[Rationalization of transfusional therapy in elective surgery. Our experience].
The paper reports the authors' experience regarding the rationalisation of transfusional therapy. The high risks of infection or damage to the immune system have highlighted the need to review the approach used by the anesthetist, surgeon or hematologist resulting in major cultural changes and the development of methods for the use of autologous blood. The study was carried out by comparing 2 similar periods of surgical activity in which the sole variant was the different attitude of the anesthetist who utilised blood transfusion on the basis of pre, intra and postoperative hematocrit values; in addition, the Authors report the results obtained in a group of patients enrolled for EIN. They observed that by using simple rationalisation a 30% saving, equivalent to 101 blood units, was achieved; EIN was performed in 20 patients out of the 32 enrolled with an effective 20% saving equivalent to 40 units; calculating the theoretical saving which could be obtained by total EIN and rationalisation, a saving of as much as 58% equivalent to 198 units could be achieved. Even if many aspects still require definition, good rationalisation, even using simple techniques, coupled with the availability of autologous blood certainly makes blood transfusion safer and less expensive.
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Istituto di Anestesiologia e Rianimazione, Università degli Studi di Siena.
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D001803:Blood Transfusion / Q000706:statistics & numerical data*; D006438:Hemodilution; D006801:Humans; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*
Razionalizzazione della terapia trasfusionale nella chirurgia di elezione. Nostra esperienza.