Russell G N, Peterson S, Harper S J, Fox M A
University Department of Anaesthesia, Royal Liverpool Hospital.
BMJ. 1988 Nov 26;297(6660):1390-1. doi: 10.1136/bmj.297.6660.1390.
The transfusion laboratories of 32 cardiothoracic surgical centres for adults were surveyed to determine the donor blood requirement for open heart surgery in the United Kingdom. Details of the transfusion practice and the use of blood conservation techniques were sought from a representative senior cardiac anaesthetist at each centre. Suitable data were received from 24 transfusion laboratories (75%) and 29 anaesthetists (90%). The mean (SD) blood use was 5.07 (1.53) units per operation. Seven centres routinely transfused fresh frozen plasma to all patients postoperatively. Experience with autologous deposit (three centres), "cell separators" (four centres), and the reinfusion of shed mediastinal blood (four centres) was limited. Prebypass phlebotomy for postbypass reinfusion (14 centres) and the infusion of residual oxygenator blood (27 centres) were the conservation techniques most commonly applied. In only nine centres was a postoperative normovolaemic anaemia to a haemoglobin concentration of less than 100 g/l accepted. Applying blood conservation techniques more widely would help to maintain blood supplies and reduce morbidity and mortality related to transfusion.
对英国32个成人心脏胸外科手术中心的输血实验室进行了调查，以确定心脏直视手术的供血需求。从每个中心一位有代表性的资深心脏麻醉师处获取了输血实践及血液保护技术使用情况的详细信息。从24个输血实验室（75%）和29位麻醉师（90%）处收到了合适的数据。每次手术的平均（标准差）用血量为5.07（1.53）单位。7个中心常规在术后给所有患者输注新鲜冰冻血浆。自体血储存（3个中心）、“细胞分离器”（4个中心）以及纵隔引流血回输（4个中心）的经验有限。体外循环前放血用于体外循环后回输（14个中心）以及氧合器残余血液输注（27个中心）是最常用的血液保护技术。只有9个中心接受术后血红蛋白浓度低于100 g/l的正常血容量性贫血。更广泛地应用血液保护技术将有助于维持血液供应，并降低与输血相关的发病率和死亡率。
