Blood transfusion problems in the clinical recommendations “Extrauterine (ectopic) pregnancy”

Abstract

BACKGROUND: This study aimed to assess compliance to transfusion therapy recommendations in the clinical guidelines “Extrauterine (ectopic) pregnancy” with blood transfusion standards and the achievements of evidence-based medicine in transfusiology.

THE MAIN PART: The study assessed the compliance to recommendations on transfusion therapy in the clinical guidelines “Extrauterine (ectopic) pregnancy ― 2021–2022–2023 (01.07.2021)” with blood transfusion guidelines approved by the Russian Ministry of Health (laws, governmental decrees, orders of the Russian Ministry of Health, and instructions on medicines, and medical devices).

It was found that the issues of blood transfusion in the clinical recommendations “Ectopic (ectopic) pregnancy ― 2021–2022–2023 (01.07.2021)” need correction on the following points:

• replace the names of obsolete blood components with current ones;
• replace obsolete blood components with modern ones;
• provide recommendations on immunohematological examination of the recipient and selection of compatible blood components;
• exclude recommendations to use the cancelled “regulatory guillotine” orders of the the Ministry of Health of Russia;
• replace the term “factor VIII concentrate” with “cryoprecipitate” and use fibrinogen concentration rather than factor VIII activity to monitor the efficiency of cryoprecipitate;
• when describing a massive transfusion protocol, clarify that four units must be pooled to obtain a therapeutic dose of platelets, and five units extracted from a dose of whole blood must be pooled to obtain a therapeutic dose of cryoprecipitate;
• bring the recommendations in accordance with the instructions for the medical use of prothrombin complex concentrate and eptacog alfa activated;
• remove the recommendation to use fibrinogen concentrates not registered in Russia.

CONCLUSIONS: Precise recommendations for blood transfusion will improve the treatment of patients with ectopic pregnancy.

Keywords

ectopic pregnancy / guidelines / blood / blood transfusion / red blood cells / platelets / cryoprecipitate

References

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