Michaeli Burkhard, Ravussin Patrick, Chassot Pierre-Guy
Département d'anesthésiologie et de réanimation CHCVs, 1950 Sion.
Rev Med Suisse. 2006 Nov 22;2(88):2662-4, 2666-7.
The general concept of blood saving covers a number of technical and pharmacological actions which all aim to maintain the erythrocyte mass of the patient, and of which blood transfusion is only one. Severe anemia (Hb <60-80 g/l) increases postoperative mortality and morbidity. However, its correction by blood transfusion tends to worsen the prognosis. It is therefore imperative to conserve the patient's blood by any means possible. Detecting anemia is of primary importance. Whenever possible, its cause should be identified and treated. Depending on the detected anemia, as well as the blood loss expected during surgery, the patient should receive EPO (anemia with foreseeable moderate blood loss), or autologous pre-donation associated with EPO (anemia with foreseeable large blood loss).
血液保护的总体概念涵盖了许多技术和药理学措施，所有这些措施的目的都是维持患者的红细胞量，而输血只是其中之一。严重贫血（血红蛋白<60-80 g/l）会增加术后死亡率和发病率。然而，通过输血纠正贫血往往会使预后恶化。因此，必须尽可能地保存患者的血液。检测贫血至关重要。只要有可能，就应确定并治疗其病因。根据检测到的贫血情况以及手术期间预计的失血量，患者应接受促红细胞生成素（预计有中度失血的贫血），或与促红细胞生成素联合的自体预存献血（预计有大量失血的贫血）。
