Blood salvage techniques to avoid homologous blood transfusion in orthopaedic surgery

B. Borghi, F. Stagni, I. Bacchilega

Research output: Contribution to journalArticle

Abstract

The assessment of expected and tolerated blood loss allows us to define transfusion needs and to choose the cheapest method to meet them. The choice is wide:A) Predonation, also in order to haemodilute, if necessary with the support of iron B) Exogenous erythropoietin (rHuEPO) as support for or as an alternative to predepositing (Jehovah's witnesses) 150-300 UI/kg daily or on alternate days combined with iron i.v. (200-300 mg of iron polysaccharate/day). C) Sterile collection of blood lost during surgery, eventually reinfused if Hb falls more than 2 g/dl. D) Intraoperative hypotension if possible epidural hypotension with medial arterial pressure about 50 mm Hg. E) Monitoring of postoperative bleeding and reinfusing of red cells lost during the first postoperative 8-10 hours after sedimentation and microfiltration. F) Antithromboembolic prophylaxis in doses adapted to body weight and haemocoagulation. H) Spread of predeposited ARBC over the first 3 days after surgery. The intra and/or postoperative use of salvaged blood in major surgery may be an alternative to or combined with other techniques of blood conservation currently available.

Original languageEnglish
Pages (from-to)30-35
Number of pages6
JournalInternal Medicine Clinical and Laboratory
Volume9
Issue number1
Publication statusPublished - 2001

Keywords

  • Autologous and allogenic transfusion
  • Autotransfusion
  • Perioperative blood salvage

ASJC Scopus subject areas

  • Internal Medicine

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