Janvier G, Bricard H
Département d'Anesthésie-Réanimation I, Hôpital Pellegrin-Tripode, Bordeaux.
Ann Chir. 1992;46(5):384-98.
Tactics in blood transfusion have evolved considerably during the last ten years. Awareness of infectious risks and economic considerations have lead legislators to draw the guidelines for a safer transfusion. Their aim is to promote a better transfusion in smaller quantities at a lower risk. The goal of perioperative blood replacement is to maintain hemoglobin, blood volume and coagulation factors at an adequate level. This can be carried out by either homologous or autologous transfusion. Fresh frozen plasma transfusion is only required in severe bleeding where coagulation factors are depleted. The plasma substitutes must be used according to their intrinsic properties and their cost. The choice of an autologous technique depends on the type of surgical procedure, the expected blood loss and the economic resources available. Autologous blood transfusion may be optimized by the association of various techniques. This transfusion strategy must be elaborated by all the medical protagonists implicated in transfusion procedures.
在过去十年间，输血策略已发生了相当大的演变。对感染风险的认识以及经济因素促使立法者制定了更安全输血的指导方针。其目的是推动以更低风险进行更少量的优质输血。围手术期血液置换的目标是将血红蛋白、血容量和凝血因子维持在适当水平。这可以通过同种异体输血或自体输血来实现。仅在严重出血且凝血因子耗竭时才需要输注新鲜冰冻血浆。血浆代用品必须根据其固有特性及其成本来使用。自体技术的选择取决于外科手术的类型、预期失血量以及可用的经济资源。自体输血可通过多种技术的联合使用而得到优化。这种输血策略必须由参与输血程序的所有医学相关人员共同制定。
