[Assessment of transfusion requirements: a way to in improve perioperative management of blood products?].
Autogenic blood transfusion is indispensable in emergency surgery situations involving severe blood loss. It may also be required in some non-emergency surgical and obstetrical situations. The use of blood-sparing techniques as an alternative to autogenic blood transfusions blood loss can be especially beneficial in tropical settings where the risk of viral transmission is high. The combined use of blood-sparing and autogenic transfusion techniques requires preoperative assessment of transfusion requirements. The expected amount of preoperative blood loss must be determined and compared with the acceptable amount of blood loss for the patient in function of transfusion threshold. Various techniques to reduce the need for autogenic blood transfusion can be used depending on locally available resources. Blood-sparing techniques include treatment to increase the patient's baseline hemoglobin rates, use of cell saving systems for autologous blood transfusion, and/or perioperative transfusion of recuperated blood. In this article these techniques are illustrated in two practical clinical cases.
Ponchel
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Département d'Anesthésie-Réanimation-Urgences, Hôpital d'Instruction des Armées, Marseille, France. daru@hia-laveran.fr
Saby
R C
RC
Gil
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C
Petrognani
R
R
Carpentier
J P
JP
D001804:Blood Transfusion, Autologous; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D006801:Humans; D019106:Postoperative Hemorrhage; D011300:Preoperative Care; D018570:Risk Assessment; D014777:Virus Diseases / Q000517:prevention & control / Q000635:transmission