Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery

Lisander, Björn; Ivarsson, Ingemar; Jacobsson, Staffan

doi:10.1111/j.1399-6576.1998.tb05305.x

Cited by 55 publications

(59 citation statements)

References 23 publications

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“…One was the drain loss which was the sum of the drain collection on Day 1 (Day 1 drain loss) and on Day 2 (Day 2 drain loss). The other parameter was the total blood loss calculated by the hemoglobin balance method [12,19], which involved measuring hemoglobin levels at several stages. This calculation gave a better estimation of the combined external loss, ie, intraoperative loss plus drain loss and the internal (hidden) blood loss.…”

Section: Methodsmentioning

confidence: 99%

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Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Maniar

Kumar²,

Singhi

et al. 2012

Clinical Orthopaedics &Amp; Related Research

275

256

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Background The antifibrinolytic tranexamic acid reduces surgical blood loss, but studies have not identified an optimal regimen. Questions/purposes We studied different dosages, timings, and modes of administration to identify the most effective regimen of tranexamic acid in achieving maximum reduction of blood loss in TKA. Methods We prospectively studied five regimens (four intravenous, one local; 40 patients each) with a control group (no tranexamic acid). The four intravenous (10-mg/kg dose) regimens included (1) intraoperative dose (IO) given before tourniquet deflation, (2) additional preoperative dose (POIO), (3) additional postoperative dose (IOPO), and (4) all three doses (POIOPO). The fifth regimen was a single local application (LA). Two independent parameters of drain loss and total blood loss, calculated by the hemoglobin balance method, were evaluated statistically. Results Both parameters were reduced in all five regimens as against the control. A significant reduction in drain loss was seen in the POIO, IOPO, and POIOPO groups whereas total blood loss was significantly reduced in the POIO, POIOPO, and LA groups. The POIOPO group had the least drain loss (303 mL) and least total blood loss (688 mL). The IO group had the greatest drain loss and the IOPO group the greatest total blood loss. Conclusions Single-dose tranexamic acid did not give effective results. The two-dose regimen of POIO was the least amount necessary for effective results. When compared against the control, this regimen produced reduction of drain loss and total blood loss, whereas the IOPO regimen did not. The three-dose regimen of POIOPO produced maximum effective reduction of drain loss and total blood loss.

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Section: Methodsmentioning

confidence: 99%

“…From these, the total blood loss in milliliters was calculated as follows [12,19]: total blood loss = 1000 * Hb loss /Hb i .…”

Section: Methodsmentioning

confidence: 99%

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Maniar

Kumar²,

Singhi

et al. 2012

Clinical Orthopaedics &Amp; Related Research

275

256

View full text Add to dashboard Cite

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“…However, it is not clear whether use of Cell Saver decreases the need for other transfusions in this patient population. While some studies have found that Cell Saver use decreases the need for other blood transfusion in orthopedic surgery [1][2][3][4], others have found its use to be of little or no benefit [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies examining the usefulness of Cell Saver in orthopedic surgery have included mostly adult patients [1][2][3][4][5], with the exception of Siller et al [6], who studied adolescents undergoing spinal fusion for idiopathic scoliosis. To our knowledge, there has been no published study examining scoliosis patients of all ages and etiologies to determine the usefulness of Cell Saver in this setting.…”

Section: Introductionmentioning

confidence: 99%

Cell Saver: Is it beneficial in scoliosis surgery?

Weiss

Skaggs

Tanner

et al. 2007

Journal of Children's Orthopaedics

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“…After completion of each cycle, the bowl can be filled again as often as required. The hematocrit of the final erythrocyte supension is regulated by an optical sensor in the centrifugation chamber, targeting a packed cell volume of 55-70% 4,5,[11][12][13] . Modified cell separation can also be performed by passing collected blood repeatedly through a vortex mixing filter with longitudinal channels and microporous plastic membranes (Haemocell System 350 ® , Haemonetics TM ), under continuous washing with saline solution 8 .…”

Section: Figurementioning

confidence: 99%

Intraoperative Autotransfusion of RBC and PRP

Gombotz

Kulier

1999

Transfus Alt Transfus Med

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IntraoperativeAutotransfusion of RBC and PRP TATM 1999;3:5-13 • Intraoperative autotransfusion In addition, IP may be used when other autologous whole blood harvesting techniques are not an option. DEPARTMENT OF ANESTHESIOLOGY AND INTENSIVE CARE UNIVERSITY OF GRAZ GRAZ, AUSTRIATransfusion Alternatives in Transfusion Medicine VOLUME 1 NUMBER 3 DECEMBER 1999 Background summaryIntraoperative autotransfusion (IAT) is defined as the reinfusion of patient blood salvaged during and after surgery. IAT plays an important role in the context of perioperative blood saving strategies, having gained standard-of-care status in many surgical procedures 1,6 .The principle of IAT is to collect intraor postoperatively shed blood continuously from the operative field. The salvaged blood is aspirated from the wound site and collected in a dedicated reservoir. Under standard conditions, red cells are subsequently separated, washed, concentrated and stored for later retransfusion to the patient. Only erythrocytes are saved and retransfused; simultaneous volume and plasma replacement has to be provided, especially after processing of large quantities of shed blood 4 .In contrast to stored RBCs, freshly salvaged autologous red cells show uncompromized functional capacity, oxygen delivery to tissues and survival, indicating that IAT has no significant detrimental effects on erythrocytes 7,8 . IAT is most effective when combined with other autologous methods, particularly with preoperative autologous blood donation, acute normovolemic hemodilution or adjuvant drug therapies 4, 9, 10 . Methods Cell separation (washed blood)This technique is based on centrifugation, separating red blood cells (RBCs) from the lighter components and fluids, including plasma, saline and the buffy coat (Cell Saver, Haemolite ® , Haemonetics TM , Braintree, MA; Figure 1). Before starting the procedure, the operator must fill the system with 100-200 mL heparinized saline ("priming"), in order to prevent cells from binding to membrane surfaces initiating microaggregation, and to diminish frictional forces and damage to the cellu- Figure 1lar components 4,8 . Blood released at the wound site is aspirated via a double-lumen suction catheter (80-100 mm Hg), immediately anticoagulated (30,000 IU heparin in 1000 mL saline) at the suction tip, and stored in a plastic cardiotomy reservoir, equipped with a 120 µm microaggregate filter. When a minimum of 1000 mL shed blood is collected, it is pumped into a rotating separation chamber (Latham bowl, 225 mL adaptable capacity), washed with 1000-1500 mL saline and concentrated. Whenever the extent or kind of surgical debris requires more extensive washing, processing cycles can be selected manually, and in emergency cases, washing can be skipped entirely. For pediatric patients, smaller centrifuges are available. As soon as the preset hematocrit is reached, the spinning separator chamber stops, and packed RBCs, suspended in saline solution, are pumped into an infusion bag, while the waste products are removed 4, 11 . Afte...

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Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery

Abstract: Autotransfusion has a limited efficacy to decrease the need for allogeneic blood, and other blood-saving methods should be added for this purpose. It is difficult to predict the need for allogeneic blood preoperatively.

Cited by 55 publications

References 23 publications

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Cell Saver: Is it beneficial in scoliosis surgery?

Intraoperative Autotransfusion of RBC and PRP

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