多量出血症例における術中輸血の検討

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  • A Survey of Intraoperative Blood Transfusions in Patients with Massive Blood Loss.

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A retrospective survey on appropriateness of the use of blood products, colloid solution and crystalloid solution was carried out in 62 patients who were operated on in our hospital in 1990 and whose intraoperative blood loss exceeded over 2, 000ml. Homologous red blood cell transfusion was started when the blood loss was estimated 400ml. At this point the hemoglobin and hematocrit values were 9g/dl and 30%, respectively. <br>In 30% of all cases, red blood cell transfusion was started prior to colloid fluid infusion. Colloid fluid should be administrated prior to red blood cell transfusion. Whole blood was used in one fourth of the red blood cell transfusions. Because packed red blood cells contain the same amount of hemoglobin as whole blood, there was little need to transfuse whole blood, so packed red blood cells should be transfused instead of whole blood. Fresh-frozen plasma was administrated when the blood loss was estimated 1, 200ml. To keep the blood coagulation function, it is sufficient to start fresh-frozen plasma administration at 2, 000ml loss of blood. Blood should be transfused as appropriately as possible in patients with massive blood loss during operations.

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