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Blood Transfusion and Alternative Therapies

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General Surgery

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Pearls and Pitfalls

  • Blood transfusion is substantially overutilized and has significant associated risk, including: transfusion reactions, transmission of blood borne pathogens, and immune suppression.

  • The accepted transfusion “trigger” in euvolemic patients is 7 gm/dl for healthy individuals and 8–9 gm/dl for patients with co-morbidities associated with decreased cardiopulmonary reserve.

  • Blood transfusion is an independent predictor of MOF, SIRS, increased infection, and mortality in patients with severe injuries and undergoing complex surgical procedures.

  • Transfusion of only the amount of blood that maximizes immediate survival and minimizes late inflammatory complications is the goal of resuscitation.

  • Trauma patients and other patients in hemorrhagic shock should be transfused based upon blood pressure, pulse, and other measurements of decreased perfusion rather than relying upon laboratory values.

  • “The triad of death” including bleeding, hypothermia, and acidosis, leads to the...

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Selected Readings

  • Blajchman MA (2006) The clinical benefits of the leukoreduction of blood products. J Trauma 60:583–590

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  • Hebert TC, Wells G, Blajchman MA, et al. (1999) A multi-centered randomized control clinical trial of transfusion requirements in critical care. New Engl J Med 340:409–417

    Article  PubMed  CAS  Google Scholar 

  • Practice Guidelines for Perioperative Blood Transfusion and Adjuvant Therapies (2006) An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Anesthesiology 105:198–208

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  • Madjdpour C, et al. (2005) Perioperative blood transfusions. Value, risks, and guidelines. Anaesthesist, 54:67–80

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Authors
  1. Henry M. Cryer
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Editor information

Editors and Affiliations

  1. Department of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of Medicine, Birmingham, AL, USA

    Kirby I. Bland MD (Fay Fletcher Kerner Professor and Chairman) (Fay Fletcher Kerner Professor and Chairman)

  2. Department of General and Visceral Surgery, University of Heidelberg, Heidelberg, Germany

    Markus W. Büchler MD (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  3. Department of Surgery, University Hospital, Santiago, Chile

    Attila Csendes MD, FACS (Hon) (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  4. James C. Mason Professor of Surgery Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Michael G. Sarr MD

  5. Department of Clinical and Surgical Sciences, The University of Edinburgh Royal Infirmary of Edinburgh, Edinburgh, UK

    O. James Garden MBChB, MD, FRCS (Ed), FRCP (Ed), FRACS (Hon) (Regius Professor of Clinical Surgery) (Regius Professor of Clinical Surgery)

  6. Department of Surgery, The University of Hong Kong Queen Mary Hospital, Hong Kong, China

    John Wong BSc (Med (Syd)), MBBS (Syd), PhD (Syd), MD (Hon (Syd)), FRACS, FRCS (Edin), FRCS (Glasg), FACS (Hon) (Chair Professor) (Chair Professor)

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© 2009 Springer Science+Business Media, LLC

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Cryer, H.M. (2009). Blood Transfusion and Alternative Therapies. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_5

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  • DOI: https://doi.org/10.1007/978-1-84628-833-3_5

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-832-6

  • Online ISBN: 978-1-84628-833-3

  • eBook Packages: MedicineReference Module Medicine

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