Korean J Anesthesiol.  2019 Apr;72(2):91-118. 10.4097/kja.d.18.00322.

Korean clinical practice guideline for perioperative red blood cell transfusion from Korean Society of Anesthesiologists

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Anesthesiology and Pain Medicine, Dankook University Hospital, Cheonan, Korea.
  • 3Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
  • 4Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
  • 5Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. leho@naver.com
  • 6Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 7Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 8Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, Korea.
  • 9Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
  • 10Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Considering the functional role of red blood cells (RBC) in maintaining oxygen supply to tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component in safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Additionally, excessive utilization of pRBCs may aggravate prognosis or increase the risk of developing infectious diseases. Appropriate perioperative RBC transfusion is, therefore, crucial for the management of patient safety and medical resource conservation. These concerns motivated us to develop the present clinical practice guideline for evidence-based efficient and safe perioperative RBC transfusion management considering the current clinical landscape.
METHODS
This guideline was obtained after the revision and refinement of exemplary clinical practice guidelines developed in advanced countries. This was followed by rigorous evidence-based reassessment considering the healthcare environment of the country.
RESULTS
This guideline covers all important aspects of perioperative RBC transfusion, such as preoperative anemia management, appropriate RBC storage period, and leukoreduction (removal of white blood cells using filters), reversal of perioperative bleeding tendency, strategies for perioperative RBC transfusion, appropriate blood management protocols, efforts to reduce blood transfusion requirements, and patient monitoring during a perioperative transfusion.
CONCLUSIONS
This guideline will aid decisions related to RBC transfusion in healthcare settings and minimize patient risk associated with unnecessary pRBC transfusion.

Keyword

Blood transfusion; Clinical practice guideline; Perioperative management; Red blood cells

MeSH Terms

Anemia
Blood Transfusion
Communicable Diseases
Delivery of Health Care
Erythrocyte Transfusion*
Erythrocytes*
Hemorrhage
Humans
Leukocytes
Monitoring, Physiologic
Oxygen
Patient Safety
Prognosis
Oxygen

Cited by  1 articles

Common Data Model-based Analysis of Selective Leukoreduction Protocol Compliance at Three Hospitals
Sooin Choi, Soo Jeong Choi, Jeong Won Shin, Young Ahn Yoon
Ann Lab Med. 2023;43(2):187-195.    doi: 10.3343/alm.2023.43.2.187.

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