Blood transfusion and haemostatic management in the perioperative period

McIntyre, Allan J.

doi:10.1007/bf03008848

Cited by 6 publications

(2 citation statements)

References 40 publications

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“…Due to the increased insight into adaptation mechanisms to anae mia, it is, however, generally accepted that transfusion of red cells is rarely indicated to obtain a haemoglobin con centration over 10 g/dl [9,[21][22][23][24]. Although the decline of cardiac performance in elderly patients might explain why lower haemoglobin levels are not accepted by anaesthesiologists during and after surgery, the rationale for higher haemoglobin levels in the elderly is not supported by data Biesma …”

Section: Reduction Of Homologous Blood Requirementmentioning

confidence: 95%

Red Blood Cell Transfusions for Total Hip Replacement in a Regional Hospital

Biesma¹,

Iperen²,

Kraaijenhagen³

et al. 1994

Vox Sanguinis

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To evaluate changes in the need for homologous blood and to assess the impact of autologous blood transfusion, red cell transfusions in unilateral total hip replacement surgery, performed electively in the period 1986-1991, were studied in a regional hospital. Transfusion data, perioperative blood loss and postoperative haemoglobin concentration of 495 patients were analysed. From 1986 to 1991, the percentage of patients not transfused with homologous blood increased from 18.5 to 45.5%. After the introduction of an autologous blood transfusion programme in 1987, 116 of 430 patients (27.0%) donated autologous blood. No increase in the percentage of autologous donors was observed during the study. Most common reasons for nonparticipation were the patient’s age, doctors’ underordering and logistic limitations. 81.9% of autologous donors had total hip replacement surgery without homologous transfusions. Mean blood loss reduced significantly from 1,373±781 ml in 1986 to 958 ±582 ml in 1991 (p < 0.001). Transfusion requirement in the nonautologous patients fell from 2.6±1.8 units in 1986 to 1.4±1.4 units per patient in 1989 and increased thereafter to 2.2±2.1 units in 1991 (p<0.01) and showed a strong correlation with blood loss (r = 0.58; p< 0.001). No changes in postoperative haemoglobin concentration were observed throughout the study. In conclusion, collection of autologous blood is effective, albeit still underutilized, to reduce homologous blood requirement. The close correlation between blood loss and transfusion requirement accentuates the role of surgical practice in the reduction of homologous transfusions.

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Section: Reduction Of Homologous Blood Requirementmentioning

confidence: 95%

Red Blood Cell Transfusions for Total Hip Replacement in a Regional Hospital

Biesma¹,

Iperen²,

Kraaijenhagen³

et al. 1994

Vox Sanguinis

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“…Dentro de las diferentes medidas para ahorro de sangre encontramos: (11,17,18) : a. Implementar los principios quirúrgicos Halstedianos basados en el buen trato a los tejidos, estricta hemostasia, disección por planos y ligaduras selectivas. b. Utilizar dispositivos que disminuyan el sangrado, como el electrocauterio, el láser de Argón, la cirugía endoscópica o video asistida, escalpelo ultrasónico o de radiofrecuencia, pegantes de fibrina y técnicas procoagulantes tópicas.…”

Section: Manejo Intraoperatoriounclassified

Sangrado mayor en paciente adulto. Testigo de Jehová

Tocancipá

Ortiz

2011

RFS

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El sangrado mayor (SM) se define como la pérdida de la volemia en un período de tiempo inferior a 24 horas o la pérdida del 50% de la volemia en un lapso de tiempo inferior a 3 horas en un individuo previamente sano. Teniendo en cuenta la firme posición a rechazar cualquier transfusión de sangre o sus componentes por parte de los Testigos de Jehová, el manejo del sangrado mayor en ellos es un reto ya sea en los servicios de urgencias o de cirugía, con serias repercusiones éticas y legales. El anticiparse al sangrado mayor en Testigos de Jehová permite instaurar acciones preventivas al choque hipovolémico. Para el tratamiento de pacientes Testigos de Jehová con sangrado mayor, se proponen metas terapéuticas que incluyen la realización de intervenciones hemostáticas o farmacológicas durante el tratamiento quirúrgico y en el posoperatorio, plantear metas hemodinámicas y de ventilación mecánica apropiadas. Se hace una revisión narrativa de la literatura de los últimos 10 años y se exponen las acciones preventivas, las metas terapéuticas y las diferentes intervenciones de las que se dispone actualmente para enfrentar el SM.

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Hemostasis and Coagulation

Levi

Poll

2008

Surgery

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Blood transfusion and haemostatic management in the perioperative period

Cited by 6 publications

References 40 publications

Red Blood Cell Transfusions for Total Hip Replacement in a Regional Hospital

Red Blood Cell Transfusions for Total Hip Replacement in a Regional Hospital

Sangrado mayor en paciente adulto. Testigo de Jehová

Hemostasis and Coagulation

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