ＭＳＢＯＳ，Ｔｙｐｅ ａｎｄ Ｓｃｒｅｅｎの血液有効利用における効果と問題点について

Abstract

The objective of this study is to evaluate the effects and problems of the maximum surgical blood order schedule (MSBOS) and type and screen (T & S) system on the usage of blood for surgical procedures.Although 303 units of blood were prepared and cross-matched for 142 cases of the selected 8 types of surgical procedures assigned by T & S during a year before the initiation of the system, only 31 units of blood were prepared for 130 cases of those during a year after the initiation. In some of the surgical procedures assigned by various units of MSBOS, the average units of blood prepared were decreased. In the procedures of radical mastectomy and total gastrectomy, the system of MSBOS was not effective in reducing the units of blood prepared. The method of anesthesia such as deliberate hypotension that can reduce the volume of blood loss or precise classification of the surgical procedure should be considered to decide the units of MSBOS for radical mastectomy or total gastrectomy, respectively. In addition, the units of MSBOS should be re-evaluated for the procedures for which autologous blood are preoperatively prepared. The units of autologous blood prepared are thought to be reduced from the previous MSBOS units.These results indicate that the system is effective in reducing the units prepared and that the MSBOS and T & S should be re-evaluated depending on the changes of anesthetic method or surgical procedures and the application of autologous blood donation programs.