Equal Ratio Ventilation Reduces Blood Loss During Posterior Lumbar Interbody Fusion Surgery

Kim, Hye-Bin; Kweon, Tae Dong; Chang, Chul Ho; Kim, Ji Young; Kim, Kyung Sub

doi:10.1097/brs.0000000000003957

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…There were selected nine studies about different techniques of spine arthrodesis, being two of them (Cao et al, 2020;Bydon et al, 2014) about cervical fusion, two (Liu et al, 2014;Li et al, 2019) of them about thoracic fusion and five (Fujimori et al, 2014;Hung et al, 2021;Campbell et al, 2018;Goodnough et al, 2019;Kim et al, 2021) of them about lumbar fusion. When analyzing the spine pathology treated, two of the studies were about spondylosis (Fujimori et al, 2014;Campbell et al, 2018), another two were about spondylolisthesis (Hung et al, 2021;Goodnough et al, 2019), two were about spinal tuberculosis (Liu et al, 2014;Li et al, 2019), two were about adjacent segment disease (ASD) (Cao et al, 2020;Bydon et al, 2014), and one of the studies did not specify the disease (Kim et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

“…Out of the six different lumbar fusion techniques that were selected to be a part of the present study, PLIF was the one that showed a considerable bleeding difference when compared to the others. Even though this method has an effective access to the spine, it is also associated to higher bleeding levels, since the prone position alters hemodynamic and ventilation, possibly causing engorgement of vertebral veins (Kim et al, 2021). On the other hand, OLIF showed smaller bleeding.…”

Section: Discussionmentioning

confidence: 99%

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Spinal fusion surgery blood loss: a narrative review abstract

Rocha

Silva²,

Souza³

et al. 2022

RSD

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Spinal fusion surgeries are commonly associated to great blood losses that, besides being able to directly harm the procedure, can be associated to a higher risk of serious complications due to the blood transfusion needed afterwards. Therefore, the present study aims to review the literature towards blood loss in different techniques of spinal fusion. For this, nine studies were selected, being two of them about cervical spine fusion, two of them about thoracic spine fusion and five of them about lumbar spine fusion, to compare and analyze twelve different techniques. The spinal fusion in thoracic and lumbar interbody arthrodesis were the ones that shown greatest blood loss.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spinal fusion surgery blood loss: a narrative review abstract

Rocha

Silva²,

Souza³

et al. 2022

RSD

View full text Add to dashboard Cite

show abstract

“…However, there are some studies in which PCV has been reported to be signi cantly associated with lesser intraoperative blood loss (18-20, 23). Reduced intraoperative blood loss has been argued to be related to decreased intrathoracic pressure and improved venous drainage which may be in turn due to decreased peak inspiratory pressure (PIP) during PCV (20,21,24).…”

Section: Discussionmentioning

confidence: 99%

Surgical Bleeding in Patients Undergoing Posterior Lumbar Inter body Fusion Surgery: A Randomized Clinical Trial Evaluating the Effect of Two Mechanical Ventilation Mode Types

Hajijafari

Ziloochi

Salimian

et al. 2022

Preprint

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Background The purpose of the study was to compare the effect of using Volume-Controlled Ventilation (VCV) versus Pressure-Controlled Ventilation (PCV) on blood loss in patients undergoing Posterior Lumbar Inter body Fusion (PLIF) surgery. Methods In a randomized, single-blinded, parallel design, 78 patients candidate for PLIF surgery were randomly allocated into two groups of 39 to mechanically ventilated using VCV or PCV mode. All the patients were operated in prone position by one surgeon. Amount of intraoperative surgical bleeding, transfusion requirement, surgeon satisfaction, hemodynamic parameters, heart rate, and blood pressure were measured as outcomes. Results PCV group showed slightly better outcomes than VCV group in terms of mean blood loss (431 cc vs. 465 cc), transfusion requirement (0.40 vs. 0.43 unit), and surgeon satisfaction (82.1% vs. 74.4%); however, the differences were not statistically significant. Diastolic blood pressure 90 and 105 min. after induction were significantly lower in PCV group (P = 0.043 & 0.019 respectively); however, blood pressure in other times, hemoglobin levels, and mean heart rate were similar in two groups. Conclusions In patients undergoing Posterior Lumbar Inter body Fusion surgery, mode of ventilation cannot make significant difference in terms of blood loss; however, some minor benefits in outcomes may lead to the selection of PCV rather than VCV. More studies with larger sample size, and investigating more factors may be needed.

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“…Excessive blood loss often occurs during spine fusion surgery [24], but the reasons for the occurrence of HBL are unclear. A study using labeled red blood cells showed that the main source of HBL is the extravasation of blood into tissues [25].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for perioperative hidden blood loss after one-segment posterior circumferential decompression surgery on thoracic ossification of the posterior longitudinal ligament: a finding of the double-layer sign on CT

Liang

Zhao

Wang

et al. 2022

Preprint

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Background: Hidden blood loss (HBL) is of increasing interest to spine surgeons. This retrospective study aimed to evaluate perioperative HBL and its risk factors in patients undergoing one-segment posterior circumferential decompression surgery on thoracic ossification of the posterior longitudinal ligament (T-OPLL). Method: We retrospectively studied 112 patients diagnosed with T-OPLL following posterior circumferential decompression surgery from August 2015 to June 2020. Patient demographics, blood loss-related parameters, surgery-related data and imaging parameters were extracted. Postoperative complications were also recorded. Pearson or Spearman correlation analysis was used to investigate the correlation between patient demographics and HBL. Multivariate linear regression analysis was performed to determine the independent risk factors associated with HBL. Results: Forty-five men and 67 women were involved in this research, with an average age of 56.4 ± 10.2 years. The mean HBL was 459.6±275.4 ml, accounting for 56.5% of the total blood loss. Multiple linear regression analysis showed that double-layer sign (P＝0.000), ossification occupancy ratio (OOR) >60%(P=0.030), age (P=0.010), hematocrit (Hct) loss (P=0.034), and postoperative Hct (P = 0.016) were independent risk factors for HBL. However, OPLL morphology (P=0.319), operation time (P=0.587), hemoglobin (Hb) loss (P=0.644), and postoperative Hb (P=0.952) were not significantly different from HBL. Conclusion: A high proportion of HBL was found after posterior circumferential decompression surgery on T-OPLL during the perioperative period,which should not be overlooked. Double-layer sign, OOR> 60%, age, Hct loss and postoperative Hct are independent risk factors for HBL.

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Equal Ratio Ventilation Reduces Blood Loss During Posterior Lumbar Interbody Fusion Surgery

Cited by 5 publications

References 31 publications

Spinal fusion surgery blood loss: a narrative review abstract

Spinal fusion surgery blood loss: a narrative review abstract

Surgical Bleeding in Patients Undergoing Posterior Lumbar Inter body Fusion Surgery: A Randomized Clinical Trial Evaluating the Effect of Two Mechanical Ventilation Mode Types

Risk factors for perioperative hidden blood loss after one-segment posterior circumferential decompression surgery on thoracic ossification of the posterior longitudinal ligament: a finding of the double-layer sign on CT

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