Canadian Journal of Anaesthesia

, Volume 41, Supplement 1, pp R52–R69

Blood products: when to use them and how to avoid them

  • Jean-François Hardy
  • Sylvain Belisle
  • Danielle Robitaille
Refresher Course Outline — Saturday, June 18 Track II


Despite the complications associated with transfusions,HBP remains an essential therapeutic modality, without which many major surgical procedures would be impossible. Clinicians must realize that transfusion of HBP is the most frequent transplantation of living tissue between humans. Even if known infectious complications could be eliminated, transfusion ofHBP will never be a totally safe procedure. New transfusion-related complications, the magnitude of which is unknown, such as graft-vs-host disease in immunocompetent patients, have emerged recently. Other, as yet unidentified, pathogens will undoubtedly be transmitted by HBP in the future.

A number of strategies exist that can reduce, and sometimes abolish, the need forHBP. Unfortunately, some of these may remain unavailable to our patients because of financial constraints on the Canadian health care system. Nonetheless, physicians must always keep in mind that the first and foremost strategy to avoid transfusion ofHBP is their thorough understanding of the pathophysiological mechanisms involved in anaemia and coagulopathy, and their thoughtful adherence to published guidelines for the practice of transfusion.7,11–13,17

Du bon usage des dérivés du sang


Malgré les complications associées aux transfusions, les PSH demeurent essentiels et sans eux plusieurs interventions chirurgicales majeures seraient irréalisables. Les cliniciens doivent réaliser que les transfusions de PSH représentent les transplantations de tissus les plus fréquentes entre humains, et que même si on réussissait à éliminer complètement les complications infectieuses, les transfusions de PSH ne deviendront jamais complètement inoffensives. De nouvelles complications transfusionnelles comme la réaction du greffon contre l’hôte chez des patients immunocompétents ont fait récemment leur apparition. A l’avenir, d’autres pathogènes, non encore identifiés seront indubitablement transmis par les PHS.

Certaines stratégies peuvent diminuer et quelquefois abolir les besoins de PHS. Malheureusement, quelquesunes ne sont pas disponibles pour nos patients à cause des contraintes du système des soins de santé canadien. Toutefois, les médecins doivent toujours avoir à l’esprit que la première et la principale stratégie permettant d’éviter les PHS consiste en une bonne compréhension des mécanismes physiopathologiques impliqués dans l’anémie et les coagulopathies et leur adhérence inconditionnelle aux critères de la pratique transfusionnelle.7,11–13,17


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Copyright information

© Canadian Anesthesiologists 1994

Authors and Affiliations

  • Jean-François Hardy
    • 1
  • Sylvain Belisle
    • 1
  • Danielle Robitaille
    • 1
  1. 1.Departments of AnaesthesiaHaematology of the Université de Montréal, Montreal Heart InstituteMontréal

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