ANESTHESIA AND AUTOLOGOUS TRANSFUSION

The anaesthesiologist plays a central role in co-ordinating the combin ed application of the various blood saving techniques. In fact, to car ry out transfusion therapy correctly, the anaesthesiologist must plan the right number of units of predeposit blood during the first examina tion, estimate the salvage of intra and post operative blood loss and spread the infusion of the units over the first three days in order to keep the patient in a state of haemodilution. From January 1992 to Ju ne 1994 in the department of anaesthesia and the intensive care unit, 980 patients were treated for total joint replacement: 714 total hips (7 after removal of plates and screws) 145 revisions, and 121 total kn ee prostheses. Basal Hb was 13.4 +/- 1.4 g/dl (range 6.7 - 17.9 g/dl). Homologous transfusions were carried out in 6.3% of these patients. T he need to use homologous transfusions was negatively influenced by fe male sex, coronary heart disease (p = 0.005), length of surgery and ty pe of antithromboembolic prophylaxis (indobufen has a significantly lo w incidence - p = 0.0001 - compared to calcium heparin or low molecula r weight heparin).