Blood transfusion requirement in surgery for femoral artery aneurysms

Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion requirement in patients undergoing surgery for femoral artery aneurysms.

The blood transfusion requirements of 120 patients undergoing surgery for femoral artery aneurysms were studied. All patients underwent routine pre-operative and postoperative haemoglobin measurement. Operative blood loss was also assessed.

The transfusion requirements were correlated with the type of aneurysms, the existence of preoperative anaemia and intraoperative blood loss. A total of 62 (52%) patients were transfused with a total of 144 units. Out of 90 patients with anastomotic femoral aneurysms, 42 patients were transfused with a total of 89 units. The average measured intraoperative blood loss was 635 ml. Out of 17 patients with atherosclerotic femoral aneurysms, 13 patients were transfused with a total of 34 units. The average measured intraoperative blood loss was 1107 ml. Out of 13 patients with traumatic or mycotic femoral aneurysms, 7 patients were transfused with a total of 21 units. The average measured intraoperative blood loss was 536 ml.

Patients with a preoperative haemoglobin < 7 mmol/l should be cross-matched 3-4 units. When the preoperative haemoglobin is between 7 and 9 mmol/l, patients should be cross-matched 1-2 units, whereas it should be safe to group and antibody screen patients with a preoperative haemoglobin > 10 mmol/l.