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Optimal hemotherapy in elective surgery.

J J Michiels, H A Bruining, F C Kothe

    The Netherlands Journal of Surgery
    |April 1, 1985
    PubMed
    Summary
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    Implementing evidence-based guidelines for blood transfusion practices, including ABO Rh-D typing and surgical blood order schedules, improves hemotherapy safety and reduces costs in elective surgery.

    Area of Science:

    • Transfusion Medicine
    • Surgical Hemotherapy
    • Health Economics

    Background:

    • Objective guidelines are needed to optimize hemotherapy in elective surgery.
    • Current practices may lead to excessive preoperative crossmatching and resource waste.

    Purpose of the Study:

    • To establish evidence-based guidelines for preoperative blood testing and transfusion in elective surgery.
    • To improve the quality, safety, and economic efficiency of blood transfusion services.

    Main Methods:

    • Analysis of transfusion incidence and crossmatch/transfusion ratios for various surgical procedures.
    • Recommendations for preoperative testing based on transfusion likelihood (e.g., ABO Rh-D typing, antibody screening).
    • Proposal for using surgical blood order schedules (SBOS) to manage preoperative crossmatching.

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    Main Results:

    • Procedures with low transfusion incidence require only ABO Rh-D typing and antibody screening.
    • For moderate to high incidence procedures, crossmatch units should match historical average transfusion.
    • Colloid solutions can replace initial blood loss up to two units in stable patients.

    Conclusions:

    • Appropriate guidelines and recommendations enhance blood transfusion quality and safety.
    • Utilizing SBOS effectively reduces unnecessary preoperative crossmatching.
    • Optimized transfusion strategies lead to substantial economic savings.