Binam F, Bogne J B, Takongmo S, Meli J R, Kaptune Noche L
Service d'Anesthésie-Réanimation, l'Hôpital Central, Yaoundé, Cameroun.
Med Trop (Mars). 1998;58(1):57-61.
The purpose of this prospective study was to analyze compliance by surgical teams with new guidelines for blood transfusion. Study was focused on routine, presumably hemorrhagic procedures performed electively in adults at the Central Hospital in Yaounde, Cameroon. Overall blood loss was less than 20% of the total volume in 89% of the 303 patients included. Blood loss was between 20 and 30% in 10.6% and greater than 30% in 0.3%. Administration of replacement blood products was warranted only in the last two groups. Blood transfusion was performed in 104 patients and was unjustified in 81.7%. Seven percent of the remaining 199 patients presented indications for transfusion which was not performed and not compensated for by appropriate alternative precautions. At least one unit of whole blood had been requested and delivered to the operating room in 70% of cases with blood loss less than 20%, but was used in only 45% of cases. This study demonstrates poor compliance with new guidelines for blood transfusion in the surgical setting. Overconsumption of blood products represents the main problem. These findings underline the need for wider teaching of new blood transfusion strategies. Interest in this information is usually great in developing countries where blood banks are faced with limited facilities, qualified personnel, and supplies.
这项前瞻性研究的目的是分析外科团队对输血新指南的遵循情况。研究聚焦于喀麦隆雅温得中心医院对成人择期进行的常规、推测为出血性的手术。在纳入的303例患者中，89%的患者总失血量少于总量的20%。10.6%的患者失血量在20%至30%之间，0.3%的患者失血量超过30%。仅在后两组患者中才需要输注替代血液制品。104例患者接受了输血，其中81.7%的输血不合理。其余199例患者中有7%存在输血指征，但未进行输血，也未采取适当的替代预防措施。在失血量少于20%的病例中，70%的情况下至少申请了一个单位的全血并送至手术室，但仅45%的病例使用了这些全血。这项研究表明，在手术环境中，对输血新指南的遵循情况较差。血液制品的过度消耗是主要问题。这些发现强调了更广泛地传授新输血策略的必要性。在血库面临设施有限、合格人员短缺和供应不足问题的发展中国家，对这一信息的关注度通常很高。
