ABBREVIATIONSANHacute normovolemic hemodilutionPACUpostanesthesia care unitPerioperative blood management for patients undergoing liver resection has changed a great deal over the past several decades. Advances in surgical and anesthetic techniques and alterations in the definitions of resectability have changed how patients are managed before, after, and during surgery. Currently, manipulation of the central venous pressure, vascular clamping techniques, dissection devices, topical hemostatic agents, and pharmacologic agents such as antifibrinolytics are used to reduce blood loss in liver surgery. The introduction of these techniques, in addition to changes in transfusion thresholds over time, appears to have decreased transfusion rates overall, with a large, single‐center study demonstrating a decrease in transfusion prevalence from 83% in the late 1980s to 43% in the late 1990s. Current evidence suggests that approximately 22% of liver resection patients in North America receive a perioperative transfusion. There is limited high‐quality evidence on the impact of blood loss and blood transfusions in liver resection, although some retrospective data suggest that transfusions may lead to increased complications and cancer recurrence, independent of known confounders. Evidence from other areas of surgery and medicine suggest that a more restrictive use of red blood cell (RBC) transfusions is at least equivalent, or possibly
Transfusion – Wiley
Published: Jan 1, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
All the latest content is available, no embargo periods.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud