Establishing practice guidelines for surgical blood management.
Medical practice guidelines have been promoted as a way to improve the cost-effectiveness of medical care. Algorithms for the transfusion of red blood cells, plasma, and platelets may be especially useful in the surgical setting if they incorporate point-of-care information that is both physiologic and patient-specific for transfusion decision making. Therefore, the goals of guidelines for surgical blood management should be twofold. They should (1) acknowledge patient-specific variability while addressing physician- and institution-dependent variables; and (2) improve blood component management by developing more physiologic clinical indicators of the need for allogeneic red blood cell transfusion.
Department of Medicine, Pathology, and Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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Goodnough
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Despotis
D000465:Algorithms; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000191:economics / Q000592:standards*; D001026:Coronary Artery Bypass; D003362:Cost-Benefit Analysis; D017707:Erythrocyte Transfusion / Q000379:methods; D006489:Hemostatic Techniques; D006801:Humans; D017410:Practice Guidelines as Topic; D013514:Surgical Procedures, Operative