[Reduction of preparatory bank blood requirements in adult cardiac surgery].
The importance of blood conservation to minimize homologous blood use in cardiac surgery is well-accepted. In addition, it is financially important to minimize unnecessary and avoidable bank blood prepared, because once the blood products were taken into a hospital, it could not be returned to the blood bank in Japan. We tried to safely reduce the amount of bank blood products requested in 185 consecutive adult cardiac operations for 18 months. First 6 months' observation revealed that only 2 patients received blood transfusion among 34 patients whose products of weight (kg) and hemoglobin (g/dl) were more than 700. We called the product "a transfusion index", and the amounts of blood prepared were newly set as follows: a transfusion index less than 500; 6 units or more of cross-matched red cell concentrate, 500-700; 2 to 4 units of cross-matched red cell concentrate, more than 700; no cross-matched bank blood. In next 6 months, the amounts of cross-matched blood reduced from 4.8 units to 3.9 units per patient. Last 6 months, we prepared no blood products for the patients whose transfusion indexes were more than 700. The amounts of prepared red cell concentrate reduced to 2.1 units per patient, however, additional blood requirements during the operations did not show significant increase. A transfusion index depends on the patient's weight and preoperative hemoglobin is a simple and useful indicator to anticipate blood requirements.
Shigeta
Osamu
O
Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.
Oosaka
M
M
Watanabe
K
K
Imazuru
T
T
Konishi
T
T
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000379:methods*; D006348:Cardiac Surgical Procedures; D006801:Humans; D008875:Middle Aged