A survey of physicians' attitudes toward blood transfusion in patients undergoing cesarean section

Objective: This study was undertaken to evaluate the attitude of anesthesiologists and gynecologists to the use of blood during cesarean section operation and, on the basis of the results, to ascertain the need for improvement of current transfusion guidelines. Study design: A scenario-based survey was performed. Results: The response rate was 94% (327/347) among anesthesiologists and 91% (355/391) among gynecologists. The majority of responders selected a hemoglobin threshold ranging from 7.5 to 8.5 g/dL (62%). Threshold hemoglobin concentration differed significantly (P<.001) between anesthesiologists (median, 7.5 g/dL) and gynecologists (median, 8 g/dL). At that threshold, 56% of anesthesiologists compared with 86% of gynecologists administered 2 units of blood (P<.05). When transfusing packed cells, most practitioners would give 2 units regardless of the transfusion threshold. Conclusion: Our findings demonstrate differing approaches to current transfusion protocols. Transfusion consensus recommendations should be improved and unified to enhance red blood cell transfusion practices for relatively young and healthy patients undergoing anesthesia and surgery. (C) 2004 Elsevier Inc. All rights reserved.