BLOOD TRANSFUSION IN THE EMERGENCY ROOM: EXPERIENCE OF IBN TOFAIL HOSPITAL IN MARRAKECH

Blood transfusion is frequently performed in intensive care. We carried out a prospective study with the objective of evaluating transfusion practices in the emergency room, transfusion thresholds, mortality, prognostic factors and transfusion deviations of labile blood products (LBP) compared to the recommendations of learned societies.This prospective survey was conducted in the vital emergency department of the Ibn Tofail hospital in Marrakech over a period of 6 months, and made it possible to collect data from 50 patients transfused in the emergency room. The mean age was 38±17 years. Patients with no particular pathological history accounted for 10% of cases. The mean SOFA score was 6.34 and the mean APACHE II score was 19.5. Indications for blood transfusion were dominated by hemodynamic instability (71.9%), acute hemorrhage (23.1%) and clinical intolerance of anemia (3.8%). Packed red blood cells (GC) were the most transfused blood product (76.9% of the total amount of transfused LBPs) followed by fresh frozen plasma (FFP) (8.1%) and platelet packs (CP) (1. 3%). The average consumption of CG was 2.3 ± 0.7 units per patient. His transfusion threshold responded to a restrictive strategy. The prescriptions complied with the recommendations of the Afsaps. The average consumption of PFC was 5.27±1.22 units per patient. Five transfusion episodes were deemed inappropriate. CPs were only transfused in 9 study patients. The average consumption was 4.4± 1.3 CP per patient. A single transfusion discrepancy was observed in a single patient. The mean hospital stay was 4±2.5 days. The mean hemoglobin transfusion threshold was 8.3±1.6 g/dl versus 10.3±1.6 g/dl post-transfusion.The mortality rate in the study was 36.9%. Transfusion was not a risk factor for mortality. Six patients developed post-transfusion accidents. Hyperthermia, the initial severity of the disease (high APACHE II and SOFA scores), coagulopathy and renal insufficiency were considered to be poor prognostic factors.