Autologous blood transfusion in total knee replacement surgery

Šarkanović, Mirka Lukić; Gvozdenović, Ljiljana; Savić, D; Ilić, Miroslav; Jovanović, Gordana

doi:10.2298/vsp1303274l

Cited by 10 publications

(13 citation statements)

References 6 publications

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“…In the present study, the view taken was that, unlike in the cases of the above authors, 25 the patients who underwent homologous blood transfusion received this solely because they presented symptoms of tissue hypoperfusion. The hematimetric variation criteria were not determinants for the transfusions.…”

Section: Discussionmentioning

confidence: 63%

“…Other authors 25 who studied transfusions of autologous and homologous blood in TKA surgery cases made comparisons through distributing the patients into two groups: those who received homologous blood transfusions and those who received autologous blood transfusions. They emphasized that the indication for transfusion for both groups was when the patient presented a postoperative hemoglobin level of 8.5 g/dL.…”

Section: Discussionmentioning

confidence: 99%

“…These authors 25 took the view that this was the explanation for higher hemoglobin levels in the homologous transfusion group, which was not seen in the autologous group because the protocol for this was controlled by the technique and the anesthesia by the anesthesiologist.…”

Section: Discussionmentioning

confidence: 99%

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Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Cardozo¹,

Souza²,

Alves³

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo analyze the relationship between hematimetric variation and the presence of clinical symptoms of hypoperfusion for indicating blood transfusion in patients undergoing total knee arthroplasty.MethodsA retrospective analysis was conducted on data gathered from the medical files of 55 patients with a diagnosis of gonarthrosis, who underwent total knee arthroplasty at a hospital orthopedics and traumatology service between February 2011 and December 2012. The patients studied presented unilateral joint degeneration and fitted into the indications for surgical treatment. All the patients underwent a preoperative cardiological evaluation, presenting a pattern of ASA I–III and absence of blood dyscrasia, and preoperative hemoglobin measurements were made. However, no minimum hematimetric value was established for the surgical treatment; there were only clinical criteria for blood perfusion.ResultsAmong the 55 patients, 35 were female and 20 were male, and the mean age was 68 years. Six patients underwent homologous blood transfusion, because of their clinical condition of tissue hypoperfusion, persistent hypotension, loss of consciousness, sweating and coercible vomiting. They presented postoperative hemoglobin of 7.5–8.8 g/dL.ConclusionFor patients with falls in hemoglobin counts greater than 20% and values lower than 9 g/dL after the surgery, there is a possible need for blood transfusion, which should only be indicated when accompanied by major symptoms of tissue hypoperfusion.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Cardozo¹,

Souza²,

Alves³

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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“…Outros autores, 25 que estudaram as transfusões de sangue autólogo e homólogo em cirurgia de ATJ, fizeram um comparativo e distribuíram os pacientes em dois grupos: os que receberam transfusão de sangue homólogo e aqueles que receberam transfusão de sangue autólogo. Enfatizaram que a indicação de transfusão para ambos os grupos foi quando o paciente apresentava nível de hemoglobina pós--operatória igual a 8,5 g/dL.…”

Section: Discussionunclassified

Artroplastia total do joelho: indicação de transfusão sanguínea de acordo com a variação hematimétrica e os sintomas clínicos de hipoperfusão

