Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-18T20:23:57.821Z Has data issue: false hasContentIssue false
  • English
  • Français

Transfusion Therapy During War and Peace in Sarajevo

Published online by Cambridge University Press:  28 June 2012

Mirza Begovic  and
Abdulah Kozlicic
Mirza Begovic*
Affiliation:
Department of Transfusiology, State Hospital of Sarajevo, Republic of Bosnia and Herzegovina
Abdulah Kozlicic
Affiliation:
Department of Preventive Medicine and Microbiology, State Hospital of Sarajevo, Republic of Bosnia and Herzegovina.
*
Principal Investigator, Disaster Reanimatology Study Group, International Resuscitation Research Center, Department of Anesthesiology/CCM, University of Pittsburgh Medical Center, Pittsburgh, PA 15260USA
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

blood bankingblood conservationdisaster medicinefluid resuscitationmilitary medicinenormovolemic hemodilutiontransfusiologytransfusion therapyvolume expanderswar
Type
Invited Papers
Information
Prehospital and Disaster Medicine , Volume 9 , supplement S1: Invited Papers from Sarajevo , June 1994 , pp. S16 - S19
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Radovic, M, Vojvodic, V: Snabdevanje krvju, albuminom i infuzijskim rastvorima u ratu. Vojnosanit Pregl 1991;48:195–200.Google Scholar
2. Buffat, JJ: Le choc traumatiqu e de l'avant. Med Armees 1986;14:401–408.Google Scholar
3. De Oliveira, AG: The use of blood transusion under military operational conditions. Rev Int Serv Sante Forces Armees 1988;61:213–219.Google Scholar
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;15:1–13.CrossRefGoogle Scholar
5. Daum, J: Supplying armed forces with blood. Med Corps Int 1986;1:22–26.Google Scholar
6. Radovic, M, Taseski, J: Sluzba za transfuziju krvi i ratovi. Vojnosanit Pregl 1979;36:359–364.Google Scholar
7. Fabre, G: Revitaillement en sang et derives en compagne. Rev Int Serv Sante Forces Armees 1989;62:144–148.Google Scholar
8. Mintz, PD: Theraputic use of blood components. In: Current Therapy. Philadelphia: W.B. Saunders Co., 1989, pp 392–398.Google Scholar
9. Widmann, FK: Technical Manual of American Association of Blood Banks, 9th ed. Basel: S Karger, 1984.Google Scholar
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 69–79.Google Scholar
11. Office of Medical Application of Research. National Institutes of Health, Bethesda. Perioperative red blood cell transfusion—Consensus conference. JAMA 1988;260:2700–2703.CrossRefGoogle Scholar
12. Mozes, B, Epstein, M et al. : Evaluation of the appropriateness of blood and blood product transfusion using preset criteria. Transfusion 1989:29:473–476.Google Scholar
13. Ratna hirurgija. Beograd: Vojnoizdavacki zavod; 1980.Google Scholar
14. Menitove, JE: Blood utilization. In: Wallas, CH, McCarty, LJ, New Frontiers in Blood Banking. Arlington, Va.: American Association of Blood Banks, 1986:1–20.Google Scholar