ABSTRACT
The Consensus Document on Alternatives to Allogenic Blood Transfusion (AABT) has been drawn up by a panel of experts from 5 scientific societies. The Spanish Societies of Anesthesiology (SEDAR), Critical Care Medicine and Coronary Units (SEMICYUC), Hematology and Hemotherapy (AEHH), Blood Transfusion (SETS) and Thrombosis and Hemostasis (SETH) have sponsored and participated in this Consensus Document. Alternatives to blood transfusion have been divided into pharmacological and non-pharmacological, with 4 modules and 12 topics. The main objective variable was the reduction of allogenic blood transfusions and/or the number of transfused patients. The extent to which this objective was achieved by each AABT was evaluated using the Delphi method, which classifies the grade of recommendation from A (supported by controlled studies) to E (non-controlled studies and expert opinion). The experts concluded that most of the indications for AABT were based on middle or low grades of recommendation, "C", "D", or "E", thus indicating the need for further controlled studies.
Subject(s)
Hemorrhage/therapy , Aminocaproic Acid/administration & dosage , Aminocaproic Acid/adverse effects , Aminocaproic Acid/therapeutic use , Antifibrinolytic Agents/administration & dosage , Antifibrinolytic Agents/adverse effects , Antifibrinolytic Agents/therapeutic use , Aprotinin/administration & dosage , Aprotinin/adverse effects , Aprotinin/therapeutic use , Blood Loss, Surgical/prevention & control , Blood Substitutes/administration & dosage , Blood Substitutes/adverse effects , Blood Substitutes/therapeutic use , Blood Transfusion, Autologous , Colloids/administration & dosage , Colloids/adverse effects , Colloids/therapeutic use , Crystalloid Solutions , Deamino Arginine Vasopressin/administration & dosage , Deamino Arginine Vasopressin/adverse effects , Deamino Arginine Vasopressin/therapeutic use , Evidence-Based Medicine , Factor VIIa/administration & dosage , Factor VIIa/adverse effects , Factor VIIa/therapeutic use , Hematinics/administration & dosage , Hematinics/adverse effects , Hematinics/therapeutic use , Hemodilution , Hemorrhage/drug therapy , Hemostatics/administration & dosage , Hemostatics/adverse effects , Hemostatics/therapeutic use , Humans , Iron/administration & dosage , Iron/adverse effects , Iron/therapeutic use , Isotonic Solutions/administration & dosage , Isotonic Solutions/adverse effects , Isotonic Solutions/therapeutic use , Operative Blood Salvage , Postoperative Hemorrhage/drug therapy , Premedication , Randomized Controlled Trials as Topic/statistics & numerical data , Recombinant Proteins/administration & dosage , Recombinant Proteins/adverse effects , Recombinant Proteins/therapeutic use , Tranexamic Acid/administration & dosage , Tranexamic Acid/adverse effects , Tranexamic Acid/therapeutic useABSTRACT
El Documento de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica (ATSA) ha sido elaborado por un panel de expertos pertenecientes a 5 sociedades científicas. Han participado y patrocinado las sociedades españolas de Anestesiología (SEDAR), Medicina Intensiva (SEMICYUC), Hematología y Hemoterapia (AEHH), Transfusión sanguínea (SETS) y Trombosis y Hemostasia (SETH). Las alternativas a la transfusión se han clasificado en farmacológicas y no farmacológicas, con un total de 4 módulos y 12 tópicos. La disminución de las transfusiones de sangre alogénica y/o el número de pacientes transfundidos fue la principal variable objetivo. El grado de cumplimiento de este objetivo, para cada ATSA, se llevó a cabo siguiendo la metodología Delphi, que clasifica el grado de recomendación desde «A» (apoyado por estudios controlados) hasta «E» (estudios no controlados y opinión de expertos). Los expertos concluyeron que la mayor parte de las indicaciones de las ATSA se sustentan en grados de recomendación medios y bajos, «C», «D» o «E», precisándose nuevos estudios controlados (AU)
The Consensus Document on Alternatives to Allogenic Blood Transfusion (AABT) has been drawn up by a panel of experts from 5 scientific societies. The Spanish Societies of Anesthesiology (SEDAR), Critical Care Medicine and Coronary Units (SEMICYUC), Hematology and Hemotherapy (AEHH), Blood Transfusion (SETS) and Thrombosis and Hemostasis (SETH) have sponsored and participated in this Consensus Document. Alternatives to blood transfusion have been divided into pharmacological and non-pharmacological, with 4 modules and 12 topics. The main objective variable was the reduction of allogenic blood transfusions and/or the number of transfused patients. The extent to which this objective was achieved by each AABT was evaluated using the Delphi method, which classifies the grade of recommendation from A (supported by controlled studies) to E (non-controlled studies and expert opinion). The experts concluded that most of the indications for AABT were based on middle or low grades of recommendation, «C», «D», or «E», thus indicating the need for further controlled studies (AU)
