Correlation of coagulopathy and pulmonary insufficiency with blood transfusion in spinal fusions

In a review of 210 spinal fusions, the platelet count and the arterial-alveolar oxygen tension ratio both decreased as the blood transfused increased, but were not correlated with positive fluid balance. In procedures that might require more than 70-80 ml/kg of blood, such as myelodysplastic, paralytic, and congenital spinal surgery, the coagulation system and arterial gases should be monitored frequently intraoperatively and postoperatively.