Avaliação da perda sanguínea na artroplastia total do joelho com e sem soltura do torniquete

Vasconcelos, José Wanderley; Vasconcelos, Gerusa de Arruda

doi:10.1590/s1413-78522011000100007

Cited by 7 publications

(8 citation statements)

References 24 publications

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“… 12 The moment of tourniquet removal as the best option for preserving blood stock, however, is controversial. Vasconcelos 4 observed that the removal of the intraoperative or postoperative tourniquet showed no difference in blood loss when comparing hemoglobin and hematocrit variation in the pre and postoperative period.…”

Section: Discussionmentioning

confidence: 99%

“… 3 To reduce the number of blood transfusions in TKA, some care has been described to minimize perioperative and postoperative bleeding, such as occlusion of the femoral milling hole with bone graft, use of pneumatic tourniquet and suction drain, improvement of surgical technique, use of tranexamic acid, local infusion with norepinephrine and, more recently, the placement of gel with platelets in the operative wound. 4 …”

Section: Introductionmentioning

confidence: 99%

“…The moment of its withdrawal, however, is controversial in the literature; it can be done intraoperatively, soon after prosthesis cementing for direct hemostasis of the wound, or after the suture and placement of a compressive dressing. 4 …”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…Certain methods assist in reducing the bleeding, such as use of pneumatic cuffs, minimally invasive surgery and antifibrinolytic substances 1, 2, 3. With the aim of diminishing the number of blood transfusions during TKA, certain precautions for minimizing trans and postoperative bleeding have been described, such as use of pneumatic tourniquets and suction drains, improvement of surgical techniques, use of tranexamic acid, local infusion of norepinephrine, occlusion of the femoral milling orifice using a bone graft femoral, and most recently, placement of gel containing platelets in the operative wound 4 . Ischemia in TKA provides a cleaner surgical field, makes it easier to place the implants and provides a better interface for the cement 5, 6.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Blood Loss after Early or Late Release of Ischemia in Patients Undergoing Total Knee Replacement

Leão

Souza

Ferreira

2013

Revista Brasileira de Ortopedia (English Edition)

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a b s t r a c tObjective: compare blood loss in 40 patients underwent to unilateral total knee replacement with the release of ischemia before and after skin closure and compressive dressing.Methods: in a prospective randomized study, in 40 patients underwent to total knee replacement, dividing then into two groups: group A in which the ischemia was released before skin closure, allowing bleeding control and group B where the ischemia was released after skin suture and pressure dressing. We compared the results of laboratory tests of serum hemoglobin before surgery and 48 hours postoperatively, the blood volume contained in vacuum suction drain and the transfusions that was necessary. Results: As a result, the post operative serum hemoglobin levels had a mean decrease of 3.57 g/dL in group A and 4.24 g/dL in group B with an average of 0.67g/dL difference between them, statistically insignificant. The observed mean drainage, in the vacuum drain, were 705 mL in group A and 700 mL in group B.The 5ml difference between medians was considered statistically insignificant. The number of patients who received transfusions was four patients in both groups and all received two units of red blood cells. Conclusion: the post operative serum hemoglobin levels, as well as the need of blood transfusion, in the patient underwent to total knee replacement, where the ischemia was released before wound closure, has no statistical effect in comparison with patients where the sutures and bandages were done after the ischemia release. Level of Evidence IB -Individual randomized controlled trial with narrow confidence interval.

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“…Для минимизации потери крови в интра-и послеоперационном периоде был предложен ряд методик, таких как окклюзия отверстия бедренной кости костным трансплантатом, использование пневматического жгута, усовершенствование операционного доступа, инъекции транексамовой кислоты в область сустава, местная инфузия адреналина, размещение геля с тромбоцитами в операционной ране и др. [4,5]. Однако у пациентов, перенесших операцию эндопротезирования, все же сохраняется относительно высокий риск возникновения массивного кровотечения в послеоперационном периоде [6].…”

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Assessment of blood loss in total knee arthroplasty depending on the type of the endoprosthesis

Abelevich¹,

Abelevich²,

Марочков³

2018

N.N. Priorov Journal of Traumatology and Orthopedics

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Введение. В современных условиях эндопротезирование суставов стало одним из основных методов лечения, позволяющих восстановить движение в суставе, опороспособность нижней конечности и быстро вернуть пациента к активному образу жизни. Тотальное эндопротезирование коленного сустава сопровождается значительной кровопотерей, обусловливающей снижение уровня гемоглобина, а также более высокую потребность в переливании крови в послеоперационном периоде. Цель исследования: оценить объем кровопотери у пациентов, перенесших тотальное эндопротезирование коленного сустава, в зависимости от конструкции эндопротеза. Пациенты и методы. Проведено ретроспективное исследование, в которое вошли 73 пациента с гонартрозом III стадии по классификации Н.С. Косинской. Пациентам 1-й группы (n=50) были установлены стандартные тотальные конструкции эндопротезов коленного сустава цементной фиксации, пациентам 2-й группы (n=23)-связанные ротационные конструкции. Определяли содержание гемоглобина и значение гематокрита до и через 24 ч после операции. Рассчитывали объем интра-и послеоперационной (через 24 ч) кровопотери, используя формулу гемоглобинового баланса.

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Avaliação da perda sanguínea na artroplastia total do joelho com e sem soltura do torniquete

Cited by 7 publications

References 24 publications

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

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

Evaluation of Blood Loss after Early or Late Release of Ischemia in Patients Undergoing Total Knee Replacement

Assessment of blood loss in total knee arthroplasty depending on the type of the endoprosthesis

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