Transfusion Medicine — Blood Conservation

Goodnough, Lawrence T.; Brecher, Mark E.; Kanter, Michael H.; AuBuchon, James P.

doi:10.1056/nejm199902183400706

Cited by 286 publications

(46 citation statements)

References 79 publications

(62 reference statements)

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“…Some authors recommended pre-operative blood donation [14], correction of preoperative anaemia [15], autologous donation and retransfusion systems [10,[16][17][18][19][20][21][22][23], supplementation of erythropoietin or iron [24,25], pharmacologic agents like tranexamic acid [26,27], plasmapheresis, normovolaemic haemodilution [28][29][30][31] and post-operative red blood cell salvage [32].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an autologous transfusion system following cemented and non-cemented revisions of total hip arthroplasty

Hawi

Kendoff

Hessling

et al. 2014

International Orthopaedics (SICOT)

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Purpose The goal of this study was to analyse the efficacy of blood autotransfusion using a continuous autologous transfusion system in revisions of total hip arthroplasty (THA). We looked at whether administration of allogeneic blood units was reduced in these cases and if there is a difference between cemented and non-cemented revisions. Methods Between January 2011 and December 2011, patients being treated with revision THA were included (n=411). The following parameters were analysed: patient age, gender, weight (kg), height (cm), body mass index (BMI, kg/m 2 ), surgical diagnosis, treatment and American Society of Anesthesiologists (ASA) classification score. The difference between pre-and post-operative haemoglobin (Hb, g/dl), amount of peri-operative blood loss (ml), amount of retransfused washed shed blood and amount of allogeneic and/or autologous transfusion (ml) were recorded. Results In both the cemented and non-cemented revision THA groups, there was no significant difference between pre-and post-operative Hb with or without using an autotransfusion system. In 92 of 186 cemented cases using an autologous transfusion system (49.5 %) and 38 of 117 non-cemented cases using an autologous transfusion system (32.5 %), allogeneic blood transfusion (ABT) was required. Cemented procedures using an autologous transfusion system got significantly more ABTs than non-cemented procedures using an autologous transfusion system (p=0.0042, odds ratio=2.035).Conclusions Use of an autologous transfusion system did not reduce the amount of ABT in revision THA in the patient cohort reported here. In our opinion, general blood management is required before and during surgery to reduce administration of ABT.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of an autologous transfusion system following cemented and non-cemented revisions of total hip arthroplasty

Hawi

Kendoff

Hessling

et al. 2014

International Orthopaedics (SICOT)

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“…Accordingly, the percentage of autologous blood units transfused yearly in the US has increased from 0.8% in 1982, to 3.1% in 1989, and to 5.0% in 1992 [3, 4]. Preoperative autologous blood donation (PAD) had become standard practice in patients undergoing orthopedic procedures [5, 6]and radical prostatectomy [7, 8].…”

Section: Introductionmentioning

confidence: 99%

“…Preoperative autologous blood donation (PAD) had become standard practice in patients undergoing orthopedic procedures [5, 6]and radical prostatectomy [7, 8]. However, recent studies have reflected a decline in PAD since 1992; in 1997, the percentage of blood transfused in the US that was autologous was 3.7% [3, 4]. Recent reports have demonstrated that this practice is not cost–effective and of is uncertain benefit [7, 9, 10, 11].…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial of Acute Normovolemic Hemodilution Compared to Preoperative Autologous Blood Donation in Total Knee Arthroplasty

et al. 1999

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The value of acute normovolemic hemodilution (ANH) compared to preoperative autologous blood donation (PAD) in elective surgery is controversial. We therefore conducted a prospective, randomized study to compare these techniques in patients undergoing total knee arthroplasty. ANH patients underwent up to 4 units phlebotomy or to a target hematocrit level of 28% after induction of anesthesia. PAD patients were asked to donate 1 (unilateral) or 2 (bilateral, revisions) units before admission. Mean baseline hematocrit levels were not different between ANH and PAD patients (40.6±4.1 vs. 38.4±3.4, p = 0.09). Eight (73%) of 11 patients undergoing bilateral revision procedures received a total of 22 allogeneic blood units, whereas only 3 (14%) of 21 patients undergoing primary, unilateral procedures received a total of 3 allogeneic units (p = 0.002). We found no differences in allogeneic blood transfusions between ANH and PAD cohorts for all (n = 32) patients (1.0±1.2 vs. 0.6±1.4, p = 0.45), for unilateral knee (n = 21) replacement (0.25±0.46 vs. 0.08±0.28, p = 0.29), or for bilateral/revision (n = 11) procedures (1.9±1.3 vs. 2.5±1.9, p = 0.53). We conclude that each technique is equally effective in reducing allogeneic blood exposure. Patients undergoing revision or bilateral knee arthroplasties require adjunctive therapy to autologous blood procurement to further reduce allogeneic blood exposure.

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“…Thus, each technique was equally effective in reducing allogeneic blood exposure. Table 2 summarizes selected, controlled studies of acute hemodilution compared to predonation of autologous blood 28 .…”

Section: Clinical Studiesmentioning

confidence: 99%

Acute Normovolemic Hemodilution

Goodnough

1999

Transfus Alt Transfus Med

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SUMMARY I Acute normovolemic hemodilution is a point of care method of autologous blood procurement. Acute hemodilution has several inherent advantages over preoperative autologous blood donation: it is inexpensive, does not require testing, and has none of the risks of administrative error or bacterial contamination related to stored blood. The clinical efficacy of acute hemodilution is increasingly apparent. This technique will also serve as a foundation for the use of emerging oxygen carrying solutions.

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Transfusion Medicine — Blood Conservation

Cited by 286 publications

References 79 publications

Effectiveness of an autologous transfusion system following cemented and non-cemented revisions of total hip arthroplasty

Effectiveness of an autologous transfusion system following cemented and non-cemented revisions of total hip arthroplasty

A Randomized Trial of Acute Normovolemic Hemodilution Compared to Preoperative Autologous Blood Donation in Total Knee Arthroplasty

Acute Normovolemic Hemodilution

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