Blood Transfusion Clinical Trial
Official title:
Allogenic Blood Transfusion During Elective Open Abdominal Aortic Surgery and Its Predictors: a Retrospective Database Study at a Tertiary Hospital in Croatia
Open surgery on the abdominal aorta is a high risk procedure associated with an intravascular
volume blood loss and thereby, with high requirement for blood and blood product transfusion.
The aim of this study was to establish the rate for allogenic blood transfusion (ABT) during
elective open abdominal aortic surgery and find parameters associated with ABT requirements.
Two distinct clinical entities affect the abdominal aorta: abdominal aortic aneurysm (AAA)
and aortoiliac occlusive disease (AIOD). These are multifactorial vascular disorders caused
by complex genetic and environmental factors. Older patients with more comorbidity are often
affected. Open abdominal aortic surgery is associated with high mortality rate. Even in
specialised institutions it varies from 2 to 5%. Similar results can be compared to mortality
for coronary artery bypass grafting. This reflects the complexity of the surgery and the
general health of those patients. It is associated with intravascular volume blood loss and,
thereby, with a high requirement for blood and blood products transfusion. Allogenic blood
transfusion (ABT) has been associated with an increased risk of tumour recurrence,
postoperative infection, acute lung injury, perioperative myocardial infarction,
postoperative low-output cardiac failure, and increased mortality.
In the last decades, multiple strategies have been undertaken to prevent massive
intraoperative blood loss during elective surgery and allogenic blood transfusion
requirement. One of the method advocates a preoperative increase in red blood cells level
using B12, folic acid and iron supplements or with erythropoietin usage. Other methods
involve the optimisation of surgical technique and the use of a machine for intraoperative
blood salvage, known as "cell saver".
The aim of this study was to establish the rate for ABT during elective open abdominal aortic
surgery, find parameters associated with ABT requirements, and optimise the investigators
hospital's maximum surgical blood ordering schedule (MSBOS).
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