Eight‐year experience of bloodless surgery at a tertiary care hospital in Korea. Issue 5 (23rd August 2012)

• Record Type: Journal Article
• Authors: Jo, Kyung Il; Shin, Jeong Won; Choi, Tae Yoon; Park, Yu Jin; Youm, Wook; Kim, Moon Jung
• Is Part Of: Transfusion. Volume 53:Issue 5(2013)
• Page Start: 948
• Page End: 954
• Publication Date: 2012-08-23
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/j.1537-2995.2012.03859.x
• Languages: English
• ISSNs: 0041-1132

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold>BACKGROUND:</bold> The Soonchunhyang University Hospital Bloodless Center was established in 2000, and more than 2000 bloodless surgeries has been performed there since. This study was carried out to analyze the characteristics of patients who underwent bloodless surgery and the influences of postoperative lowest hemoglobin level (Hb<sub>low</sub>) along with the lowest postoperative Hb/preoperative Hb ratio (Hb<sub>low/pre</sub>) on successful completion of bloodless surgery.</p> <p> <bold>STUDY DESIGN AND METHODS:</bold> A total of 1407 patients were included. Patients were divided according to Hb<sub>low</sub> into not more than 7 and more than 7 g/dL groups and compared regarding use of transfusion alternatives, coexisting risk factors, and mortality rate. They were also grouped as Hb<sub>low/pre</sub> of not more than 0.5 or more than 0.5, and mortalities were compared between them.</p> <p> <bold>RESULTS:</bold> Jehovah's Witnesses comprised 1323 (94.0%) of the total population. The frequency of simultaneous use of erythropoietin and iron was significantly higher in Hb<sub>low</sub> of not more than 7 group than in more than 7 g/dL group, as was the use of hemostatics. Among risk factors urging transfusion, the frequencies of cardiovascular disease and cerebrovascular accident were higher in Hb<sub>low</sub> of not more than 7 than in the more than 7 g/dL group. Mortality rates in Hb<sub>low</sub> of not more than 7 g/dL and Hb<sub>low/pre</sub> of not more than 0.5 groups were significantly higher than those in Hb<sub>low</sub> of more than 7 g/dL and Hb<sub>low/pre</sub> of more than 0.5 groups, respectively.</p> <p> <bold>CONCLUSION:</bold> We have provided an effective bloodless surgery program for the past 10 years. A prospective multicenter study with other bloodless centers in Korea concerning mortality rates, actual operative blood loss, and postoperative complications in high‐risk group of patients would be needed to establish evidence‐based guidelines for bloodless surgery.</p> </abstract>