Surgeons' knowledge, attitude, and use of preoperative autologous blood donation

Abstract

Before a comprehensive educational program on preoperative autologous blood donation was begun, 118 surgeons from three different areas of the country were tested to assess their baseline knowledge and attitude about this practice. Test results were correlated with the percentage of eligible patients that the surgeons actually referred for preoperative donation during a period of observation. The purpose of this preliminary effort was to identify areas in the educational program that required emphasis. Overall, the surgeons' attitude toward preoperative donation was quite favorable, but their depth of knowledge varied. Misunderstandings may have led to diminished use of this service (eg, about 50% didn't realize that many patients with medical conditions or low hematocrits are permitted to donate). However, it is not clear that simply bolstering surgeons' knowledge will increase their appropriate use of preoperative donation. When all 118 surgeons were studied, their knowledge and attitude were unrelated to the percentage of eligible patients referred. However, when 44 surgeons who managed the largest number of eligible patients were analyzed separately, their use of preoperative donation was directly correlated with their knowledge and attitude. The local awareness of AIDS also significantly influenced the use of this service. It is proposed that knowledge of preoperative donation may be important for inducing surgeons to begin referring patients for this service. Once a pattern of successful participation is established, referral seems to increase with the acquisition of working knowledge.

Evaluation of awareness and utilization of an autologous blood transfusion programme

“…It is the safest source of blood as it avoids the risk of alloimmunization to red cell-, platelet-and HLA-antigens, transmission of bloodborne diseases, allergic reactions and incompatibility problems. ABT may also represent a valuable resource to supplement the blood supply to a blood transfusion centre (Kruskall et al, 1986;Straurs et al, 1990;Zuck & Carey, 1990;Lee et al, 1993).…”

“…While most recipients of homologous blood will not encounter serious morbidity from the potential complications, efforts to minimize these risks whenever possible are only prudent. Identifying candidates for a Transfusion Medicine, 1997, 7, 197-202 preoperative autologous blood transfusion programme, encouraging their participation and facilitating the multidonation process are all important elements in reducing these risks and increasing the safety of blood transfusion (Straurs et al, 1990;Gillon et al, 1991).…”

Determinants of Physician Ordering of Preoperative Autologous Donations

“…This study indicates that overuse of PAD can be ad dressed at least as readily as underuse [6]. By using a simple approach, multiple objectives can be realized.…”

“…Our results indicate that a sub stantial proportion of transfusions around elective sur gery utilized autologous blood but that overutilization of the autologous blook collection service was limiting the system efficiency. Thus, unlike earlier studies [1,6], the educational intervention devised stressed appropriate, that was not likely to be transfused. Although the inter vention used in this study appeared to have an effect for at least 5 months, staff turnover (particularly of house offi cers) and the passage of time may diminish the effective ness of the intervention after longer time periods and ne cessitate a reeducation effort.…”

Isovolemic hemodilution and skeletal muscle function during ischemia and reperfusion

“…Hemodilution with plasma substitutes is of wide use in surgical disciplines to prevent postoperative thromboembolism and to improve the rheological properties of blood as well as the microvascular perfusion. [1][2][3][4] In isovolemic hemodilution, whole blood is replaced by an equal amount of isoosmotic plasma substitute. The lowered hematocrit leads to a decrease in blood viscosity, which lowers resistance to flow and increases the cardiac output and thereby the tissue perfusion.…”