Background and Goal of Study:The aim of this study is to evaluate intraoperative fluid resuscitation in
patients who underwent high risk major abdominal surgery and to compare the mortality and morbidity of
intraoperative restrictive blood transfusion versus liberal blood transfusion.
Materials and Methods:Among three hundred and fifty-two ASA (American Society of
Anesthesiologists) scores were III-V patients who have had elective major abdominal surgery between
July 2014-July 2015, 141 were included in the study. Patients were divided into two groups according to
their blood transfusion management as "restrictive" (group R) and "liberal" (group L). Demographic data,
preoperative, intraoperative, and postoperative complications, duration of hospitalization, intensive care
unit stay, mortality and discharge rates were investigated.
Results and Discussion:Demographic and preoperative data were similar in both groups (group L,
n=49; and group R, n=92). However, the number of ASA IV patients in Group R was higher than Group
L (p<0.005). Intraoperative data (preoperative and postoperative haemoglobin values, type of surgery,
duration of operation, total amount of crystalloid and colloid, fresh frozen plasma and erythrocyte
suspension counts) were similar in both groups and it was seen that Group L had more colloid
transfusion than Group R. Postoperative complications, mortality/discharge ratio, duration of
hospitalization and intensive care unit stay were similar in both groups. However, the rate of minor
infections was 26.5% in Group L and 7.6% in Group R, which was statistically significantly higher (p =
0.002).
Conclusion(s):In high-risk patients, restrictive blood transfusion strategies should be used due to the
positive effects of morbidity, mortality, and discharge compared to liberal blood transfusion strategies
without applying fluid-restricting protocols

02 / Effects of intraoperative liquid and restrictive blood transfusion management to hospital discharge in high risk patients on major abdominal surgery