TRANSFUSION OF BLOOD AND BLOOD COMPONENTS IN POLYTRAUMATISED PATIENTS AT CELJE HOSPITAL (1998–2001)
Abstract
Background. The replacement of fluids after severe injuries is always a complex issue, either in medical doctrine or in clinical practice. Regardless of the fact, daily work with patients requires the clearest possible guidelines and their regular monitoring.
Methods. We made a chart showing the number of patients and the quantity of blood or blood components used in the Celje General Hospital in the past four years.
Results. The analyses have shown that indications for the use of blood or blood components have narrowed. At the same time, it is quite evident that it is difficult and also risky to decide on a transfusion only on the given laboratory values. Only a careful analysis of the therapy has shown that the decision on a transfusion is based on both, the clinical picture and its development, the evaluation of visible and invisible loss of blood, and on regular and extensive laboratory monitoring.
Conclusions. Despite improved surgical techniques and introduction of new transfusion strategies loss of blood and need for transfusion during and after polytrauma surgeries is still rather high. In the analysed four year period, the maintained level of haemoglobin in patients that had a major surgery has slightly declined. It is therefore essential to cooperate with the respective hospital transfusion committee and prepare as well as follow up some clear guidelines for the rationalisation, not only restriction of transfusion of blood and blood components.
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References
American College of Surgeons Committee on Trauma. Shock. In: Advanced trauma life support course for physicians. Chicago: American College of Surgeons Committee on Trauma 1997: 103–8.
Division of Trauma and Surgical Critical Care Los Angeles Country & University of Southern California Trauma Center. Massive blood transfusion in trauma. http://www.usc.edu/hsc/medicine/surgery/trauma/trauma_protocols/massbld.html
Kerkkamp H.E.M. European blood menagement practise in ortopedic surgery. In: Anaemia menagement in surgery and critical care. Abstract book 9th Annual Meeting of the European Society of Anaesthesiologists. Gothenburg: European Society of Anaesthesiologists, 2000: 6–7.
Mc Farland JG. Perioperative blood transfusions: indications and options. Chest 1999; 115: 113S–21S.
Muller G, N’tial I, Nist M et al. Application of blood transfusion guidelines in a major hospital of Kinshasa, Zaire. AIDS 1992; 6: 431–2.
ASA Task force. Practice guidelines for blood component therapy. Anesthesiology 1996; 84: 32–2.
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