Authors
Pokhabov D.S., Tankaeva Kh.S., Kuzmin N.S., Madzaev S.R., Zhiburt E.B., Shalygin L.D.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Rationale: the education of pediatric transfusion doctors aims to create evidence-based clinical thinking that leads to better outcomes.
Objective: to assess the change in knowledge about the appointment of erythrocyte transfusion in children over 15 years.
Methods: using the original questionnaire on 4 clinical situations, we determined the knowledge of 110 doctors about the hemoglobin level at which erythrocytes should be transfused to children, as well as the volume of transfused erythrocytes. The results were compared with the answers of 134 colleagues 15 years ago. The results were evaluated by descriptive statistics at a significance level of p<0.05.
Results: in all 4 scenarios, there was a statistically significant reduction in the proportion of physicians who ordered blood transfusions at a higher hemoglobin concentration and at an increased dose of injected red blood cells.
In total, in all simulated situations, doctors in 2023 would prescribe a transfusion:
a) with a hemoglobin concentration above 90 g/l — in 10.7% of cases, and in 2008 — in 36.5% (p<0.001),
b) in the maximum suggested dose (20 ml/kg) l — in 5.4% of cases, and in 2008 — in 17.6% (p<0.001).
Despite the increase in adherence to the restrictive tactics of erythrocyte transfusion, the heterogeneity of the answers of the interviewed specialists attracts attention: the share of the most frequent answers about the threshold level of hemoglobin in different scenarios ranged from 29.8% to 75.5% (in 2008 — from 24.6 % to 57.3%.
Conclusion: based on the results of 2 surveys of doctors on the threshold level of hemoglobin for prescribing blood components and the dose of red blood cells transfused to children, performed in 2008 and 2023. it has been established that changes in knowledge about blood transfusion in children increase physicians’ adherence to restrictive tactics of erythrocyte transfusions. The heterogeneity of the answers of the interviewed specialists necessitates the improvement of educational activities in the field of clinical transfusiology.
Keywords: blood, blood transfusion, erythrocytes, knowledge, restrictive, liberal.
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