[The concept of blood components in surgical hemotherapy ]

During the past 7 years, 85% of all red cell units have been transfused as concentrates (RCC) with a haematocrit of 70% at our University Hospital. The basic concept is to exploit the differing critical levels of various parameters in the circulation of the patient. In per cent of normal, we have: blood volume 100%, haematocrit 80%, total serum protein 60%, plasmatic coagulation factors 35%, and platelets 25%. This permits the stepwise use of a plasma substitute, RCC, 5% albumin, and fresh frozen plasma or whole blood. A retrospective, but carefully controlled study of 372 patients showed that this system has no negative effects on the postoperative course. Its logistic advantage is that the plasma from the blood donations used to treat about 80% of surgical patients can be diverted to fractionation into specific derivatives, whereas it does not increase the needs for albumin.