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A Critical Assessment of the Use of Blood Transfusions During Major Gastric Operations

A Critical Assessment of the Use of Blood Transfusions During Major Gastric Operations Abstract The value of whole blood transfusions in making safer some surgical procedures and in extending the operability of certain lesions is established in surgical literature and verified by every surgeon's personal experience. This favorable experience may have led to a current practice of using blood transfusions without discrimination. Also effective in perpetuating the indiscriminate use of blood transfusions are some unquestioned dogmas that reappear in surgical literature year after year. Critical evidence in support of some of these clichés is glaringly in want. We wish to examine critically some of these canons, and their implied assumptions, which give authority to disregard the harm and to respect only the benefit that may be expected from the transfusion of 5,000,000 pints of whole blood in this country in one year. Certain authors are quoted because their statements are succinct and often repeated. We do not know whether these men still hold valid References 1. The records of the V.A. patients were made available to us for review and analysis through the interest and generosity of Dr. Paul North, Chief of Surgery, Dallas Veterans Administration Hospital. 2. Coller, F. A.; Crook, C. E., and lob, V.: Blood Loss in Surgical Operations , J.A.M.A. 126:1, 1944.Crossref 3. Gatch, W. D., and Little, W. D.: Amount of Blood Lost During Some of the More Common Operations , J.A.M.A. 83:1075, 1924.Crossref 4. Saltzstein, H. C., and Linkner, L. M.: Blood Loss During Operations , J.A.M.A. 149:722, 1952.Crossref 5. Downs, J. W.: The Problem of Overtransfusion in Massive Hemorrhage , Ann. Surg. 148:73, 1958.Crossref 6. Mithoefer, J.: Hazard of Transfusion in Patients with Chronic Anemia , Am. J. Surg. 89:740, 1955.Crossref 7. Pratt, G. H.: Surgical Correction of Lymphedema , J.A.M.A. 147:1121, 1951.Crossref 8. Bonica, J. J., and Lyter, C. S.: Measurement of Blood Loss During Surgical Operations , Am. J. Surg. 81:496, 1951.Crossref 9. Shropulos, G.; Kincaid, B.; Strickland, W., and Wilson B.: Unpublished data. 10. Crook, C. E.; lob, V., and Coller, F. A.: Correction of Blood Loss During Surgical Operations , Surg. Gynec. & Obst. 82:417, 1946. 11. Wallensten, S.: Results of Surgical Treatment of Peptic Ulcer by Partial Gastrectomy , Acta chir. scandinav. (Supp. 191) , p. 1, 1954. 12. Randall, R. E., Jr., and Papper, S.: Mechanism of Postoperative Limitation in Sodium Excretion , J. Clin. Invest. 37:1628, 1958. 13. Wise, W.; Head, L. R.; Morse, M., and Allen, J. G.: The Physiological Effects of Acute Anemia Produced by the Replacement of Serial Hemorrhages with Dextran, Plasma, and Whole Blood , Forum 8:18, 1957. 14. DeGowin, E. L.; Hardin, R. C., and Alsever, J. B.: Blood Transfusion , Philadelphia, W. B. Saunders Company, 1949. 15. Allen, J. G., and Sayman, W. A.: Blood Transfusions and Serum Hepatitis , Ann. Surg. 150:455, 1959. 16. Miller, E. D., and Tisdall, L. H.: Reactions to 10,000 Pooled Liquid Human Plasma Transfusions , J.A.M.A. 128:863, 1945. 17. Braude, A. I.; Sanford, J. P.; Bartlett, J. E., and Mallery, O. T., Jr.: Effects and Clinical Significance of Bacterial Contaminants in Transfused Blood , J. Lab. & Clin. Med. 39:902, 1952. 18. Crisp, W. E.: One Pint of Blood , Obst. & Gvnec. 7:216, 1956. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

A Critical Assessment of the Use of Blood Transfusions During Major Gastric Operations

