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The use of technologies to decrease peri-operative allogenic blood transfusion: results of practice variation in
1Department of Anesthesia, Bnai Zion Medical Center, Haifa, Israel. edna_k@netvision.net.il
The Israel Medical Association Journal : IMAJ
|December 4, 2001
Summary
This study surveyed Israeli hospitals on methods to reduce allogeneic blood transfusions. Significant variations in the use of drugs, cell salvage, and other techniques were found across surgical departments.
Area of Science:
- Transfusion Medicine
- Surgical Safety
- Healthcare Management
Background:
- Growing concerns regarding allogeneic blood transfusion side effects drive interest in peri-operative transfusion minimization.
- Key technologies include pharmaceuticals (aprotinin, desmopressin, tranexamic acid, erythropoietin) and techniques (acute normovolemic hemodilution, cell salvage, autologous pre-donation).
Purpose of the Study:
- To assess the current utilization of seven specific technologies aimed at minimizing allogeneic blood transfusion in Israel.
Main Methods:
- A 1996-97 survey was conducted in Israeli hospitals with over 50 beds and relevant surgical departments (cardiac, vascular, orthopedic, urology).
- Department heads were queried on the current use, extent of use, and influencing factors for each technology.
Main Results:
- Pharmaceutical use for transfusion reduction was highest in cardiac surgery.
- Pre-operative autologous blood donation showed moderate use in orthopedics but was limited in other departments.
- Acute normovolemic hemodilution was primarily used in cardiac departments, while cell salvage was moderately used across most departments except urology.
Conclusions:
- Substantial variability exists in the adoption and application of peri-operative allogeneic blood transfusion minimization strategies across different surgical specialties in Israel.