Use of interventions to minimise perioperative allogeneic blood transfusion in Australia: A survey by the International Study of Perioperative Transfusion (ISPOT) study group

David A. Henry, Kim M. Henderson, Jayne L. Fryer, Carla J. Treloar, Katherine M. McGrath, Sandra F. Deveridge

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)

Abstract

Objective: To investigate use of interventions to minimise need for perioperative transfusion of allogeneic blood in surgical units in Australia. Design: Two questionnaire-based surveys of practice. Setting: All hospitals in Australia, 1996-1997. Participants: Survey 1: all Australian hospitals that have at least 50 beds and undertake surgery; Survey 2: surgical units identified as using the interventions. Main outcome measures: Reported rates of use of the various interventions (preoperative autologous donation, acute normovolaemic haemodilution [ANH], cell salvage, and drugs); use of guidelines; and perceptions about the appropriateness of current levels of use. Results: Survey 1 was returned by 349 of 400 hospitals (87%) and Survey 2 by 324 of 578 surgical units (56%). Preoperative autologous donation was most widely used (70% of hospitals), most commonly in units performing orthopaedic or vascular surgery (65% and 37%, respectively). Cell salvage and ANH were used by 27% and 24% of hospitals, respectively, most often in units performing cardiothoracic (40% and 44%, respectively) and vascular surgery (29% and 15%, respectively). These three interventions were used significantly more in private than in public hospitals (P < 0.05). Use of printed guidelines was uncommon. Respondents considered that autologous transfusion techniques should be used more widely because of their perceived efficacy and concerns about safety of allogeneic blood. Perceived barriers to greater use included lack of surgeon or physician interest, uncertain scheduling of surgery in public hospitals and cost (cell salvage). Drugs to minimise blood loss were used by fewer than 10% of hospitals. Conclusions: Interventions to minimise the need for perioperative allogeneic blood transfusion (apart from drugs) are widely used in Australia. However, enthusiasm for intraoperative techniques of re-infusing autologous blood needs to be assessed against the evidence of their efficacy and costeffectiveness.

Original languageEnglish
Pages (from-to)365-369
Number of pages5
JournalMedical Journal of Australia
Volume172
Issue number8
Publication statusPublished - 17 Apr 2000
Externally publishedYes

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Blood Transfusion
Hemodilution
Public Hospitals
Blood Vessels
Pharmaceutical Preparations
Guidelines
Blood Safety
Hospital Costs
Surveys and Questionnaires
Orthopedics
Outcome Assessment (Health Care)
Physicians

Cite this

Henry, David A. ; Henderson, Kim M. ; Fryer, Jayne L. ; Treloar, Carla J. ; McGrath, Katherine M. ; Deveridge, Sandra F. / Use of interventions to minimise perioperative allogeneic blood transfusion in Australia : A survey by the International Study of Perioperative Transfusion (ISPOT) study group. In: Medical Journal of Australia. 2000 ; Vol. 172, No. 8. pp. 365-369.
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title = "Use of interventions to minimise perioperative allogeneic blood transfusion in Australia: A survey by the International Study of Perioperative Transfusion (ISPOT) study group",
abstract = "Objective: To investigate use of interventions to minimise need for perioperative transfusion of allogeneic blood in surgical units in Australia. Design: Two questionnaire-based surveys of practice. Setting: All hospitals in Australia, 1996-1997. Participants: Survey 1: all Australian hospitals that have at least 50 beds and undertake surgery; Survey 2: surgical units identified as using the interventions. Main outcome measures: Reported rates of use of the various interventions (preoperative autologous donation, acute normovolaemic haemodilution [ANH], cell salvage, and drugs); use of guidelines; and perceptions about the appropriateness of current levels of use. Results: Survey 1 was returned by 349 of 400 hospitals (87{\%}) and Survey 2 by 324 of 578 surgical units (56{\%}). Preoperative autologous donation was most widely used (70{\%} of hospitals), most commonly in units performing orthopaedic or vascular surgery (65{\%} and 37{\%}, respectively). Cell salvage and ANH were used by 27{\%} and 24{\%} of hospitals, respectively, most often in units performing cardiothoracic (40{\%} and 44{\%}, respectively) and vascular surgery (29{\%} and 15{\%}, respectively). These three interventions were used significantly more in private than in public hospitals (P < 0.05). Use of printed guidelines was uncommon. Respondents considered that autologous transfusion techniques should be used more widely because of their perceived efficacy and concerns about safety of allogeneic blood. Perceived barriers to greater use included lack of surgeon or physician interest, uncertain scheduling of surgery in public hospitals and cost (cell salvage). Drugs to minimise blood loss were used by fewer than 10{\%} of hospitals. Conclusions: Interventions to minimise the need for perioperative allogeneic blood transfusion (apart from drugs) are widely used in Australia. However, enthusiasm for intraoperative techniques of re-infusing autologous blood needs to be assessed against the evidence of their efficacy and costeffectiveness.",
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Use of interventions to minimise perioperative allogeneic blood transfusion in Australia : A survey by the International Study of Perioperative Transfusion (ISPOT) study group. / Henry, David A.; Henderson, Kim M.; Fryer, Jayne L.; Treloar, Carla J.; McGrath, Katherine M.; Deveridge, Sandra F.

