Research On The Safety And Effectivity Of Peri-operative Transfusion Trigger Score

Objective: To evaluate the safety and effectivity of transfusion plan guided byperi—operative transfusion trigger score(POTTS)in patients with hemoglobin(Hb) levelranged from6to10g/dL.Methods: Select the first affiliated hospital of Dalian Medical University, radicalsurgery for tumors of digestive tract, as well as a total of40cases of spinal surgerypatients,3cases of radical resection of upper gastrointestinal tumor surgery,28cases ofradical resection of lower gastrointestinal tumors, spine surgery9. Inclusion criteria:aged more than14years of age, place of permanent residence <2500meters above sealevel, ASA rating of ⅰ-ⅲ expected peri (preoperative, intraoperative, and postoperative)Hb might be <10g/dL. A randomized, single-blind, placebo-controlled, parallelapproach experiment40patients were divided into two groups: POTTS steering groups(group a, n=20) and Hb≥10g/dL Group (group n=20). Exclude emergency operation,suffering from blood diseases, hemoglobin, oxygen-carrying capacity of defects, mustbe of acute hypervolemic hemodilution in surgery, tumor metastasis has occurred, orwithin3months of participation in other clinical trials researchers and do not meet thetest. Determination of Hb basis respectively within2weeks prior to surgery,intra-operative blood loss are400ml,800mL,1200mL,1600mL,2000mL, de facto Hbvalues, within24hours after surgery and Hb values within24hours prior to discharge,as well as the entire perioperative considering the infusion of allogeneic red blood cellsuspension Hb values. Main observation indicators: patients surgery period (beforsurgery, and in the surgery, and after surgery) respectively lost note RBC hanging liquid of proportion, entered RBC hanging liquid of total, complications of occurredrate and mortality; secondary observation indicators: patients surgery after24hourswithin and discharged befor24hours within hemoglobin of recovery situation, surgeryafter drainage tube placed time, patients total hospital time and hospital duringtransfusion related costs.Results: In this study, two groups of patients were20cases before the age, sex, weight,duration of anesthesia, surgery comparative analysis of Hb values, intraoperative bloodloss and other general information on the results were not statistically significant (P>0.05). Perioperative red blood cell suspension preoperative transfusion rates were3(15%),8(40%); surgery4(20%),16(80%); postoperative1(5%),2(10%),perioperative transfusion in patients of group A was significantly lower than theproportion of red blood cell suspension group B, the comparison was statisticallysignificant (P <0.05). RBC suspensions were respectively172±80ml,828±176ml, Agroup was significantly lower than group B, there were statistically significantcomparison results (P <0.05). Both groups there were no serious complications anddeaths caused by a blood transfusion. Two groups of patients within24hours aftersurgery and before discharge Hb Hb compare comparison was not statisticallysignificant (P>0.05). Postoperative drainage tube placement time and totalhospitalization time compared with no statistical significance (P>0.05). Transfusionduring hospitalization costs associated with the two groups were522.8±246.5,2235.7±489, perioperative transfusion-related costs in group A was significantly lower thanthat of group B patients, there were statistically significant comparison results (P<0.05).Conclusions: POTTS programme guidance can effectively reduce perioperativeinfusion of blood transfusion and transfusion of red cell suspension, in maintainingpatients ’ vital signs while reducing perioperative blood volume, able to do blood-savingresources. Instructions on blood transfusion and apply a POTTS did not increase theincidence of postoperative complications of blood transfusion and mortality, nor does itaffect patients with Hb before and been discharged from hospital after recovery, ensuring the safety and efficacy of perioperative blood transfusion. POTTS programmeguidance blood transfusions can save costs associated with hospitalization for patients,thereby reducing the financial burden on patients and their families.