J.Jpn. Surg. Soc.. 106(1): 13-17, 2005

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Feature topic

ALLOGENIC BLOOD TRANSFUSION FOR SURGERY

Blood transfusion against surgical patients is mainly as a replacement therapy for intra‐operative bleeding.
Transfusion trigger depends on to maintain 12 ml/kg/min oxygen carrying capacity. Oxygen consumption depends on oxygen carrying capacity which multiplicity hemoglobin concentration and cardiac output. The government of United States decided the transfusion trigger of surgical patients at hemoglobin 7.0 g/dl except patients who have cardiac problem at 1988. The indication of plasma and platelet transfusion is limited in surgical field. Because bleeding tendency is usually a contra-indication of surgery itself. Dilution coagulopathy due to massive bleeding exceed one blood volume is the main indication of plasma and platelet transfusion. It is necessary to administrate fresh frozen plasma for replenishing coagulation function with 30% of one body plasma volume when prothrombin time prolong more than 16 seconds. Platelet transfusion is effective for hemostasis in case of massive bleeding which exceed 1.5 blood volume and also peripheral blood platelet count indicate lower than 50,000/mm³.

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