| Combined preoperative autologous blood donation and intra-operative cell salvage for hip surgery. | |
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MedLine Citation:
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PMID: 20065365 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To review records of 161 consecutive hip surgery patients for whom preoperative autologous blood donation (PABD) was used in combination with intra-operative cell salvage (ICS). METHODS: 114 women and 14 men aged 41 to 86 (mean, 64) years underwent 135 primary total hip arthroplasties (THAs), whereas 19 women and 7 men aged 16 to 52 (mean, 35) years underwent 26 rotational acetabular osteotomies (RAOs). Two or 3 weeks before the operation, patients deposited one unit (400 ml) of blood weekly, so long as their haemoglobin levels exceeded 110 g/l (if they had osteoarthritis) or 100 g/l (if they had rheumatoid arthritis). Patients were given oral ferrous sulphate, lactated Ringer's solution, and recombinant human erythropoietin. 800 and 1200 ml of blood were deposited for patients undergoing THA and RAO, respectively. Intra-operatively, ICS was carried out using a continuous autotransfusion system. The blood from ICS was transfused first, and then the blood from PABD was transfused during the latter half of the operation. RESULTS: By combining PABD and ICS, homologous blood transfusion was avoided in all patients, even in those with unexpected massive bleeding during surgery. In 3 patients, one unit of deposited autologous blood was discarded, because they showed no sign of anaemia. The mean total blood loss was almost 1.5 times higher in RAO than in THA patients (1095 vs 1550 ml). In the THA and RAO patients respectively, the mean amount of ICS was 181 and 210 ml, whereas the mean total blood transfusion volume was 975 and 1394 ml. No complications (including infection) related to autologous blood transfusion were observed during PABD, the surgery or the postoperative period. CONCLUSION: Homologous blood transfusion was avoided with the use of PABD and ICS. Preoperative donation of 800 and 1200 ml of blood (combined with ICS) seemed optimal, as only 3 units of blood were discarded. |
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Authors:
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Reiko Kubota; Masahiko Nozawa; Keiji Matsuda; Katsuhiko Maezawa; Sung-Gon Kim; Kouichi Maeda; Takashi Ikegami; Kentarou Hayashi; Masataka Nagayama; Haruka Kaneko |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of orthopaedic surgery (Hong Kong) Volume: 17 ISSN: 1022-5536 ISO Abbreviation: J Orthop Surg (Hong Kong) Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2010-01-12 Completed Date: 2010-04-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9440382 Medline TA: J Orthop Surg (Hong Kong) Country: China |
Other Details:
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Languages: eng Pagination: 288-90 Citation Subset: IM |
Affiliation:
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Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip* Blood Loss, Surgical Blood Transfusion, Autologous* Cell Separation / methods* Female Humans Male Middle Aged Osteotomy Treatment Outcome |
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