Soares Joyce Mendes, Queiroz Athos Gabriel Vilela, Queiroz Vaniely Kaliny Pinheiro de, Falbo Ana Rodrigues, Silva Marcelo Neves, Couceiro Tania Cursino de Menezes, Lima Luciana Cavalcanti
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brasil.
Rev Bras Anestesiol. 2017 Nov-Dec;67(6):584-591. doi: 10.1016/j.bjan.2016.09.011. Epub 2016 Oct 10.
Blood is an important resource in several lifesaving interventions, such as anemia correction and improvement of oxygen transport capacity. Despite advances, packed red blood cell (PRBC) transfusion still involves risks. The aim of this study was to describe the knowledge of anesthesiologists about the indications, adverse effects, and alternatives to red blood cell transfusion intraoperatively.
Cross-sectional study using a questionnaire containing multiple choice questions and clinical cases related to relevant factors on the decision whether to perform PRBC transfusion, its adverse effects, hemoglobin triggers, preventive measures, and blood conservation strategies. The questionnaire was filled without the presence of the investigator. Likert scale was used and the average rank of responses was calculated. The Epi Info 7 software was used for data analysis.
79% of the institution's anesthesiologists answered the questionnaire; 100% identified the main adverse effects related to blood transfusion. When asked about the factors that influence the transfusion decision, hemoglobin level had the highest agreement (MR=4.46) followed by heart disease (MR=4.26); hematocrit (MR=4.34); age (RM=4.1) and microcirculation evaluation (MR=4.22). Respondents (82.3%) identified levels of Hb=6g.dL as a trigger to transfuse healthy patient. Regarding blood conservation strategies, hypervolemic hemodilution (MR=2.81) and decided by drugs (MR=2.95) were the least reported.
We identify a good understanding of anesthesiologists about PRBC transfusion; however, there is a need for refresher courses on the subject.
血液是多种挽救生命干预措施中的重要资源，如纠正贫血和提高氧运输能力。尽管取得了进展，但浓缩红细胞（PRBC）输血仍存在风险。本研究的目的是描述麻醉医生对术中红细胞输血的适应证、不良反应及替代方法的了解情况。
采用横断面研究，使用包含多项选择题和与决定是否进行PRBC输血的相关因素、其不良反应、血红蛋白触发因素、预防措施及血液保护策略相关的临床病例的问卷。问卷在没有调查人员在场的情况下填写。使用李克特量表并计算回答的平均排名。使用Epi Info 7软件进行数据分析。
该机构79%的麻醉医生回答了问卷；100%的人识别出与输血相关的主要不良反应。当被问及影响输血决定的因素时，血红蛋白水平的认可度最高（MR = 4.46），其次是心脏病（MR = 4.26）；血细胞比容（MR = 4.34）；年龄（RM = 4.1）和微循环评估（MR = 4.22）。82.3%的受访者认为血红蛋白水平=6g.dL是健康患者输血的触发因素。关于血液保护策略，高容量血液稀释（MR = 2.81）和药物决定（MR = 2.95）的报告最少。
我们发现麻醉医生对PRBC输血有较好的理解；然而，该主题仍需要进修课程。
