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Speciality
Spotlight

 



 


Orthopaedics


 

 


Blood Loss and Replacement
Orthopaedics Joint Replacement
  

  • Schmied K, Schiferer A, Sessler
    DI, et al
    The Effects of Red-Cell
    Scavenging, Hemodilution, and Active Warming on
    Allogenic Blood Requirements in Patients Undergoing
    Hip or Knee Arthroplasty

    Anesth Analg 86: 387-391
     
    There are several methods of
    decreasing blood loss to minimize transfusion
    requirements after surgery.
    The effects of red-cell scavenging acute
    normovolemic hemodilution forced air warming on
    perioperative allogenic blood requirements were
    retrospectively investigated in patients undergoing
    hip and knee arthroplasty.
     
    Of 821 patients evaluated, red
    cell scavenging was used in 578, hemodilution in 518
    and active warming in 532. 
    A larger hematocrit of 26% 
    was selected in patients under 65,
    28% in patients over 65 and 30% of more in
    patients over 65 with significant cardiovascular
    disease. The first 500 ml blood
    loss was replaced with 3 ml of crystalloid for every 1
    ml. Of blood loss; additional blood loss was replaced
    with colloid, hemodilution blood, scavenged red cells,
    and then with allogenic blood transfusions. Predictors
    of transfusion requirements were entered into
    multivariate analyses.
     
    Results showed that requirement
    of allogenic blood transfusion reduced from 1.3 Units
    to 0.6 Units. All methods
    significantly reduced transfusion requirements.
    Preoperative and postoperative hemoglobin
    concentrations did not change appreciably during the
    study period.

      

 


 

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Speciality Spotlight

 

 

Blood Loss and Replacement
Orthopaedics Joint Replacement
  

  • Schmied K, Schiferer A, Sessler DI, et al
    The Effects of Red-Cell Scavenging, Hemodilution, and Active Warming on Allogenic Blood Requirements in Patients Undergoing Hip or Knee Arthroplasty
    Anesth Analg 86: 387-391
     
    There are several methods of decreasing blood loss to minimize transfusion requirements after surgery. The effects of red-cell scavenging acute normovolemic hemodilution forced air warming on perioperative allogenic blood requirements were retrospectively investigated in patients undergoing hip and knee arthroplasty.
     
    Of 821 patients evaluated, red cell scavenging was used in 578, hemodilution in 518 and active warming in 532.  A larger hematocrit of 26%  was selected in patients under 65, 28% in patients over 65 and 30% of more in patients over 65 with significant cardiovascular disease. The first 500 ml blood loss was replaced with 3 ml of crystalloid for every 1 ml. Of blood loss; additional blood loss was replaced with colloid, hemodilution blood, scavenged red cells, and then with allogenic blood transfusions. Predictors of transfusion requirements were entered into multivariate analyses.
     
    Results showed that requirement of allogenic blood transfusion reduced from 1.3 Units to 0.6 Units. All methods significantly reduced transfusion requirements. Preoperative and postoperative hemoglobin concentrations did not change appreciably during the study period.