Blood Management Strategies in Total Knee Arthroplasty

Liu, David; Dan, Michael; Martos, Sara Martinez; Beller, Elaine

doi:10.5792/ksrr.2016.28.3.179

Cited by 65 publications

(69 citation statements)

References 56 publications

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“…According to the criteria of patient blood management (PBM) [9,10], there was no indication for a blood transfusion. The patient received 2 l of balanced electrolyte solution as volume replacement.…”

Section: Discussionmentioning

confidence: 99%

Multiple asystole events in a patient undergoing total knee arthroplasty - a case report

Burgdorff

Flöther

Wohlrab

2019

Preprint

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Background: Unexpected cardiac arrest in patients during surgery is associated with high mortality. Reasons are often multifactorial and unclear. Case presentation: This case report describes a patient who developed reversible asystole during knee surgery under general anaesthesia. All diagnostic cardiac examinations were unremarkable. After surgery, the patient showed no further symptoms. Conclusion: To prevent cardiac arrest due to non-cardiac reasons, patients with a high risk for asystole caused by vasovagal reflex or by pain need to be identified. Preoperative conditions such as hypovolemia need to be improved prior to surgery, and additional monitoring should be used. Further investigations to determine the influence of non-cardiac disease and long-term medication are necessary.

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Section: Discussionmentioning

confidence: 99%

Multiple asystole events in a patient undergoing total knee arthroplasty - a case report

Burgdorff

Flöther

Wohlrab

2019

Preprint

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“…Various studies have provided mixed results in the reduction in blood transfusions with reinfusion drains, but risk of transfusion reactions and similar adverse events still exists, particularly with unwashed red blood cell reinfusion. 57 Guzel et al compared IA TXA to closed suction drainage alone and to postoperative reinfusion drainage demonstrating significantly lower TR, drainage volume, and overall cost with TXA. 58 The substantial cost savings and favorable safety profile of TXA relative to reinfusion drains have helped in rendering them obsolete in TKA.…”

Section: Postoperative Suction Drainsmentioning

confidence: 99%

“…58 The substantial cost savings and favorable safety profile of TXA relative to reinfusion drains have helped in rendering them obsolete in TKA. 57…”

Section: Postoperative Suction Drainsmentioning

confidence: 99%

Minimizing Blood Loss and Transfusions in Total Knee Arthroplasty

2018

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Blood loss management is critical to positive outcomes in patients undergoing total knee arthroplasty (TKA). Transfusions are associated with an increased risk of major and minor adverse events, length of hospitalization, and overall cost associated with surgery. Many techniques have been investigated and compared. Tranexamic acid (TXA), an antifibrinolytic drug widely known to reduce blood loss, may be a bridge to the goal of eliminating blood transfusions from TKA. Administration of TXA can be performed intravenously, topically at the knee joint, orally, or in combination. A single bolus or multiple doses have reduced total blood loss and transfusion rates consistently, safely, and cost-effectively. The uptake in use of TXA by surgeons has been slow due to concerns in patients deemed high risk for thromboembolic events. Newer evidence from studies specifically involving high-risk patients demonstrates that TXA is indeed safe in this cohort and provides benefits that greatly outweigh potential risks. Incorporation of TXA as a routine part of TKA is in the best interest of patients, health care teams, and medical institutions. TXA can be employed seamlessly with other blood saving techniques and has the capacity to increase productivity and decrease overall cost. This can be achieved by reducing the incidence of transfusion and length of stay, and the need for practices such as preoperative anemia treatment and suction drainage.

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“…They are hypertension and anticoagulants. 4 An individualised strategy based on patient's specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods, and can be employed in various combinations.…”

Section: Introductionmentioning

confidence: 99%

Blood Loss in Tka Under Tourniquet Control, Will It Lead to Haemodynamic Instability

B¹,

P²

2017

jemds

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BACKGROUNDTotal knee arthroplasty is one of the major surgeries, where considerable haemorrhage should be expected leading to haemodynamic instability and subsequent delay in ambulation and recovery. The soft tissue release and bone cuts required for TKA are the major sites from which haemorrhage is expected. MATERIALS AND METHODSOur study is to know the blood loss following TKA in our case series, and at what severity it can lead to postoperative blood transfusions and whether it can lead to haemodynamic instability or not with the given perioperative protocol. Blood loss is analysed in the groups with above and below average Hb and PCV with continuous tachycardia and hypotension. RESULTSOut of 168 patients in study group requirement for blood transfusion is for 93 cases, requiring transfusion with tachycardia and fall in BP and 5 cases requiring transfusion in both the below-above mean group of Hb and PCV respectively. CONCLUSIONThe haematocrit changes seen postoperatively are dependent on the haemodilution, going by the drop in Hb and PCV seen in both groups undergoing the same surgery with same indication, same approach, same surgeon and implant, even when the Hb and PCV levels are normal.

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Blood Management Strategies in Total Knee Arthroplasty

Cited by 65 publications

References 56 publications

Multiple asystole events in a patient undergoing total knee arthroplasty - a case report

Multiple asystole events in a patient undergoing total knee arthroplasty - a case report

Minimizing Blood Loss and Transfusions in Total Knee Arthroplasty

Blood Loss in Tka Under Tourniquet Control, Will It Lead to Haemodynamic Instability

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