Blood saving protocol in elective total knee arthroplasty

Kourtzis, Nikolaos; Pafilas, Dimitrios; Kasimatis, Georgios

doi:10.1016/j.amjsurg.2003.11.022

Cited by 45 publications

(37 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results were comparable with those of other studies14,15,24,25) that showed blood loss could be reduced by 145-396 mL when the medullary canal was not breached during TKA. Although the frequency of transfusion was lower in the EM group in our study, it was still higher compared to some recent studies4,6). We attributed this to the broad indications for transfusion we set in this study; a blood transfusion was performed when hemoglobin was <8 g/dL or when dyspnea, palpitation, dizziness, or abnormal vital signs were noted, even if the hemoglobin was 8-10 g/dL.…”

Section: Discussioncontrasting

confidence: 63%

Efficacy of Extramedullary Femoral Component Alignment Guide System for Blood Saving after Total Knee Arthroplasty

Jeon

Kim

Lee

et al. 2012

Knee Surg Relat Res

View full text Add to dashboard Cite

PurposeTo compare the extramedullary femoral alignment guide system with the conventional intramedullary alignment guide system for bleeding and transfusion rate after total knee arthroplasty (TKA).Materials and MethodsForty-nine female TKA patients were randomized into two groups: intramedullary (IM) group vs. extramedullary (EM) group. Drained volume of blood, hemoglobin concentration, hemoglobin drop, and transfusion rate were compared between the two groups. Wound problems, bleeding-related problems and thromboembolic complications were collected.ResultsThe mean drained volume via vacuum drainage was less in the EM group than that in the IM group (482.9 mL vs. 266.8 mL, p=0.001). Hemoglobin at 5 days after surgery was higher in the EM group (9.3 g/dL vs. 9.9 g/dL, p=0.002) than that in the IM group. The drop in hemoglobin after 5 days was smaller in the EM group (3.5 g/dL vs. 2.9 g/dL, p=0.003) than that in the IM group. The EM group had a lower prevalence of allogeneic transfusion (45.0% vs. 20.5%, p=0.026) than that in the IM group. No significant complications developed in either group.ConclusionsThe results suggest that the extramedullary femoral alignment guide technique is an advantageous method that can reduce the drained volume of blood and the allogeneic transfusion rate.

show abstract

Section: Discussioncontrasting

confidence: 63%

Efficacy of Extramedullary Femoral Component Alignment Guide System for Blood Saving after Total Knee Arthroplasty

Jeon

Kim

Lee

et al. 2012

Knee Surg Relat Res

View full text Add to dashboard Cite

show abstract

“…The blood saving protocol used in this study, however, has proved to be useful because the proportion patients receiving transfusions (2.9% for Group A, 5.2% for Group B) was greatly reduced with respect to that of previously published series 2‐4,7,8,17,18 despite 21 percent (66/312) of the patients presented a preoperative Hb level of lower than 130 g per L. In addition, because iron sucrose is considered to be a safe IV iron formulation, 20 it is not surprising that no adverse effects of iron sucrose administration were witnessed either in this study or in the previous ones 9,10 . In addition, for patients with a preoperative Hb level of less than 130 g per L, our blood saving protocol seems to be as effective as either another more complex and expensive protocols, with rHuEPO alone 12,21 or in combination with other blood conservation methods, 22‐24 or a flow chart on the use of blood transfusion, with a lower transfusion trigger (Hb < 70 g/L) 25 …”

Section: Discussionmentioning

confidence: 65%

Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Therefore, recent regimens of iron, folic acid, vitamin C have been proposed combined with erythropoietin. These studies have shown significant reduction in the need for allogeneic blood transfusion [12].…”

Section: Discussionmentioning

confidence: 99%

Post-Operative Hypertension after Total Knee Arthroplasty and the Effects on Transfusion Rates

et al. 2012

View full text Add to dashboard Cite

Transfusions are a cause of significant patient morbidity as well as expense. Anesthesia literature has examined controlled intraoperative hypotension as a means for reducing blood loss and transfusions. Our hypothesis is that inversely increased blood pressure post-operatively would then lead to increased blood loss and transfusions.We examined 105 consecutive patients who underwent TKA. We found a significant odds ratio of 1.123 for pre-operative hematocrit. For post-operative blood pressure, we calculated an insignificant odds ratio of 1.007, proving no relationship between post-operative blood pressure and transfusions.This is the first study to examine increased post-operative blood pressure's contribution to transfusion rates. Although we confirmed that low pre-operative hematocrit contributes to increased transfusions, we did not find a relationship between post-operative blood pressure and transfusions.

show abstract

Blood saving protocol in elective total knee arthroplasty

Cited by 45 publications

References 34 publications

Efficacy of Extramedullary Femoral Component Alignment Guide System for Blood Saving after Total Knee Arthroplasty

Efficacy of Extramedullary Femoral Component Alignment Guide System for Blood Saving after Total Knee Arthroplasty

Perioperative intravenous iron, with or without erythropoietin, plus restrictive transfusion protocol reduce the need for allogeneic blood after knee replacement surgery

Post-Operative Hypertension after Total Knee Arthroplasty and the Effects on Transfusion Rates

Contact Info

Product

Resources

About