Shander Aryeh
Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, Englewood Hospital and Medical Center, NJ 07631, USA.
Crit Care Med. 2003 Dec;31(12 Suppl):S708-14. doi: 10.1097/01.CCM.0000098038.18919.7A.
The principle aim of "bloodless surgery" is to minimize blood loss and to reduce or eliminate exposure to allogeneic blood transfusion. The risks associated with blood transfusions have been well documented, and it is the goal of bloodless surgery centers to avoid complications and unnecessary use of blood. Blood transfusion is a significant adjunct to perioperative resuscitation. However, we aim to elucidate different approaches to minimizing blood loss and avoiding transfusion.
In this document, we review the background and current status of bloodless surgery centers and then the different approaches to achieve the program goals.
There is no one single universal blood conservation strategy that is applicable to all patients and populations. Factors such as preexisting disease will alter the approach; however, it is the ability of any program to form a comprehensive strategy for blood conservation that is integral to the success of any such program.
The success of a bloodless surgery program requires both teamwork and careful cooperation between the blood bank, pharmacy, administration, hematologists, surgeon, and anesthesiologist to ensure that the goals of minimizing blood loss and avoiding transfusion are met.
“无血手术”的主要目标是尽量减少失血,并减少或消除异体输血。输血相关风险已有充分记录,无血手术中心的目标是避免并发症和不必要的输血。输血是围手术期复苏的重要辅助手段。然而,我们旨在阐明尽量减少失血和避免输血的不同方法。
在本文中,我们回顾了无血手术中心的背景和现状,然后介绍实现项目目标的不同方法。
没有一种适用于所有患者和人群的通用血液保护策略。诸如既往疾病等因素会改变方法;然而,任何项目制定全面血液保护策略的能力对于任何此类项目的成功至关重要。
无血手术项目的成功需要血库、药房、行政部门、血液学家、外科医生和麻醉师之间的团队合作与密切协作,以确保实现尽量减少失血和避免输血的目标。