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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
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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

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