Korean Journal of Anesthesiology

The Korean Society of Anesthesiologists (대한마취통증의학회)
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Korean clinical practice guideline for perioperative red blood cell transfusion from Korean Society of Anesthesiologists

  • Koo, Bon-Nyeo (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Kwon, Min A (Department of Anesthesiology and Pain Medicine, Dankook University Hospital) ;
  • Kim, Sang-Hyun (Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Jong Yeop (Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine) ;
  • Moon, Young-Jin (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Sun Young (Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine) ;
  • Lee, Eun-Ho (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chae, Min Suk (Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Choi, Sung Uk (Department of Anesthesiology and Pain Medicine, Korea University College of Medicine) ;
  • Choi, Jeong-Hyun (Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine) ;
  • Hwang, Jin-Young (Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine)
  • Received : 2018.11.19
  • Accepted : 2018.11.27
  • Published : 2019.04.01
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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.

Keywords

Acknowledgement

Supported by the Korean Society of Anesthesiologists and developed under the direction of Tae-Yop Kim, M.D., Director, Committee on Academic Affairs.

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