Loo S, Low T C
Department of Anaesthesiology, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 1997 Mar;26(2):193-9.
A current concern in perioperative transfusion therapy is the balance between maintaining adequate haemoglobin level and yet avoiding unnecessary homologous blood transfusion. Strategies to minimise the perioperative use of homologous blood include redefining the traditional transfusion trigger of "10/30 rule", and the use of autologous transfusion therapy. Current recommendations for transfusion triggers advocate determining the "minimum acceptable haemoglobin level" for patients according to various other physiological or surgical factors. The current status of practice amongst anaesthetists in the above mentioned transfusion strategies was assessed using a national survey. An overall response rate of 59.4% was obtained. Results showed wide variation among respondents in their criteria used for preoperative and intraoperative transfusion. Recommendations on perioperative transfusion triggers made by various authors were also summarised. Autologous transfusion therapy was also not frequently practised-the reasons for this were identified. We concluded that in order to continually improve on the anaesthetic community's quality of perioperative care, continued education on the subject must be carried out. Certain practical issues also need to be addressed to facilitate the use of perioperative autologous transfusion therapy.
围手术期输血治疗当前关注的问题是在维持足够血红蛋白水平与避免不必要的同种异体输血之间取得平衡。尽量减少围手术期同种异体血使用的策略包括重新定义传统的“10/30规则”输血触发阈值以及采用自体输血治疗。当前关于输血触发阈值的建议主张根据各种其他生理或手术因素来确定患者的“最低可接受血红蛋白水平”。通过一项全国性调查评估了麻醉医生在上述输血策略方面的实际应用现状。总体回复率为59.4%。结果显示，受访者在术前和术中输血所用标准方面存在很大差异。还总结了不同作者关于围手术期输血触发阈值的建议。自体输血治疗的应用也不频繁——并找出了其中的原因。我们得出结论，为了持续提高麻醉学界围手术期护理的质量，必须开展关于该主题的继续教育。还需要解决一些实际问题，以促进围手术期自体输血治疗的使用。
