Autotransfusion with predeposit-haemodilution and perioperative blood salvage: 20 years of experience

B. Borghi, G. Fanelli, D. Celleno

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background. Through a prospective study, we evaluated the efficacy of an integrated autotransfusion regimen comprised of predeposit-hemodiluition and intra and post-operative blood salvage in major orthopaedic surgery. Methods. We examined the records of 2303 consecutive patients (1524 females and 779 males, mean age 62.7, standard deviation 11 years (range 16-90 yrs), pre- operative haemoglobin (Hb) concentration 13.5 (SD 1.4) (range 6.7-19.3) g/dl undergong total hip arthroplasty (THA 1582 patients), THA after the removal of internal fixation devices (RFD+THA, 25 patients), total knee arthroplasty (TKA, 347 patients), revision surgery of the hip (HR, cup+stem revision, 248 patients; cup revision 64 patients; stem revision 23 patients) and total knee revision (TKR 14 patients). We estimated that the number of predonations (MSBOS - maximum surgery blood order schedule) was 2 units for THA, TKA and TKR, and 3 units for partial or total hip revision and for total hip arthroplasty with fixation removal. Results. It was possible to obtain the MSBOS in 2070 patients (89.8%). Homologous red blood cell (HRBC) transfusion were carried out in 184 patients (8%). We found that the need to use HRBC was significantly associated with failure to meet the number of MSBOS, female sex, lower pre-operative Hb concentration, use of calcium heparin for antithrombosis prophylaxis, more extensive surgery, a higher ASA rating and co-existing diseases such as coronary artery disease. Conclusions. Cooperation among anaesthesis, transfusionists and surgeons in the application of an integrated autotransfusion regimen enabled us to treat 92% of our patients with only autotransfusion.

Original languageEnglish
Pages (from-to)230-234
Number of pages5
JournalInternational Journal of Artificial Organs
Volume22
Issue number4
Publication statusPublished - Apr 1999

Fingerprint

Autologous Blood Transfusions
Tacrine
Salvaging
Hemodilution
Arthroplasty
Surgery
Blood
Hemoglobin
Hemoglobins
Hip
Orthopedics
Calcium
Cells
Operative Blood Salvage
Internal Fixators
Erythrocyte Transfusion
Knee Replacement Arthroplasties
Reoperation
Coronary Artery Disease
Knee

Keywords

  • Antithromboembolic prophylaxis
  • Autologous and allogenic transfusion
  • Hip and knee surgery
  • Perioperative blood recovery
  • Predeposit

ASJC Scopus subject areas

  • Biophysics

Cite this

Autotransfusion with predeposit-haemodilution and perioperative blood salvage : 20 years of experience. / Borghi, B.; Fanelli, G.; Celleno, D.

In: International Journal of Artificial Organs, Vol. 22, No. 4, 04.1999, p. 230-234.

Research output: Contribution to journalArticle

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abstract = "Background. Through a prospective study, we evaluated the efficacy of an integrated autotransfusion regimen comprised of predeposit-hemodiluition and intra and post-operative blood salvage in major orthopaedic surgery. Methods. We examined the records of 2303 consecutive patients (1524 females and 779 males, mean age 62.7, standard deviation 11 years (range 16-90 yrs), pre- operative haemoglobin (Hb) concentration 13.5 (SD 1.4) (range 6.7-19.3) g/dl undergong total hip arthroplasty (THA 1582 patients), THA after the removal of internal fixation devices (RFD+THA, 25 patients), total knee arthroplasty (TKA, 347 patients), revision surgery of the hip (HR, cup+stem revision, 248 patients; cup revision 64 patients; stem revision 23 patients) and total knee revision (TKR 14 patients). We estimated that the number of predonations (MSBOS - maximum surgery blood order schedule) was 2 units for THA, TKA and TKR, and 3 units for partial or total hip revision and for total hip arthroplasty with fixation removal. Results. It was possible to obtain the MSBOS in 2070 patients (89.8{\%}). Homologous red blood cell (HRBC) transfusion were carried out in 184 patients (8{\%}). We found that the need to use HRBC was significantly associated with failure to meet the number of MSBOS, female sex, lower pre-operative Hb concentration, use of calcium heparin for antithrombosis prophylaxis, more extensive surgery, a higher ASA rating and co-existing diseases such as coronary artery disease. Conclusions. Cooperation among anaesthesis, transfusionists and surgeons in the application of an integrated autotransfusion regimen enabled us to treat 92{\%} of our patients with only autotransfusion.",
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