Perioperative interventions to decrease transfusion of allogeneic blood products.
OBJECTIVE
To discuss some of the many options available for decreasing perioperative transfusion of allogeneic blood products.


METHODS
We review the issues that focus on the goal of developing an appropriate transfusion strategy in consideration of the individual patient's preexisting conditions, physiologic requirements, perioperative stress, and coagulation status.


RESULTS
Increased awareness of transfusion-related morbidity from allogeneic blood products has resulted in increased development and application of alternatives to allogeneic transfusion. Preoperative donation and perioperative collection of autologous blood and blood products decrease exposure to allogeneic blood. Pharmacologic agents, such as antifibrinolytics, may also decrease the need for allogeneic transfusion. Perioperative use of laboratory tests of coagulation function facilitates the rapid and specific diagnosis of coagulation disorders.


CONCLUSIONS
Physicians now have considerable appreciation of the risks and benefits of blood product transfusion. This knowledge has resulted in conservative and scientific approaches to therapy for perioperative bleeding and coagulopathy.
Ereth
M H
MH
Department of Anesthesiology, Mayo Clinic Rochester, MN 55905.
Oliver
W C
WC
Santrach
P J
PJ
D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D016913:Blood Component Transfusion / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000295:instrumentation; D017558:Elective Surgical Procedures; D006489:Hemostatic Techniques; D006801:Humans; D007432:Intraoperative Period; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*