Predictors of Transfusion Risk in Elective Knee Surgery

Does Tranexamic Acid Save Blood in Minimally Invasive Total Knee Arthroplasty?

“…The total mean blood loss in the control group for MIS-TKA in our study was 1453 mL, which is similar to reported rates for conventional TKAs using intraoperative blood loss and postoperative drainage or by maximum loss of Hb level as methods of calculation [5,9,11,13,16,17,20,31] ( Table 4). The blood-saving effect of TEA in postoperative blood loss after conventional TKA was 45% to 48% in two studies [5,13].…”

“…TKA is associated with considerable blood loss, ranging from 1000 to 1500 mL after conventional TKA, with an average transfusion rate of 1 to 2 U of allogeneic blood [8,17,21]. The fibrinolytic system is activated transiently after any surgery [30], and the use of a pneumatic tourniquet to create a bloodless field is associated with increased fibrinolytic activity in the surgically treated limb in animal models [23] and for patients having elective orthopaedic surgery [10,29].…”

Targeted pre-operative autologous blood donation: a prospective study of two thousand and three hundred and fifty total hip arthroplasties

“…Keating et al showed that the application of a universal autologous donation protocol in patients with a haemoglobin greater than 13 g/dL resulted in 66 % of the blood being wasted [8]. Potential complications of autologous blood include bacterial contamination, febrile non-hemolytic transfusion reactions, and technical or clerical errors with the handling of samples.…”

“…The role of pre-operative haemoglobin (Hb) in estimating transfusion needs has been established in several studies [3,[6][7][8]. Blood management strategies rely on optimization of pre-operative haemoglobin levels through iron supplementation with or without erythropoietin, hypotensive anaesthesia, blood salvage, pharmacologic agents, as well as pre-operative autologous blood donation [9][10][11][12][13][14].…”

“…Patients were divided by pre-operative haemoglobin level, utilizing 12.5 g/dL as a cutoff. Although the World Health Organization defines anaemia differently for males and females (less than 13 g/dL and 12 g/dL, respectively), this threshold was based on previous data from our institution showing significantly less benefit from autologous blood donation and more units wasted with haemoglobin values greater than 12.5 g/dL [8]. Patients with a hemoglobin level of 12.5 g/ dL or more were considered non-anaemic and were not asked to donate blood prior to surgery.…”