[Transfusion practices and quantification of blood loss in a surgical setting in Cameroon]

The purpose of this prospective study was to analyze compliance by surgical teams with new guidelines for blood transfusion. Study was focused on routine, presumably hemorrhagic procedures performed electively in adults at the Central Hospital in Yaounde, Cameroon. Overall blood loss was less than 20% of the total volume in 89% of the 303 patients included. Blood loss was between 20 and 30% in 10.6% and greater than 30% in 0.3%. Administration of replacement blood products was warranted only in the last two groups. Blood transfusion was performed in 104 patients and was unjustified in 81.7%. Seven percent of the remaining 199 patients presented indications for transfusion which was not performed and not compensated for by appropriate alternative precautions. At least one unit of whole blood had been requested and delivered to the operating room in 70% of cases with blood loss less than 20%, but was used in only 45% of cases. This study demonstrates poor compliance with new guidelines for blood transfusion in the surgical setting. Overconsumption of blood products represents the main problem. These findings underline the need for wider teaching of new blood transfusion strategies. Interest in this information is usually great in developing countries where blood banks are faced with limited facilities, qualified personnel, and supplies.