A guideline for transfusion of red blood cells in surgical patients

Hdl Handle:
http://hdl.handle.net/10147/82987
Title:
A guideline for transfusion of red blood cells in surgical patients
Authors:
National Blood Users Group
Affiliation:
Irish Blood Transfusion Service (IBTS)
Publisher:
Irish Blood Transfusion Service (IBTS)
Issue Date:
2000
URI:
http://hdl.handle.net/10147/82987
Item Type:
Guideline
Language:
en
Description:
Blood transfusion carries a real but unquantifiable risk of adverse outcome in surgical patients from infectious, immunological and cardiorespiratory morbid events. This risk may be reduced, but is not eliminated, by autologous transfusion techniques, which, in turn carry different risk profiles. 2. The only indication for red cell transfusion is to increase the oxygen carrying capacity so as to improve tissue oxygen delivery. 3. No single criterion can be identified as a “trigger for transfusion” because there is no readily available indicator of critical tissue oxygenation. 4. A transfusion is rarely indicated for Hb > 9g/dl. and is almost always indicated for Hb < 6g/dl, (particularly when the anaemia is acute). 5. Each patient should be considered on an individual basis with assessment of the clinical signs and symptoms, particularly those of haemodynamic instability, comorbidity and the risk of further blood loss. 6. Transfusion should be considered on a unit by unit basis. For many patients, a transfusion of a single unit may suffice to meet the clinical need of the patient and to reverse the clinical signs that led to the decision to transfuse. 7. The specific reasons for transfusion should be documented in the patient’s medical records. It may be important to be able to demonstrate that a definite indication existed for the transfusion. 8. Transfusions must only be prescribed by appropriately trained medical practitioners. 9. All patients undergoing elective surgery should be assessed pre-operatively in adequate time to identify and treat anaemia. Blood conservation strategies and alternatives to allogeneic transfusion should be considered at this time to reduce the need for allogeneic blood transfusion. 10. At operation blood loss can be reduced by good surgical and anaesthetic techniques, by minimising perioperative blood sampling, by maintaining normothermia and by the use of pharmacological agents where appropriate. 11. During and following surgery oxygen supply and demand will be improved by ensuring optimal volume status, providing adequate analgesia and supplemental oxygen and by maintaining normothermia. 12. Regular audit, education and review of guidelines should be performed in every hospital; hospital transfusion committees are the appropriate body to oversee these activities.
Keywords:
BLOOD TRANSFUSION

Full metadata record

DC FieldValue Language
dc.contributor.authorNational Blood Users Groupen
dc.date.accessioned2009-09-29T15:53:34Z-
dc.date.available2009-09-29T15:53:34Z-
dc.date.issued2000-
dc.identifier.urihttp://hdl.handle.net/10147/82987-
dc.descriptionBlood transfusion carries a real but unquantifiable risk of adverse outcome in surgical patients from infectious, immunological and cardiorespiratory morbid events. This risk may be reduced, but is not eliminated, by autologous transfusion techniques, which, in turn carry different risk profiles. 2. The only indication for red cell transfusion is to increase the oxygen carrying capacity so as to improve tissue oxygen delivery. 3. No single criterion can be identified as a “trigger for transfusion” because there is no readily available indicator of critical tissue oxygenation. 4. A transfusion is rarely indicated for Hb > 9g/dl. and is almost always indicated for Hb < 6g/dl, (particularly when the anaemia is acute). 5. Each patient should be considered on an individual basis with assessment of the clinical signs and symptoms, particularly those of haemodynamic instability, comorbidity and the risk of further blood loss. 6. Transfusion should be considered on a unit by unit basis. For many patients, a transfusion of a single unit may suffice to meet the clinical need of the patient and to reverse the clinical signs that led to the decision to transfuse. 7. The specific reasons for transfusion should be documented in the patient’s medical records. It may be important to be able to demonstrate that a definite indication existed for the transfusion. 8. Transfusions must only be prescribed by appropriately trained medical practitioners. 9. All patients undergoing elective surgery should be assessed pre-operatively in adequate time to identify and treat anaemia. Blood conservation strategies and alternatives to allogeneic transfusion should be considered at this time to reduce the need for allogeneic blood transfusion. 10. At operation blood loss can be reduced by good surgical and anaesthetic techniques, by minimising perioperative blood sampling, by maintaining normothermia and by the use of pharmacological agents where appropriate. 11. During and following surgery oxygen supply and demand will be improved by ensuring optimal volume status, providing adequate analgesia and supplemental oxygen and by maintaining normothermia. 12. Regular audit, education and review of guidelines should be performed in every hospital; hospital transfusion committees are the appropriate body to oversee these activities.en
dc.language.isoenen
dc.publisherIrish Blood Transfusion Service (IBTS)en
dc.subjectBLOOD TRANSFUSIONen
dc.titleA guideline for transfusion of red blood cells in surgical patientsen
dc.typeGuidelineen
dc.contributor.departmentIrish Blood Transfusion Service (IBTS)en
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