Comparison of Blood Loss between Neutral Drainage with Tranexamic Acid and Negative Pressure Drainage without Tranexamic Acid Following Primary Total Knee Arthroplasty

Abstract

PurposeThere are many methods to reduce massive bleeding during total knee arthroplasty (TKA). In our study, tranexamic acid and neutral drainage were used to decrease total blood loss.Materials and MethodsThe study was performed on 97 TKA patients from March 2012 to January 2013. In the study group, tranexamic acid was administered and neutral drainage was applied. The study group had group I (unilateral, n=29) and group III (bilateral, n=17). The control group had group II (unilateral, n=35) and group IV (bilateral, n=16).ResultsIn group I, the drainage volume on the 1st and 2nd postoperative days and the total drainage decreased with statistical significance (p<0.05). Between group III and group IV, group III had less drainage volume. In group III, the drainage volume on the 1st postoperative day and total drainage volume decreased statistically significantly (p<0.05). Between groups I and II, total blood loss showed no statistically significant difference, whereas between groups III and IV, the value was significantly different.ConclusionsIntravenous administration of tranexamic acid with neutral drainage for 3 postoperative hours is a recommendable method because it can be helpful in reducing total blood loss in bilateral TKA.

Postoperative shed autologous blood reinfusion does not decrease the need for allogeneic blood transfusion in unilateral and bilateral total knee arthroplasty

“…Both meta-analyses concluded that shed autologous blood reinfusion could significantly reduce the infusion rate and volume of allogeneic red blood cells. However, other studies indicated that shed autologous blood reinfusion was ineffective [6–8, 15, 16]. This view was discussed in the meta-analysis published in 2015 by Bodegom-Vos et al [9].…”

“…Correspondingly, the allogeneic blood transfusion rate reached 22–87% [2, 20–22], and the average blood transfusion was 2 units [20]. Some studies [16] suggested that the blood loss in unilateral or bilateral knee arthroplasty can be as high as 1292 and 2043 ml. Similar to this result, the total blood loss caused by unilateral and bilateral knee arthroplasty in this study exceeded 1000 and 2000 ml, respectively, and the transfusion rates were as high as 91–95% and 100%, respectively.…”

Daily blood loss transition after total knee arthroplasty with topical administration of tranexamic acid: Paradoxical blood loss after action of tranexamic acid

“…The daily transition of Hb drop and the estimated blood loss were investigated over an initial 24 h (from the beginning of TKA to 24 h after TKA), from 24 h to 48 h, and from 48 h to 72 h. The blood loss was calculated using the formula developed by Nadler et al; [13][14][15][16] the formula estimates blood volume by accounting for gender, weight, and size of the patient and calculates blood loss using the patient's blood volume and Hb reduction rate. If transfusion was performed, 0.7 g/dL per 1unit (320 mL of packed red blood cells) was added to the value of Hb drop.…”

Effectiveness of iron supplementation in the perioperative management of total knee arthroplasty: a systematic review

“…Allogenic transfusion can lead to increased length of stay, perioperative infection, and increased cost of treatment. Many methods have been tried to reduce allogenic transfusion, such as oral and intravenous administration of tranexamic acid, or intra-articular or subcutaneous routes to reduce transfusion rate [6][7][8][9]. The auto-transfusion system is a method that reduces allogenic transfusion during TKA [10].…”