Blood salvage techniques to avoid homologous blood transfusion in orthopaedic surgery

B. Borghi, F. Stagni, I. Bacchilega

Research output: Contribution to journalArticlepeer-review

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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