[Measures for allogeneic blood conservation in surgery].

Area of Science:

• Anesthesiology and Perioperative Medicine
• Transfusion Medicine
• Surgical Oncology

Context:

• Allogeneic blood transfusions carry inherent risks, including transfusion-transmitted infections and immunological adverse effects.
• Reducing reliance on allogeneic transfusions is a critical goal in patient blood management.
• Optimizing surgical techniques and patient-specific hematocrit levels are key to minimizing transfusion needs.

Purpose:

• To outline strategies for reducing the need for allogeneic blood transfusions.
• To discuss various blood conservation techniques and their appropriate application.
• To emphasize the importance of individualized patient care in transfusion management.

Summary:

• Essential strategies to reduce allogeneic transfusions include accepting individually adjusted lowest hematocrit levels and minimizing intraoperative blood loss through optimal surgical techniques.
• Additional accepted interventions encompass preoperative autologous blood donation (with erythropoietin support), preoperative hemodilution (with erythropoietin support), intraoperative and postoperative blood salvage, pharmacologic interventions to accelerate hemostasis, and controlled hypotension.
• The efficacy and indication of these measures are patient-specific, necessitating an individualized approach and optimal combination of methods for effective blood conservation planning.

Impact:

• Implementation of these blood conservation strategies can significantly decrease the risks associated with allogeneic blood transfusions.
• Individualized treatment plans and careful consideration of risks versus benefits are crucial for successful blood management.
• The development of algorithms for predicting transfusion needs can aid in preoperative planning and enhance patient safety.