A.M.A. Archives Surgery , Volume 80 (5) – May 1, 1960

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1960.01290220052008
Publisher site
See Article on Publisher Site

Abstract

Abstract The value of whole blood transfusions in making safer some surgical procedures and in extending the operability of certain lesions is established in surgical literature and verified by every surgeon's personal experience. This favorable experience may have led to a current practice of using blood transfusions without discrimination. Also effective in perpetuating the indiscriminate use of blood transfusions are some unquestioned dogmas that reappear in surgical literature year after year. Critical evidence in support of some of these clichés is glaringly in want. We wish to examine critically some of these canons, and their implied assumptions, which give authority to disregard the harm and to respect only the benefit that may be expected from the transfusion of 5,000,000 pints of whole blood in this country in one year. Certain authors are quoted because their statements are succinct and often repeated. We do not know whether these men still hold valid References 1. The records of the V.A. patients were made available to us for review and analysis through the interest and generosity of Dr. Paul North, Chief of Surgery, Dallas Veterans Administration Hospital. 2. Coller, F. A.; Crook, C. E., and lob, V.: Blood Loss in Surgical Operations , J.A.M.A. 126:1, 1944.Crossref 3. Gatch, W. D., and Little, W. D.: Amount of Blood Lost During Some of the More Common Operations , J.A.M.A. 83:1075, 1924.Crossref 4. Saltzstein, H. C., and Linkner, L. M.: Blood Loss During Operations , J.A.M.A. 149:722, 1952.Crossref 5. Downs, J. W.: The Problem of Overtransfusion in Massive Hemorrhage , Ann. Surg. 148:73, 1958.Crossref 6. Mithoefer, J.: Hazard of Transfusion in Patients with Chronic Anemia , Am. J. Surg. 89:740, 1955.Crossref 7. Pratt, G. H.: Surgical Correction of Lymphedema , J.A.M.A. 147:1121, 1951.Crossref 8. Bonica, J. J., and Lyter, C. S.: Measurement of Blood Loss During Surgical Operations , Am. J. Surg. 81:496, 1951.Crossref 9. Shropulos, G.; Kincaid, B.; Strickland, W., and Wilson B.: Unpublished data. 10. Crook, C. E.; lob, V., and Coller, F. A.: Correction of Blood Loss During Surgical Operations , Surg. Gynec. & Obst. 82:417, 1946. 11. Wallensten, S.: Results of Surgical Treatment of Peptic Ulcer by Partial Gastrectomy , Acta chir. scandinav. (Supp. 191) , p. 1, 1954. 12. Randall, R. E., Jr., and Papper, S.: Mechanism of Postoperative Limitation in Sodium Excretion , J. Clin. Invest. 37:1628, 1958. 13. Wise, W.; Head, L. R.; Morse, M., and Allen, J. G.: The Physiological Effects of Acute Anemia Produced by the Replacement of Serial Hemorrhages with Dextran, Plasma, and Whole Blood , Forum 8:18, 1957. 14. DeGowin, E. L.; Hardin, R. C., and Alsever, J. B.: Blood Transfusion , Philadelphia, W. B. Saunders Company, 1949. 15. Allen, J. G., and Sayman, W. A.: Blood Transfusions and Serum Hepatitis , Ann. Surg. 150:455, 1959. 16. Miller, E. D., and Tisdall, L. H.: Reactions to 10,000 Pooled Liquid Human Plasma Transfusions , J.A.M.A. 128:863, 1945. 17. Braude, A. I.; Sanford, J. P.; Bartlett, J. E., and Mallery, O. T., Jr.: Effects and Clinical Significance of Bacterial Contaminants in Transfused Blood , J. Lab. & Clin. Med. 39:902, 1952. 18. Crisp, W. E.: One Pint of Blood , Obst. & Gvnec. 7:216, 1956.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: May 1, 1960

References

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