Avtor/Urednik		Milovanović, Slavomir; Papuga, Vesna
Naslov		Transfuzija krvi in krvnih pripravkov pri hudo poškodovanih v SB Celje (1998-2001)
Prevedeni naslov		Transfusion of blood and blood components in polytraumatised patients at Celje hospital (1998-2001)
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 72, št. Suppl 1
Leto izdaje		2003
Obseg		str. I-103-6
Jezik		slo
Abstrakt		Background. The replacement of fluids after severe injuries is always a complex issue, either in medical doctrine or in clinical practice. Regardless of the fact, daily work with patients requires the clearest possible guidelines and their regular monitoring. Methods. We made a chart showing the number of patients and the quantity of blood or blood components used in the Celje General Hospital in the past four years. Results. The analyses have shown that indications for the use of blood or blood components have narrowed. At the same time, it is quite evident that it is difficult and also risky to decide on a transfusion only on the given laboratory values. Only a careful analysis of the therapy has shown that the decision on a transfusion is based on both, the clinical picture and its development, the evaluation of visible and invisible loss of blood, and on regular and extensive laboratory monitoring. Conclusions. Despite improved surgical techniques and introduction of new transfusion strategies loss of blood and need for transfusion during and after polytrauma surgeries is still rather high. In the analysed four yearperiod, the maintained level of haemoglobin in patients that had a major surgery has slightly declined. It is therefore essential to cooperate with the respective hospital transfusion committee and prepare as well as follow up some clear guidelines for the rationalisation, not only restriction of transfusion of blood and blood components.
Izvleček		Izhodišča. Nadomeščanje tekočin pri hudih poškodbah je vedno doktrinarni in klinični problem. Ne glede na to so pri vsakdanjem delu ob bolniku potrebne čim bolj jasne smernice in redno spremljanje njihove uporabe. Metode. Prispevek prikazuje pregled porabe krvi in krvnih pripravkov pri hudo poškodovanih bolnikih v Splošni bolnišnici Celje za obdobje štirih let. Rezultati. Analize nakazujejo, da so indikacije za uporabo krvi in krvnih pripravkov v zadnjih letih strožje. Razvidno je tudi, kako težko in tvegano se je odločiti za transfuzijo le na osnovi laboratorijskih izvidav. Šele skrbna analiza zdravljenja je pokazala, da taka odločitev temelji tako na klinični sliki in njenem razvoju, oceni vidne in nevidne izgube krvi in na rednem spremljanju razširjenih laboratorijskih preiskav. Zaključki. Kjub izboljšanju operativne tehnike in uvajanju novih transfuzijskih postopkov je izguba krvi in s tem potreba po transfuziji pri hudih poškodbah med operacijo in v prvih dneh po operaciji še vedno velika. Vzdrževana vrednost hemoglobina po operaciji se je v 4-letnem obdobju opazovanja postopno zniževala. Nujno je v sodelovanju z bolnišničnim transfuzijskim komitejem oblikovati smernice tudi za racionalizacijo in ne le za omejevanje uporabe krvi in krvnih pripravkov .
Deskriptorji		MULTIPLE TRAUMA BLOOD TRANSFUSION BLOOD LOSS, SURGICAL BLOOD COMPONENT TRANSFUSION INTENSIVE CARE UNITS HEMOGLOBINS HEMATOCRIT