Perioperative Blood Transfusion Management in Vascular Surgery

  Objective  To analyze the status quo and tendency of blood transfusion in vascular surgery and summarize the experiences of rational blood transfusion management in order to provide clinical guidance.

  Methods  Hospitalized patients who underwent vascular surgery at Peking Union Medical College Hospital from January 1, 2011 to December 31, 2014 were enrolled. The records of blood transfusion, surgical procedures, transfusion case number, transfusion components, transfusion volume, and mean transfusion volume were retrospectively analyzed.

  Results  Altogether 3989 surgical patients were included. Four hundred and six patients (10.18%) received blood transfusion in perioperative period, including 229 patients receiving allogeneic blood transfusion, 80 patients receiving autologous blood transfusion, and 97 patients receiving both. The rate of blood component transfusion was 100%. 43.60% of the patients received autologous blood transfusion, accounting for 20.60% of the total blood transfusion amount. According to the records from 2011 to 2014, with the increase of quantity and difficulty of vascular surgery (compared with 2011, the growth rate of vascular surgeries in 2012, 2013, and 2014 were 6.66%, 9.28%, and 25.13%, respectively), the total and the mean transfusion volume increased too (compared with 2011, the total blood transfusion volume in 2012, 2013, and 2014 increased by 3.07%, 12.91%, and 21.72%, and the mean transfusion volume in 2012, 2013, and 2014 increased by 10.43%, 18.56%, and 27.81%, respectively), especially the transfusion of fresh frozen plasma (FFP) (compared with 2011, the total and mean transfusion volume of FFP in 2014 increased by 96.77% and 9.83%, respectively). However, the rate of allogeneic red blood cell transfusion declined year by year (9.19%, 7.52%, 6.67%, 6.31%), along with a fluctuating increase of salvaged autologous blood usage at the 4 years(4.32%, 4.22%, 4.65%, 4.53%).

  Conclusion  Rational perioperative blood transfusion management with the using of blood component transfusion and autologous blood transfusion could effectively reduce the transfusion of allogeneic red blood cells and ensure perioperative patient safety, in the context of increasing quantity and difficulty of vascular surgery.