In: Medical Journal of Australia, Vol. 172, No. 8, 17.04.2000, p. 365-369.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Use of interventions to minimise perioperative allogeneic blood transfusion in Australia

T2 - A survey by the International Study of Perioperative Transfusion (ISPOT) study group

AU - Henry, David A.

AU - Henderson, Kim M.

AU - Fryer, Jayne L.

AU - Treloar, Carla J.

AU - McGrath, Katherine M.

AU - Deveridge, Sandra F.

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N2 - Objective: To investigate use of interventions to minimise need for perioperative transfusion of allogeneic blood in surgical units in Australia. Design: Two questionnaire-based surveys of practice. Setting: All hospitals in Australia, 1996-1997. Participants: Survey 1: all Australian hospitals that have at least 50 beds and undertake surgery; Survey 2: surgical units identified as using the interventions. Main outcome measures: Reported rates of use of the various interventions (preoperative autologous donation, acute normovolaemic haemodilution [ANH], cell salvage, and drugs); use of guidelines; and perceptions about the appropriateness of current levels of use. Results: Survey 1 was returned by 349 of 400 hospitals (87%) and Survey 2 by 324 of 578 surgical units (56%). Preoperative autologous donation was most widely used (70% of hospitals), most commonly in units performing orthopaedic or vascular surgery (65% and 37%, respectively). Cell salvage and ANH were used by 27% and 24% of hospitals, respectively, most often in units performing cardiothoracic (40% and 44%, respectively) and vascular surgery (29% and 15%, respectively). These three interventions were used significantly more in private than in public hospitals (P < 0.05). Use of printed guidelines was uncommon. Respondents considered that autologous transfusion techniques should be used more widely because of their perceived efficacy and concerns about safety of allogeneic blood. Perceived barriers to greater use included lack of surgeon or physician interest, uncertain scheduling of surgery in public hospitals and cost (cell salvage). Drugs to minimise blood loss were used by fewer than 10% of hospitals. Conclusions: Interventions to minimise the need for perioperative allogeneic blood transfusion (apart from drugs) are widely used in Australia. However, enthusiasm for intraoperative techniques of re-infusing autologous blood needs to be assessed against the evidence of their efficacy and costeffectiveness.

AB - Objective: To investigate use of interventions to minimise need for perioperative transfusion of allogeneic blood in surgical units in Australia. Design: Two questionnaire-based surveys of practice. Setting: All hospitals in Australia, 1996-1997. Participants: Survey 1: all Australian hospitals that have at least 50 beds and undertake surgery; Survey 2: surgical units identified as using the interventions. Main outcome measures: Reported rates of use of the various interventions (preoperative autologous donation, acute normovolaemic haemodilution [ANH], cell salvage, and drugs); use of guidelines; and perceptions about the appropriateness of current levels of use. Results: Survey 1 was returned by 349 of 400 hospitals (87%) and Survey 2 by 324 of 578 surgical units (56%). Preoperative autologous donation was most widely used (70% of hospitals), most commonly in units performing orthopaedic or vascular surgery (65% and 37%, respectively). Cell salvage and ANH were used by 27% and 24% of hospitals, respectively, most often in units performing cardiothoracic (40% and 44%, respectively) and vascular surgery (29% and 15%, respectively). These three interventions were used significantly more in private than in public hospitals (P < 0.05). Use of printed guidelines was uncommon. Respondents considered that autologous transfusion techniques should be used more widely because of their perceived efficacy and concerns about safety of allogeneic blood. Perceived barriers to greater use included lack of surgeon or physician interest, uncertain scheduling of surgery in public hospitals and cost (cell salvage). Drugs to minimise blood loss were used by fewer than 10% of hospitals. Conclusions: Interventions to minimise the need for perioperative allogeneic blood transfusion (apart from drugs) are widely used in Australia. However, enthusiasm for intraoperative techniques of re-infusing autologous blood needs to be assessed against the evidence of their efficacy and costeffectiveness.

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M3 - Article

VL - 172

SP - 365

EP - 369

JO - Medical Journal of Australia

JF - Medical Journal of Australia

SN - 0025-729X

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