Cardozo¹,

Souza²,

Alves³

et al. 2014

Revista Brasileira de Ortopedia

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r e v b r a s o r t o p . 2 0 1 4;4 9(5):507-512 w w w . r b o . o r g . b r Artigo Original Artroplastia total do joelho: indicação de transfusão sanguínea de acordo com a variação hematimétrica e os sintomas clínicos de hipoperfusão ଝ informações sobre o artigo Histórico do artigo: Recebido em 12 de agosto de 2013 Aceito em 12 de setembro de 2013 On-line em 20 de junho de 2014 Palavras-chave: Hemoglobina Perda sanguínea cirúrgica Articulaç ões Artroplastia Hipovolemia r e s u m o Objetivo: Analisar a relação entre a variação hematimétrica e a presença de sintomas clíni-cos de hipoperfusão para a indicação de transfusão sanguínea em pacientes submetidos a artroplastia total do joelho. Métodos: Fez-se uma análise retrospectiva dos dados coletados nos prontuários de 55 pacientes com diagnóstico de gonartrose submetidos a artroplastia unilateral total do joelho feita pelo serviço de ortopedia e traumatologia de um hospital de fevereiro de 2011 a dezembro de 2012. Os pacientes estudados apresentaram degeneração articular unilateral e se enquadraram na indicação para o tratamento cirúrgico. Todos foram submetidos a avaliação pré-operatória cardiológica e manteve-se um padrão correspondente a ASA-I até III, ausên-cia de discrasia sanguínea e mensuração de hemoglobina pré-operatória. Porém, não foi estabelecido valor hematimétrico mínimo para o tratamento cirúrgico, apenas critérios clínicos de perfusão sanguínea. Resultados: Dos 55 pacientes, 35 do sexo feminino e 20 do masculino, com média de 68 anos, apenas seis foram submetidos a transfusão sanguínea homóloga, decorrente do quadro clínico de hipoperfusão tecidual, hipotensão persistente, perda da consciência, sudorese e vômitos coercíveis e apresentaram hemoglobina pós-operatória entre 7,5 e 8,8 g/dL.Conclusão: Pacientes com queda acima de 20% na contagem de hemoglobina e valores abaixo de 9 g/dL após a cirurgia sugerem uma possível necessidade de transfusão sanguínea, que só deve ser indicada quando acompanhada de sintomas maiores de hipoperfusão tecidual.

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“…In this case, the patient may need a blood transfusion during the perioperative period [6,7]. Although allogeneic blood transfusion (ABT) is widely used in the clinic, considering its potential side effects, it is still a risk factor of potential complications such as allergic reactions, haemolysis, and even infections around the prosthesis [8,9]. Conversely, from the patient's point of view, it may extend the length of hospital stay, delay the initiation of the rehabilitation program, and increase the cost of hospitalisation, thus increasing patient burden [10].…”

Section: Introductionmentioning

confidence: 99%

Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs

Zong

et al. 2019

Preprint

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Background: The use of tranexamic acid (TXA) during primary total joint arthroplasty （pTJA） is well documented. However, whether TXA is safe for patients undergoing revision total joint arthroplasty (rTJA) remains to be resolved. Methods: This meta-analysis included 12 studies that involved 2195 cases. The primary outcomes were indicators of TXA effectiveness during perioperative perid, including blood loss, haemoglobin (Hb) level changes, allogeneic blood transfusion (ABT) rate, and number of red blood cell (RBC) units transfused per patient. The secondary outcomes included thromboembolic complications, non-thromboembolic complications, and length of hospital stay. Results: TXA administration was associated with statistically significant decreases in the primary outcomes, including ABT rate (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.14–0.41; P < 0.00001), change in Hb level (mean difference [MD], −0.84; 95% CI, −1.28 to −0.41; P=0.002), and number of RBC units transfused per patient (MD, −0.49; 95% CI, −0.61 to −0.38; P < 0.00001) in the patients undergoing rTJA. Secondary outcome assessments showed no statistically significant differences in venous thromboembolism (OR, 0.99; 95% CI, 0.31–3.14; P=0.98) and non-thromboembolic complications (OR, 0.54; 95% CI, 0.18–1.68; P=0.29) between the patients who received and those who did not receive TXA in the revision total knee arthroplasty subgroup, while a significant decrease in length of hospital stay was found in those who received TXA (MD, −2.89; 95% CI, −4.85 to −0.93; P=0.004). Conclusion: In this meta-analysis, we found that the use of TXA acid can effectively reduce the number of blood transfusions in patients undergoing TJA without increasing the complication rate.

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Autologous blood transfusion in total knee replacement surgery

Cited by 10 publications

References 6 publications

Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Artroplastia total do joelho: indicação de transfusão sanguínea de acordo com a variação hematimétrica e os sintomas clínicos de hipoperfusão

Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs

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Autologous blood transfusion in total knee replacement surgery

Cited by 10 publications

References 6 publications

Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion

Artroplastia total do joelho: indicação de transfusão sanguínea de acordo com a variação hematimétrica e os sintomas clínicos de hipoperfusão

Is tranexamic acid effective and safe for patients undergoing revision total&nbsp;hip and knee&nbsp;arthroplasty: a meta-analysisIs

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Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs