent elective cardiac surgery in Children’s Medical Center in Tehran, Iran, from March ۲۱, ۲۰۱۹, to September ۲۲, ۲۰۱۹. Data consisted of the type of surgery and the number of blood units transfused and units cross-matched, based on which cross-match to transfusion ratio (CTR), the transfusion index (TI), and transfusion probability (T%) were calculated.Results: Overall ۲۰۵ pediatric patients were included in the study. Four hundred and ten RBCs units were cross-matched, and ۲۶۲ were transfused. The overall results of the CTR, T%, and TI for all the eight types of cardiac surgery were ۱.۵۶ (۴۱۰/۲۶۲), ۷۶% (۱۵۷/۲۰۵), and ۱.۲۸ (۲۶۲/۲۰۵), respectively. The raw MSBOS for cardiac surgeries included ventricular septal defect, tetralogy of fallot, dextro-transposition of the great arteries, atrial septal defect, aortic coarctation, patent ductus arteriosus, pulmonary stenosis, and pacemaker insertion, which were ۱.۵۸, ۱.۰۳, ۱.۵۴, ۱.۶۶, ۰.۷۷, ۰, ۱.۲۵, and ۰ unit, respectively, and the figures were rounded up.Conclusion: Accurate MSBOS protocols reduce cross-match workload in laboratories, lead to the appropriate use of blood stocks with less wastage, save human and economic resources, and eventually, promote patient safety.