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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.d.18.00322    [Epub ahead of print]
Published online December 5, 2018.
Korean clinical practice guideline for perioperative red blood cell transfusion from Korean Society of Anesthesiologists
Bon-Nyeo Koo1, Min A Kwon2, Sang-Hyun Kim3, Jong Yeop Kim4, Young-Jin Moon5, Sun Young Park6, Eun-Ho Lee5, Min Suk Chae7, Sung Uk Choi8, Jeong-Hyun Choi9, Jin-Young Hwang10
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea
2Department of Anesthesiology and Pain Medicine, Dankook university hospital, Cheonan, Korea
3Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
4Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
5Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
6Department of Anesthesiology and pain medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
7Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
8Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Seoul, Korea
9Department of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
10Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, College of Medicine, Seoul National University, Seoul, Republic of Korea
Corresponding author:  Eun-Ho Lee,
Email: leho@naver.com
Received: 19 November 2018   • Accepted: 27 November 2018
Abstract
Considering the functional role of red blood cells (RBC) in maintaining a proper supply of oxygen to the tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component of safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Besides, excessive utilization of pRBCs may aggravate prognosis or increase the risk of developing infectious diseases. Appropriate perioperative RBC transfusion is, therefore, crucial for patient safety management as well as medical resource conservation management. These concerns motivated us to develop the present clinical practice guideline for evidence-based efficient and safe perioperative RBC transfusion management. This guideline is the result of the revision and refinement of exemplary clinical practice guidelines developed in advanced countries, taking into account the current clinical landscape in Korea, followed by rigorous evidence-based reassessment considering the healthcare environment of the country. This guideline covers all important aspects of perioperative RBC transfusion, such as preoperative anemia management, appropriate RBC storage period and leukoreduction (removal of white blood cells using filters), reversal of perioperative bleeding tendency, strategies for perioperative RBC transfusion, appropriate blood management protocols, efforts to reduce the blood transfusion requirements, and patient monitoring during a perioperative transfusion. It will guide decisions related to RBC transfusion in healthcare settings and minimize the patient’s risk related to unnecessary pRBC transfusion.
Key Words: Clinical practice guideline; Perioperative management; Red blood cell transfusion


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