Risks, options, and informed consent for blood transfusion in elective surgery

Goodnough, Lawrence T.; Shuck, Jerry M.

doi:10.1016/s0002-9610(06)80079-6

Cited by 100 publications

(28 citation statements)

References 67 publications

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“…The frequency of postoperative pyrexia (> 39 °C) is thought to increase fourfold for each transfused unit of homologous blood after total knee arthroplasty (Kennedy et al 1997). Febrile reactions usually occur within 30 minutes after homologous blood transfusions (Goodnough and Shuck 1990) and, in 70-85% of cases, leukocyte antibodies are found (Brubaker 1990).…”

Section: Discussionmentioning

confidence: 99%

Fever and autologous blood retransfusion after total knee arthroplasty

Dalén¹,

Nilsson²,

Engström³

2002

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Fever and autologous blood retransfusion after total knee arthroplasty

Dalén¹,

Nilsson²,

Engström³

2002

Acta Orthopaedica Scandinavica

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“…46 Written informed consent has been recommended by some authors and it has been suggested that the following elements be contained in the consent: the nature of the proposed procedure (blood transfusion); the alternatives available, including no transfusion; the expected benefits resulting from the transfusion; and the risks of blood transfusion. [126][127][128] Although the American Association of Blood Banks (AABB) Standards do not specifically address the issue of written informed consent, an AABB memorandum, dated July 10th, 1986 recommended "that patients who receive non-emergency transfusions be informed of the risks and benefits of blood products and consent to their use. "…”

Section: Informed Consent and Blood Transfusionmentioning

confidence: 99%

Perioperative haemotherapy: II. Risks and complications of blood transfusion

Crosby

1992

Can J Anaesth

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“…The very high prevalence (56%) of subsequent homologous blood exposure during surgery in this group indicates a need for early identification and treatment of the anemia. in order to give these patients the opportunity to consider the same alternatives to homolo gous blood that are available to nonanemic patients scheduled for elective surgery [24].…”

Section: Estimated Surgical Blood Lossmentioning

confidence: 99%

Prevalence and Classification of Anemia in Elective Orthopedic Surgery Patients: Implications for Blood Conservation Programs

Goodnough¹,

Vizmeg²,

Sobeck³

et al. 1992

Vox Sanguinis

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We audited 281 consecutive orthopedic patients scheduled for surgery for whom blood type/cross-matching was requested over a 6-month period. One hundred and sixty-two patients predonated autologous blood at University Hospitals of Cleveland, and 34 (21%) of these were anemic [hematocrit (Hct) ≤ 39% ] at initial donation. Twelve (35%) of these 34 anemic autologous blood donors subsequently received homologous blood. In contrast, 18 (15%) of 128 nonanemic autologous blood donors received homologous blood (p = 0.05). In 119 patients who did not donate autologous blood, 39 (33%) were anemic at admission. Of these, 22 (56%) received homologous blood. In the 80 remaining nonanemic patients, 33 (41%) received homologous blood (p = 0.119). Analysis of discharge Hct indicates that 31 (12%) of 263 evaluable patients were possibly transfused inappropriately. The anemias of a cohort of 30 autologous donors were analyzed: 5 had rheumatoid arthritis without iron deficiency. Nine (30%) others had evidence of iron deficiency. Sixteen (53%) had an unclassified anemia of chronic disease. We conclude: (1) the high rates of homologous blood exposure indicate a need for innovative blood conservation strategies in anemic autologous blood donors; (2) the prevalence of anemia and the high rates of homologous blood exposure in anemic patients who did not donate autologous blood demonstrate a need for early recognition and treatment in order to procure autologous blood and reduce homologous blood exposure; (3) the presence of inappropriate autologous and homologous transfusions demonstrates a need for more effective physician education programs that emphasize ‘no blood transfusion' as an alternative to enhance blood conservation effectiveness.

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Risks, options, and informed consent for blood transfusion in elective surgery

Cited by 100 publications

References 67 publications

Fever and autologous blood retransfusion after total knee arthroplasty

Fever and autologous blood retransfusion after total knee arthroplasty

Perioperative haemotherapy: II. Risks and complications of blood transfusion

Prevalence and Classification of Anemia in Elective Orthopedic Surgery Patients: Implications for Blood Conservation Programs

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