Korean J Blood Transfus.
2010 Apr;21(1):58-64.
An Experience of Autologous Blood Transfusion and Blood Management in Brain Tumor Surgery
- Affiliations
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- 1Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea.
- 2Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
- 3Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea.
- 4Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea. progreen@dau.ac.kr
Abstract
- BACKGROUND
Allogeneic blood transfusion has risks from transfusion-transmitted pathogens. Blood management programs are widely used for cardiovascular or orthopedic surgery, but there have been few studies that have focused on blood conservation during brain tumor resection surgery. The purpose of this study was to evaluate the benefits of blood management for brain tumor surgery.
METHODS
A total of 26 patients undergoing brain tumor resection surgery were included in the study. Thirteen patients with meningiomas, 10 patients with malignant gliomas and 3 patients with other tumors were included. The surgical blood loss was estimated by preoperative imaging studies, and the tumors that could be operated with minimal bleeding were excluded. Preoperative autologous donation (PAD) was done when the expected amount of surgical bleeding surpassed 300 mL. Preoperative embolization was performed in the patients with meningiomas whenever it was technically feasible. Six percent hydroxyethyl starch 130/0.4 (Voluven) was administered during anesthesia for expanding the blood volume and we performed meticulous surgical techniques for minimizing the blood loss.
RESULTS
The amount of bleeding was less than 300 mL in 69.2% of the patients. Preoperative autologous blood was donated by 10 patents and 20% of the PAD units were discarded. Five patients with meningimas received preoperative embolization. None of the patients, except for one patient who had massive bleeding of 7,000 mL, were transfused allogeneic blood. Eighty one percent of the patients received Voluven without complications.
CONCLUSION
Multiple strategies that include preoperative embolization, proper surgical techniques for minimizing blood loss, PAD and hydroxyehtyl starch could effectively decrease the amount of allogenic blood transfused during brain tumor resection surgery.
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