Iijima Takehiko, Iwao Yasuhide, Yorozu Tomoko, Shimizu Masaru
Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181-8611.
Masui. 2006 Oct;55(10):1282-94.
Anesthesiologists' opinions regarding the Japanese guidelines for transfusion were surveyed.
From December 28, 2004 to January 28, 2005 a questionnaire survey was performed in 958 hospitals registered with the Japanese Society for Anesthesiologists. Queries regarding the guidelines for packed red cells, fresh frozen plasma, platelet concentrates, autologous blood transfusions, and other miscellaneous subjects were sent to these hospitals.
A total of 537 hospitals (56.1%) responded to the survey. The guidelines for packed red cells were complied with and widely accepted. The trigger value of hemoglobin concentration was 7-9 g x dl(-1). Although 54.4% of the anesthesiologists used the coagulation disorder as the triggering factor for transfusion of fresh frozen plasma, only 19.6% of the hospitals monitored coagulopathy. In most hospitals, the trigger value of hemorrhage for use of fresh frozen plasma was the bleeding amount of less than 3000 ml, which is less than 70% of the recommended triggering value (bleeding exceeding 100% of circulating blood volume). The guideline for platelet concentrate transfusions for elective surgery was somewhat accepted (77.1%), but the triggering value; 3 x 10(4) x l(-1) for cardiopulmonary bypass surgery was considered too strict (41.4%).
These guidelines for transfusions appear to be widely accepted. The most dominant complaint was the inadequacy of the guidelines for rapid massive bleeding.
对麻醉医生关于日本输血指南的意见进行了调查。
2004年12月28日至2005年1月28日,对在日本麻醉医师协会注册的958家医院进行了问卷调查。向这些医院发送了关于浓缩红细胞、新鲜冰冻血浆、血小板浓缩物、自体输血及其他杂项主题指南的询问。
共有537家医院(56.1%)回复了调查。浓缩红细胞指南得到遵守并被广泛接受。血红蛋白浓度的触发值为7 - 9 g×dl⁻¹。尽管54.4%的麻醉医生将凝血障碍作为输注新鲜冰冻血浆的触发因素,但只有19.6%的医院监测凝血功能障碍。在大多数医院,使用新鲜冰冻血浆的出血触发值为出血量小于3000 ml,这低于推荐触发值(出血超过循环血容量的100%)的70%。择期手术血小板浓缩物输注指南在一定程度上被接受(77.1%),但体外循环手术的触发值3×10⁴×l⁻¹被认为过于严格(41.4%)。
这些输血指南似乎被广泛接受。最主要的抱怨是快速大量出血指南不完善。