Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Cardozo, Rodrigo Tavares; Souza, Edison Fidelis de; Alves, Wagner Campoli; Filho, Flávio Barbi

doi:10.1016/j.rboe.2013.09.002

Cited by 11 publications

(7 citation statements)

References 23 publications

(24 reference statements)

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“…No patient presented infectious complications, which may have influenced the absence of relation. The rate of blood transfusion in the present sample was in agreement with national literature 25 and did not influence the CRP curve in the acute phase.…”

Section: Discussionsupporting

confidence: 90%

Evaluation of serum levels of C-reactive protein after total knee arthroplasty

Barretto

Loures

Albuquerque

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the behavior of C-reactive protein (CRP) levels in the first three weeks after total knee arthroplasty (TKA) and define the factors related to its variation.MethodsWe evaluated the CRP values in 103 patients undergoing primary TKA. Serum CRP was measured on the day before surgery, and on the third and twenty-first days after the procedure.ResultsPCR showed sudden increase on the third day after surgery, reaching the mean value of 111.9 mg/L, median 75.9 mg/L. Only one-third of the patients returned to normal levels in the third week. In the immediate postoperative period, CRP was not correlated with body mass index (BMI), age, gender, blood transfusion, or complications.ConclusionSerum CRP remains high in the third week after TKA in most patients, and this change is primarily related to surgical trauma.

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Section: Discussionsupporting

confidence: 90%

Evaluation of serum levels of C-reactive protein after total knee arthroplasty

Barretto

Loures

Albuquerque

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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“…In both groups, the following data were evaluated: changes in systolic and diastolic blood pressure, Hb variation, postoperative blood loss, incidence and amount of blood transfusion, WBC count, albumin level, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and aspartate aminotransferase/alanine aminotransferase (AST/ALT). Blood transfusion was performed when the postoperative Hb level was ≤9 g/dL and when it was reduced by ≥20% compared to the preoperative Hb level 11) . Statistical analysis was performed using SPSS ver.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Difference in Hematologic and Hemodynamic Outcomes between Primary Total Knee Arthroplasty and Revision of Infected Total Knee Arthroplasty

Lee

Ryu

Ahn

2016

Knee Surg Relat Res

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PurposeThis study is to identify preoperative cautions for revision of infected total knee arthroplasty (TKA) by understanding the differences in hematologic and hemodynamic changes between primary TKA and revision of infected TKA.Materials and MethodsThe study included 40 patients in each of the two groups: one group with patients who underwent TKA and the other group with patients who underwent revision of infected TKA. All patients matched for age and body mass index. The following data were compared between the groups: changes in blood pressure, variations in hemoglobin level, amount of postoperative blood loss and transfused blood, incidence of blood transfusion, white blood cell (WBC) count, albumin level, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and liver enzyme level.ResultsThe hemoglobin levels, transfusion rate, and the amount of blood loss were significantly higher in the revision group (p=0.012). In both groups, CRP reached the highest level on the 3rd postoperative day but it was normalized 2 weeks postoperatively; however, the revision TKA group showed a greater tendency to normalization (p=0.029). There were significant differences between the groups in ESR, WBC, blood pressure, and changes in liver enzyme levels.ConclusionsRevision of infected TKA results in greater hemodynamic variations than primary TKA. Therefore, more efforts should be made to identify pre- and postoperative hemodynamic changes and hematologic status.

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“…Total knee arthroplasty (TKA) is a procedure with excellent results in the treatment of degenerative diseases of the knee, but it is not free from complications 1 ; it is associated with a great loss of blood, which can reach values equal to or greater than 1.5 L, a situation in which blood transfusion becomes unavoidable. 2 …”

Section: Introductionmentioning

confidence: 99%

Blood level changes in total knee arthroplasty with and without a tourniquet

Barros

Ribeiro

Dias

2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo evaluate the difference between the total blood loss in patients undergoing primary total knee arthroplasty with and without the use of tourniquet.MethodsA retrospective cohort study, with analysis of medical records of patients undergoing primary total knee arthroplasty in 2015, with and without the use of a tourniquet. Comparison was performed of hemoglobin (HB) and hematocrit (HT) variation in the complete blood count (CBC) during the pre- and post-operative period between the two groups.ResultsThere were 117 patients undergoing primary total knee arthroplasty included, minimum age of 33 and maximum of 86 years, with a mean of 67 years. 64.1% of the surgeries used a tourniquet and 35.9% did not. The mean preoperative HB in Group 1 was 13.08 and 12.97 in Group 2 (p = 0.435). The mean postoperative HB in Group 1 was 11.64 and 10.93 in Group 2 (p = 0.016). The variation of HB in Group 1 was 1.44 and 2.04 in Group 2 (p = 0.025). The mean preoperative HT in Group 1 was 38.96 and 39.01 in Group 2 (p = 0.898). The mean postoperative HT in Group 1 was 34.47 and 32.19 in Group 2 (p = 0.005). The variation of HT in Group 1 was 4.49 and 6.82 in Group 2 (p = 0.001). A total of 21 patients received transfusions RCC (red cell concentrates), as a result of HB below 8 g/dL or clinical symptoms, respectively, representing seven of Group 1 (9.3% of total intra-group) and 14 of Group 2 (33.3% of total intra-group), with p = 0.001.ConclusionIn patients undergoing primary total knee arthroplasty using a tourniquet, a lower variance in the hematimetric indices was observed and fewer blood transfusions were necessary.

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Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Cited by 11 publications

References 23 publications

Evaluation of serum levels of C-reactive protein after total knee arthroplasty

Evaluation of serum levels of C-reactive protein after total knee arthroplasty

Comparison of Difference in Hematologic and Hemodynamic Outcomes between Primary Total Knee Arthroplasty and Revision of Infected Total Knee Arthroplasty

Blood level changes in total knee arthroplasty with and without a tourniquet

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