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Transfusion Therapy During War and Peace in Sarajevo

  • Mirza Begovic (a1) and Abdulah Kozlicic (a2)

Abstract

Objective:

To investigate surgical blood usage during the siege of Sarajevo.

Methods:

Data on blood usage and pre-transfusion hematocrit (Hct) values from blood transfusion request forms in 250 wartime emergency surgical procedures during August through October 1992 (experimental group), and in 146 peacetime elective surgical procedures (control group) during April through June 1991 at the State Hospital of Sarajevo, were reviewed.

Results:

The mean number of blood units transfused per patient (blood usage rate) was 1.13 in the experimental group versus 2.56 in the control group (p <0.001). During the war, for blood conservation, normovolemic hemodilution was practiced widely. A significantly lower mean pre-transfusion Hct value of 0.21 was observed in the experimental group versus 0.27 in the control group (p <0.001).

Conclusion:

Blood-usage rate was lower during emergency surgical procedures in war than during elective surgical procedures in peacetime without apparent adverse patient outcome. This decrease in blood-usage rate in the face of increased numbers of trauma victims was the result of a planned blood-conservation program which included: stringent blood-usage criteria, and widespread implementation of casualty resuscitation using normovolemic hemodilution with colloid and crystalloid plasma substitutes.

Copyright

Corresponding author

Principal Investigator, Disaster Reanimatology Study Group, International Resuscitation Research Center, Department of Anesthesiology/CCM, University of Pittsburgh Medical Center, Pittsburgh, PA 15260USA

References

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1. Radovic, M, Vojvodic, V: Snabdevanje krvju, albuminom i infuzijskim rastvorima u ratu. Vojnosanit Pregl 1991;48:195200.
2. Buffat, JJ: Le choc traumatiqu e de l'avant. Med Armees 1986;14:401408.
3. De Oliveira, AG: The use of blood transusion under military operational conditions. Rev Int Serv Sante Forces Armees 1988;61:213219.
4. Mendelson, JA: The use of whole blood and blood volume expanders in U.S. military medical facilities in Vietnam 1966-1971. J Trauma 1975;15:113.
5. Daum, J: Supplying armed forces with blood. Med Corps Int 1986;1:2226.
6. Radovic, M, Taseski, J: Sluzba za transfuziju krvi i ratovi. Vojnosanit Pregl 1979;36:359364.
7. Fabre, G: Revitaillement en sang et derives en compagne. Rev Int Serv Sante Forces Armees 1989;62:144148.
8. Mintz, PD: Theraputic use of blood components. In: Current Therapy. Philadelphia: W.B. Saunders Co., 1989, pp 392398.
9. Widmann, FK: Technical Manual of American Association of Blood Banks, 9th ed. Basel: S Karger, 1984.
10. Thurer, RL, Kruskall, MS: Alternatives to random donor transfusion. In: Widmann, FK, Informed Consent for Blood Transfusion. Arlington, Va., American Association of Blood Banks, 1989, pp 6979.
11. Office of Medical Application of Research. National Institutes of Health, Bethesda. Perioperative red blood cell transfusion—Consensus conference. JAMA 1988;260:27002703.
12. Mozes, B, Epstein, M et al. : Evaluation of the appropriateness of blood and blood product transfusion using preset criteria. Transfusion 1989:29:473476.
13. Ratna hirurgija. Beograd: Vojnoizdavacki zavod; 1980.
14. Menitove, JE: Blood utilization. In: Wallas, CH, McCarty, LJ, New Frontiers in Blood Banking. Arlington, Va.: American Association of Blood Banks, 1986:120.

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Transfusion Therapy During War and Peace in Sarajevo

  • Mirza Begovic (a1) and Abdulah Kozlicic (a2)

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