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[Allo-transfusion saving measures in maxillofacial surgery]

R G Rohling1, A P Zimmermann, P E Haers

  • 1Klinik und Poliklinik für Kiefer- und Gesichtschirurgie, Universitätsspital Zürich.

Swiss Surgery = Schweizer Chirurgie = Chirurgie Suisse = Chirurgia Svizzera
|July 9, 1998
PubMed
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Implementing a protocol of blood-saving measures significantly reduced homologous blood transfusions in maxillo-facial surgeries. This approach, combining techniques like acute normovolemic hemodilution and cell saving, nearly eliminated the need for transfusions in major procedures.

Area of Science:

  • Anesthesiology and Surgical Care
  • Transfusion Medicine
  • Hematology

Context:

  • Maxillo-facial surgeries often involve significant blood loss (>500 ml).
  • Previous homologous blood consumption and blood-saving measure utilization were evaluated retrospectively (June 1990-May 1994).
  • A prospective study (June 1994-May 1996) assessed a blood-saving protocol in 204 patients.

Purpose:

  • To investigate the efficacy of a comprehensive blood-saving protocol in minimizing homologous blood transfusions during major maxillo-facial surgeries.
  • To compare blood utilization before and after protocol implementation.

Summary:

  • The blood-saving protocol included acute normovolemic hemodilution, controlled moderate hypotension, cell saving, preoperative autologous blood donation, and rh-erythropoietin administration.

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  • In the prospective phase, only 30 out of 204 patients required homologous blood.
  • This represented an 83% reduction in patients receiving transfusions and a decrease from 427 to 56 units of homologous blood consumed annually.

    • Impact:

    • Consequent application of blood-saving measures dramatically reduces the need for homologous blood transfusions.
    • Combining normovolemic hemodilution, cell saving, and hypotension proved most effective in minimizing transfusion requirements.
    • The study demonstrates the feasibility and significant benefits of a structured blood management program in complex surgical settings.