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[A questionnaire study about perioperative blood transfusion].
Tomoki Nishiyama1, Kazuo Hanaoka
1Surgical Center, Institute of Medical Science, University of Tokyo, Tokyo 108-8639.
Masui. the Japanese Journal of Anesthesiology
|August 13, 2003
Summary
Perioperative blood transfusion practices show widespread adoption of autologous blood transfusion and pre-transfusion radiation. However, the study reveals inconsistencies in type & screen and maximum surgical blood order schedule use, with a new guideline deemed inadequate by many.
Area of Science:
- Anesthesiology and Perioperative Medicine
- Transfusion Medicine
- Health Services Research
Context:
- The evolution of blood transfusion practices includes innovations like mannitol-adenine-phosphate, autologous blood transfusion, type & screen (T&S), maximum surgical blood order schedule (MSBOS), and new guidelines.
- Understanding the current adoption and effectiveness of these advancements in perioperative settings is crucial.
Purpose:
- To assess the current state of perioperative blood transfusion practices through a questionnaire-based study.
- To evaluate the implementation and perceived adequacy of various blood transfusion strategies and guidelines in hospitals.
Summary:
- A survey of 1,600 hospitals revealed that 40.6% responded, indicating high adoption of informed consent (89.8%) for transfusions.
- Blood loss volume, hemoglobin (8 g/dL), and hematocrit (25%) are primary transfusion triggers. Predeposited autologous transfusion (PAT) is common, with whole blood rarely prepared even for significant anticipated loss.
- Pre-transfusion radiation (89.8%) is widely practiced, yet only half of hospitals utilize T&S and/or MSBOS. Over 20% find the new transfusion guideline inadequate.
Impact:
- The findings highlight the integration of autologous blood transfusion, radiation, and leukocyte depletion in current transfusion practices.
- Despite advancements, the study points to variability in the application of T&S and MSBOS, suggesting a need for improved adherence or guideline refinement.
- The perceived inadequacy of the new guideline indicates potential gaps in its practical implementation or scope, necessitating further review and potential revision.