Beruflich Dokumente
Kultur Dokumente
TRANSFUSION IN ADULTS
Departments of Pathology
and Medicine, Stanford
University, Stanford, CA, USA
(Prof L T Goodnough MD);
Department of
Anesthesiology, Duke
University School of
Medicine, Durham, NC, USA
(Prof J H Levy MD); Rahmanizar
NHS Blood and Transplant, 1507101030050
Oxford University Hospitals
and University of Oxford,
Supervisor:
Oxford, UK
(Prof M F Murphy FRCP)
dr. Yusmalinda, Sp.An
Introduction
Followed by
In view of the risks, the safest Beetween 2007 haemolytic
and 2011 in the transfusion
blood transfusion is the one USA, TRALI reaction (23%)
not given10-12 caused the attributable to
highest non-ABO blood
number of group (13%) or
fatalities (43%) ABO (10%)
incompabilities
Introduction
Tables 1 show the largest and most influential level I studies of red blood cell.3336 Each
studied whether such patients can tolerate a restrictive transfusion strategy with the
threshold for red blood cell transfusion set at a haemoglobin concentration of 70 g/L or 80
g/L. These trials found clinical outcomes were similar to patients transfused to a
haemoglobin concentration of more than 90100 g/L.
Red Blood Cell Transfusion
The platelet count threshold for prophylactic transfusions in patients with haematological
cancers has been reduced from 2010/L to 1010/L on the basis of trials,37 which showed
little or no increased bleeding. In another trial, the dose of platelets had no effect on the
incidence of bleeding.38 The incidence of bleeding was lower in the prophylaxis group than in
the no-prophylaxis group (43% vs 50%).
Treatment with Platelets
Treatment with Plasma
Patient with trauma
Blood transfusions carry risks, and are expensive, and blood supply is
scarce. Despite recent progress made on the basis of high-quality
clinical trials, many uncertainties remain in the identification and
implementation of best transfusion practices. Additional data are
needed to establish the optimum use of red cell, platelet, and plasma
transfusions in different clinical settingseg, trauma and cardiac
surgery.