Does tourniquet use decrease blood loss following primary total knee arthroplasty in Jehovah’s Witness patients?

Levent, Ali

doi:10.5606/ehc.2020.76244

Cited by 9 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accordingly, the mortality rate was 18% in patients with an Hb level of <5.05 g/dl before transfusion, while it was reduced to 5% in patients with Hb levels above this value. In their review evaluating studies on Jehovah's Witnesses, Viele et al reported that the Hb level of non-surviving patients was <5 g/dl (15).…”

Section: Resultsmentioning

confidence: 99%

Evaluation of patients who received erythrocyte transfusion in the emergency department

Karaali¹

2022

acmr

View full text Add to dashboard Cite

Backgrounds: Decreased RBC count and decreased Hb concentration in the blood is defined as anemia. Anemia can be caused by acute excessive bleeding, hemolysis or inadequate production. If the patient is symptomatic, an immediate blood transfusion is required. Methods:A retrospective, single-center study was performed between April 2019 and April 2021 with non-traumatic, non-pregnant patients over 18 years of age, who had erythrocyte transfusion in the emergency department. For the laboratory parameters Hb, Ca and K, the initial levels from the blood analysis performed at admission to the emergency department were recorded as Hb1, potassium K1, and calcium Ca1, and the blood levels after the transfusion as Hb2, K2, and Ca2. Mortality of patients was recorded.Results: A total of 458 patients were included in the study. 44.3% of patients were male. The mean age was 66.33 ± 17.51/year. Mortality developed in 6.55%. There was a statistically significant difference in laboratory values between non-surviving and surviving patients. The mortality rate increased in patients with Hb1 values below 5.05g/dl and Hb2 values below 7.75g/dl, and patients with Ca1-2 values below 6.85mg/dl. It was determined that this increase in mortality rate was 3 to 6 times on average. Conclusions:Our findings reveal that the transfusion procedures in our clinic are in accordance with the new transfusion guidelines. It is important to use blood and blood products, the only source of which is human, for the right indication, at the right time, and in the right amounts.

show abstract

Section: Resultsmentioning

confidence: 99%

Evaluation of patients who received erythrocyte transfusion in the emergency department

Karaali¹

2022

acmr

View full text Add to dashboard Cite

show abstract

“…[ 7 - 13 ] While these researchers focused on the general patient population, other authors studied JW patients who do not give consent for ABT. [ 4 , 5 , 7 , 14 - 18 , 21 ] As a matter of course, the challenge faced by the latter group of researchers was significant since the general patient population gave consent for blood transfusion while JW declined both ABT and autologous transfusion. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13] While these researchers focused on the general patient population, other authors studied JW patients who do not give consent for ABT. [4,5,7,[14][15][16][17][18]21] As a matter of course, the challenge faced by the latter group of researchers was significant since the general patient population gave consent for blood transfusion while JW declined both ABT and autologous transfusion. [5] Jehovah's Witnesses do not consent to any type of blood transfusion (ABT or autologous blood transfusion) since they believe that blood must be disposed of when it leaves the body and stops circulating.…”

Section: Discussionmentioning

confidence: 99%

“…Based on a previous study, the mean EBL and standard deviations were used to calculate the Cohen’s d, and it was calculated as 0.80. [ 21 ] When the effect size of Cohen's d was considered 0.80, a total sample size of at least 52 (26 for cases and 26 for controls, with the allocation ratio considered 1:1) was required to achieve a power of 80% at the 5% significance level. It was decided to include 30 cases for each group, considering a drop-out rate of at least 10%.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A secure blood-saving protocol for Jehovah’s Witnesses in primary total hip replacement

