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[Massive hemorrhage during major orthopedic surgery. Metabolic consequences]
Revue De Chirurgie Orthopedique Et Reparatrice De L'Appareil Moteur
|September 1, 1976
Summary
Massive bleeding during orthopaedic surgery can be managed. Adding calcium chloride to stored blood transfusions improves cardiac function, while fresh blood prevents clotting issues. Assisted ventilation prevents post-operative complications.
Area of Science:
- Orthopaedic Surgery
- Cardiovascular Physiology
- Transfusion Medicine
Background:
- Major orthopaedic procedures like spinal deformity correction and hip prosthesis surgery carry a high risk of significant blood loss.
- Electrolyte imbalances, particularly low potassium, are common in patients undergoing these operations.
- Rapid transfusion of stored blood may not adequately support cardiac function during massive hemorrhage.
Purpose of the Study:
- To investigate methods for improving cardiac efficiency during rapid blood transfusions in orthopaedic surgery.
- To identify strategies for preventing coagulopathy and post-operative complications associated with massive hemorrhage.
- To evaluate the efficacy of specific interventions in managing patients with massive blood loss during orthopaedic procedures.
Main Methods:
- Analysis of electrolyte levels (potassium) in 44 patients undergoing major orthopaedic surgery.
- Assessment of cardiac efficiency following rapid transfusion of stored blood, with and without the addition of dilute calcium chloride.
- Administration of alkaline preparations for patients with circulatory deficiency.
- Use of fresh blood to prevent blood clotting abnormalities.
- Implementation of assisted ventilation during the post-operative period to prevent hypothermia and pulmonary complications.
Main Results:
- Low potassium levels were observed in the majority of patients.
- Addition of dilute calcium chloride to stored blood transfusions improved cardiac efficiency.
- Fresh blood effectively prevented abnormalities in blood clotting.
- Alkaline preparations were utilized in cases of circulatory deficiency.
- Assisted ventilation successfully prevented post-operative hypothermia and pulmonary complications.
Conclusions:
- Careful electrolyte management, particularly potassium levels, is crucial in patients with massive hemorrhage during orthopaedic surgery.
- Supplementation with calcium chloride during rapid transfusion of stored blood can mitigate negative impacts on cardiac function.
- The use of fresh blood is essential for maintaining normal hemostasis.
- Post-operative assisted ventilation is a key strategy for preventing serious complications like hypothermia and pulmonary issues.