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Intraoperative autotransfusion in hip arthroplasty.
G Shulman1, M J Grecula, A G Hadjipavlou
1Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Clinical Orthopaedics and Related Research
|February 23, 2002
Summary
Acute normovolemic hemodilution combined with autotransfusion significantly reduces blood product exposure and hospital stay in hip replacement surgery. This combined method is cost-effective for both primary and revision total hip replacements.
Area of Science:
- Orthopedic Surgery
- Transfusion Medicine
- Anesthesiology
Background:
- Total hip replacement (THR) surgery carries risks of significant blood loss.
- Allogeneic blood transfusions increase risks and costs.
- Autologous blood strategies aim to minimize these risks.
Purpose of the Study:
- To compare perioperative transfusion requirements in patients undergoing THR.
- To evaluate the cost-effectiveness of autologous blood techniques.
- To assess the impact on hospital length of stay.
Main Methods:
- A case-control study involving 80 patients undergoing primary or revision THR.
- Group 1: 40 patients underwent acute normovolemic hemodilution (ANH) and autotransfusion.
- Group 2: 40 patients received autotransfusion alone (control).
Main Results:
- Group 1 had a 75% lower blood product donor exposure rate (0.6 vs. 2.4 units/patient).
- Average hospital stay was significantly shorter for Group 1 (6.2 vs. 8.4 days).
- ANH with autotransfusion was cost-effective for primary and revision THR; autotransfusion alone was cost-effective only for revision THR.
Conclusions:
- ANH combined with autotransfusion is a cost-effective strategy to reduce allogeneic exposure and hospital stay in THR.
- Autotransfusion alone is cost-effective primarily for revision THR.
- Reduced immunogenic insult may contribute to shorter hospital stays.
