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Committee on Transfusion Medicine performed a survey
of ASA members’ transfusion practices in 2002.
The results of this survey were published in the
December 2003 issue of Anesthesiology.
Though anesthesiologists transfuse a large percentage
of the blood used in the United States, we found
that a majority of anesthesiologists rarely transfuse
blood in the operating room. Certain subspecialty
groups transfuse blood frequently due to the nature
of the surgical procedures in which they are involved.
We also found that most anesthesiologists generally
follow the guidelines published by ASA for transfusion
of blood products.1
The survey identified many areas where education
could improve transfusion practices. The committee
is focusing its educational efforts in these areas.
The committee continues its liaison activities with
other organizations involved in blood transfusions.
Blood shortages continue to occasionally limit the
number of surgeries that can be performed at many
hospitals.
Recently a number of drugs have become available
for the treatment of excessive bleeding. There have
been numerous case reports, case series and retrospective
studies documenting success in controlling excessive
bleeding in patients refractory to standard blood
transfusion therapy with the use of the drug recombinant
human factor VIIa. This drug has been approved by
the Food and Drug Administration for the treatment
of hemophilia and is used “off label”
for the treatment of excessive bleeding in the operating
room. The Committee on Transfusion Medicine will
be providing a panel presentation at the 2004 ASA
Annual Meeting on “Excessive Surgical Bleeding:
Role of rVIIa and Other Procoagulant Drugs.”
This panel will address the morbidity of excessive
bleeding, the etiologies of coagulopathy, the risks
of thrombosis and the mechanisms of action, pharmacology,
safety and efficacy of rVIIa and other procoagulant
drugs.
Reference:
1. Practice guidelines for blood component therapy:
A report by the American Society of Anesthesiologists
Task Force on Blood Component Therapy. Anesthesiology.
1996; 84:732-747.
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Gregory A. Nuttall, M.D., is Associate Professor
of Anesthesiology, Mayo Clinic College of Medicine,
Rochester, Minnesota. |
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