Elektronisk udgave - Sundhedsstyrelsen

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effectiveness identified. Insufficient results of cost evaluations notwithstanding,
it can be assumed that TXA and aprotinin would be
the most cost-effective of the technologies. However, knowledge of
the short as well as in the long term side effects is insufficient. Use
of aprotinin must be deemed acceptable even though aprotinin is
more expensive than TXA, considering that aprotinin, more surely
than TXA, can prevent re-operations caused by bleeding. From a
Danish perspective antifibrinolytic drugs could be a very interesting
field for some of the fields of specialisation.
EPO
Abroad, especially in the United States, the use of EPO is closely
connected with a considerably more widespread use of PAD (which,
as in the case of EPO, is not cost-effective) than in Denmark. In
Denmark EPO is not deemed a technology suitable for use in more
or less standard treatment to limit blood requirements. Only in very
special cases (e.g. when a Jehovah’s Witness undergoes an operation
or in the case of very specific groups of patients) the use of EPO can
be deemed relevant.
ANH
The examination of the effectiveness of ANH is weakened by methodological
problems, but in general ANH could be seen as an applicable
and useful technology in Danish hospitals, e.g. in connection
with major operations on younger people. However, the use of
ANH requires some planning and coordination (between anesthesiological
and surgical personnel and possibly the blood bank) and
may thus be time-consuming. With increased evidence of its effectiveness
it cannot be excluded that in the long term ANH might become
a relevant area of development in Denmark.
Autotransfusion/CS
From a clinical point of view autotransfusion/CS appears to be the
perhaps most interesting of the examined technologies; this is a
technology which would also be directly applicable and useful
within the Danish hospital service. However, one objection can be
raised, namely that the potential risk of spreading bone, tissue and
plastic particles has not been investigated sufficiently yet, neither in
relation to intraoperative and postoperative use, nor in a long-term
perspective. Using blood which has been washed would presumably
help to reduce this problem. On the other hand, equipment for