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Perioperative blood and blood component therapy
1Department of Anaesthesia, University of Cape Town, Observatory, Republic of South Africa.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|December 1, 1992
Summary
This overview discusses blood transfusion risks and alternatives for anesthesiologists. It highlights safe practices for blood component use, emphasizing patient safety and cost-effectiveness in managing perioperative anemia.
Area of Science:
- Anesthesiology
- Transfusion Medicine
- Hematology
Background:
- Blood transfusions are critical in surgery but carry risks like infection and immune suppression.
- Massive and rapid transfusions present unique challenges for anesthesiologists.
- Alternatives to homologous blood transfusion are essential for mitigating risks.
Purpose of the Study:
- To provide an anesthesiologist's perspective on blood and blood component use.
- To discuss indications, contraindications, and risks associated with blood transfusions.
- To explore strategies for preventing transfusion-related complications.
Main Methods:
- Review of current literature on blood transfusion practices.
- Analysis of risks and benefits of homologous vs. autologous blood transfusion.
- Examination of perioperative anemia management strategies.
Main Results:
- Perioperative anemia generally does not increase patient morbidity or mortality.
- Specific protocols exist for calculating blood product requirements (e.g., 4 ml/kg packed red blood cells).
- Fresh plasma is often overused; its primary indication is coagulation factor replacement.
Conclusions:
- Anesthesiologists must be well-informed to optimize the use of blood products.
- Blood products, while life-saving, are associated with significant risks and costs.
- Strategies like autologous predonation and intraoperative hemodilution can reduce homologous blood transfusion risks.