BLOOD CARE AT ELECTIVE UROLOGICAL OPERATIONS


Authors: MUDr. Bronislav Stibor;  MUDr. Roman Gál, Ph.D.;  doc. MUDr. Ivan Čundrle, CSc.
Authors‘ workplace: 1. anesteziologicko-resuscitační oddělení FN Brno
Published in: Urol List 2005; 3(1): 47-52

Overview

In case of extensive or complicated urologic operation there may arise a need of blood tranfusion aplication. The new knowledge in physiology and pathophysiology found that even strong anaemia is quite well tolerated by human organism. Former dogma to apply blood when haemoglobin is lower than 100g/l does not govern anymore. In spite of all the progress in testing donors and blood conserves, the transfusion is relatively risk ope­ration. Nowadays, it is especially the transfer of infectuous diseases which is threa­tening. After AIDS pandemy there are still new pathogenes occuring. They are transferred by blood and no routine and effective tests on them do not exist. Therefore there is a maximal effort to avoid the application of foreign blood.

In urology, the standard method of blood care has been preoperational autologous blood donorship or autotransfusion. However, nowadays it is often being replaced or complemented by acute normovolaemic haemodilution, since this method is very effective and at the same time safe and cheap.

An effective news are also the pharmacologic remedies, especially human recombinant erythropoetin or activated factor VII. Their disadvantage is that their price is still high. Suitable combination of various methods of blood care enables us to make the prevalent majority of mostly urologic operations as a part of bloodless medicine.

KEY WORDS:
blood care, anaemia, blood tranfusion, preoperational autologous blood donorship, acute normovolaemic haemodilutio, erythropoetin


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