[Transfusion practice of anesthesiologists in Spain]

To determine the packed red cell transfusion practices of Spanish anesthesiologists and the importance they placed on techniques for reducing blood product use.

One hundred letters with five copies of a questionnaire were sent to an equal number of anesthesiology and intensive care recovery departments of randomly chosen Spanish hospitals.

Forty-seven hospitals responded with 208 completed questionnaires. Responses following the questionnaire form were considered valid. Transfusions are regularly given when hematocrit falls 24% (39.4%) or 27% (37.8%) or when hemoglobin falls below 8 g% (37%) or 9 g% (30%). Most respondents considered that certain clinical situations can affect the need for transfusion: age (86.5%), coexistence of heart disease (95%) or respiratory disease (72.3%) and prior hematocrit or hemoglobin levels (88%). The most frequently applied technique for reducing the need for blood product transfusion of blood derivatives is normovolemic hemodilution, followed by autologous self-transfusion and controlled hypotension. Clinical judgement and prior blood test results are highly valued as indicators for transfusion (8.68 and 7.48 points out of 10, respectively). The respondents suggested the need for greater coordination of medical and surgical department transfusion policy, as well as the need to hold a consensus conference.

Perioperative transfusions of packed blood cells are mainly performed at 8 to 9 g% of hemoglobin, although need is often based on certain clinical features.