Fatih Dasci,

Kose,

Fernandez Maza

et al. 2023

Jt Dis Relat Surg

View full text Add to dashboard Cite

Objectives: The study aimed to analyze the efficacy of the blood management protocol developed by our team for patients who are Jehovah’s Witnesses (JW) presenting for primary total hip replacement (THR). Patients and methods: Thirty JW patients (6 males, 24 females; mean age: 70.1±9.8 years; range, 65 to 81 years) and 30 age- and sex-matched controls (6 males, 24 females; mean age: 68.7±9.1 years; range, 62 to 79 years) who underwent primary THR at our institution between January 2018 and June 2020 were retrospectively evaluated. While the surgical technique of THR was not different among the groups, blood loss management differed between the groups. Patients in the control group were given 1 g of intravenous tranexamic acid (TXA) 15 min before the surgical incision. In addition to the same TXA protocol, intraoperative cell salvage with a continuous autologous transfusion system was used for JW patients. The estimated blood loss (EBL) was determined using Meunier's formula. Hemoglobin (Hgb) decline, EBL on the first and third postoperative days, allogenic blood transfusion (ABT) requirement, and complications were analyzed between groups. Results: There were no significant differences between groups regarding demographic and clinical characteristics (p>0.05), ABT requirement (p>0.999), and Hgb decline in the first and third postoperative days (p=0.540 and p=0.836, respectively). Furthermore, both groups did not significantly differ between EBL in the first and third postoperative days (p=0.396 and p=0.616, respectively) and the length of hospital stay (p=0.547). Similar complication rates were noted for both groups. Hemoglobin level assessments revealed that values on the first and third postoperative days were significantly lower than the baseline Hgb value in both cohorts (p<0.001). Conclusion: A combination of intravenous administration of 1 g of TXA, meticulous hemostasis, and intraoperative use of cell saver constitutes a reasonable strategy for achieving the goal of transfusion-free primary THR with predictable levels of blood loss that are similar to non-JW patients.

show abstract

“…

The main goals after total knee arthroplasty (TKA) are to reduce the postoperative pain, to diminish the transfusion need, and to ensure the ability for early ambulation. [1] Local infiltration anesthesia (LIA) is an easy and uprising method to achieve these extremely complex goals. [2,3] The optimal volume and composition of the mixture are still unclear.

…”

mentioning

confidence: 99%

A randomized comparative evaluation of local infiltration analgesia, extended nerve blocks, and conventional analgesia in pain management after total knee arthroplasty

et al. 2021

View full text Add to dashboard Cite

Objectives: The aim of this study was to analyze the postoperative effects of extended nerve blocks and local infiltration analgesia (LIA) on postoperative pain control, muscle weakness, and blood loss after total knee arthroplasty (TKA). Patients and methods: Between February 24th 2020 and July 10th 2020, a total of 161 patients (55 males, 106 females; median age: 69.0 years [IQR 63.0-75.0], range, 41 to 81 years) who underwent primary TKA were randomly allocated into three parallel groups according to their concomitant procedure in a double-blind fashion: (i) those to whom nerve blockade was performed after competition of surgery under the duration of spinal anesthesia (n=50); (ii) those to whom LIA was performed during surgery (n=52), and (iii) control group (n=59). The content of LIA was 10-10 mL of 20 mg lidocaine with 0.01 mg adrenalin and 100 mg ropivacaine, 1 mL (30 mg) ketorolac, and 5 mL (500 mg) tranexamic acid was diluted by 50 mL 0.9% NaCl under aseptic conditions. Outcome parameters were the evaluation of pain until the evening of first postoperative day (24 to 36 h), mobilization, and blood loss within the first three postoperative days. Results: The pain was maximal between 4 and 8 h postoperatively, when the effect of the spinal anesthetic drugs disappeared. During this critical period, tolerable pain (Numerical Rating Scale, NRS ≤3) was observed in 52%, 42%, and 19% of nerve blockade in LIA and control groups, respectively. None of the patients complained of high-intensity pain (NRS >8) in the LIA group, which was a significant difference from the block and control groups (10% and 14%, p<0.008, respectively). There was no significant muscle weakness associated with the use of this extended block. The decrease in hemoglobin level was significantly lower in the LIA group than in the control and block groups (odds ratio [OR]: 0.379, 95% confidence interval [CI]: 0.165-0.874 for nerve blockade vs. LIA, OR: 1.189, 95% CI: 0.491-2.880 for nerve blockade vs. control, OR: 0.319, 95% CI: 0.140-0.727, respectively). The common language effect size for pain in each referred interval in each group and for decrease of hemoglobin between the first and third postoperative days fell between 0.507 and 0.680. Conclusion: This study demonstrates that LIA technique offers a fast and safe treatment option for pain relief after TKA. No clinically relevant muscle weakness was observed among groups according to field block applications. Significant advantages were also achieved in blood loss.

show abstract

Does tourniquet use decrease blood loss following primary total knee arthroplasty in Jehovah’s Witness patients?

Cited by 9 publications

References 32 publications

Evaluation of patients who received erythrocyte transfusion in the emergency department

Evaluation of patients who received erythrocyte transfusion in the emergency department

A secure blood-saving protocol for Jehovah’s Witnesses in primary total hip replacement

A randomized comparative evaluation of local infiltration analgesia, extended nerve blocks, and conventional analgesia in pain management after total knee arthroplasty

Contact Info

Product

Resources

About