Those of us who remember transfusion medicine in the old days of cardiac surgery remember the many times when blood was drawn from 20 donors the night before surgery so that there would be sufficient heparinized blood to operate the next morning. Surely cardiac surgery has come a long way since then. At the same time, so has transfusion medicine. Blood is easily available, better tested, and in better metabolic condition than ever before. Yet, blood is still a drug that has significant side effects and dangers1-3 so that it should be prescribed only after the physician has given a thorough and informed consideration of the hazards of transfusion vs its benefits in each clinical situation.
In the article written by Goodnough et al,4 a review is presented of the blood transfusion practices of 18 teaching institutions in coronary artery bypass surgery and involving 540 patients. All of