Outcomes of red blood cell transfusions prescribed in organ donors by the Digital Intern, an electronic decision support algorithm. Transfusion 2018 Feb;58(2):366-371
Date
12/02/2017Pubmed ID
29194652DOI
10.1111/trf.14424Scopus ID
2-s2.0-85036496601 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
BACKGROUND: The Digital Intern (DI) is an electronic decision support tool for the management of organ donors. One algorithm determines the dose, in units of red blood cells to be transfused, based on hematocrit (Hct) thresholds and targets. The effectiveness of the transfusion dose calculated by the DI in terms of achieving the selected Hct target and the duration of the targeted dose is not known.
STUDY DESIGN AND METHODS: This was a retrospective study to describe the outcomes of transfusions prescribed by the DI. Pre- and posttransfusion Hct levels were compared to define response and all posttransfusion Hct values were plotted to evaluate the duration of the prescribed dose.
RESULTS: A total of 120 organ donors were studied and 22 donors had 28 transfusions (six were transfused twice). The transfused donors were a mix of trauma and medical admissions and brain death and cardiac death donors. The transfusion target of 24% Hct was attained in 96% of transfusions. The mean number of units transfused was 1.4 and the mean time from transfusion to procurement was 19.8 hours. There was a decline in Hct over time after transfusion in all but one case with a mean decline of 1.9% Hct over 13 hours. Six donors were transfused twice, likely due to a longer donor time period (41.7 hr vs. 27 hr).
CONCLUSIONS: The DI provided transfusion dosing that achieved the desired threshold in the majority of organ donors transfused. Ongoing work focuses on application of this technology to transfusions in general patient populations.
Author List
Connor JP, Raife T, Medow JEAuthor
Joshua E. Medow MD Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AlgorithmsDecision Making, Computer-Assisted
Erythrocyte Transfusion
Female
Humans
Male
Retrospective Studies
Risk Factors
Tissue Donors
