PERIOPERATIVE INTERVENTIONS TO DECREASE TRANSFUSION OF ALLOGENEIC BLOOD PRODUCTS

Objective: To discuss some of the many options available for decreasin g perioperative transfusion of allogeneic blood products. Design: We r eview the issues that focus on the goal of developing an appropriate t ransfusion strategy in consideration of the individual patient's preex isting conditions, physiologic requirements, perioperative stress, and coagulation status. Results: Increased awareness of transfusion-relat ed morbidity from allogeneic blood products has resulted in increased development and application of alternatives to allogeneic transfusion. Preoperative donation and perioperative collection of autologous bloo d and blood products decrease exposure to allogeneic blood. Pharmacolo gic agents, such as antifibrinolytics, may also decrease the need for allogeneic transfusion. Perioperative use of laboratory tests of coagu lation function facilitates the rapid and specific diagnosis of coagul ation disorders. Conclusion: Physicians now have considerable apprecia tion of the risks and benefits of blood product transfusion. This know ledge has resulted in conservative and scientific approaches to therap y for perioperative bleeding and coagulopathy.