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.
Goodnough
L T
LT
Department of Medicine, Pathology, and Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Despotis
G J
GJ
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