[Acute bleeding and intensive therapy methods after a hip joint total replacement (case report)]

Total replacement of hip joint is considered as the most traumatic and bloody intervention in surgery as it is characterized with an expressed bleeding. It is done a total hip joint replacement of 1044 patients of both sexes from 25 to 80 years old. It was developed a complex and optimal infusion-transfusion therapy with total hip joint replacement. It is described a case of the female patient who had acute bleeding after an operation and further syndrome of disseminated intravascular coagulation DIC. It had developed a vicious circle: coagulation factors were consumed quicker than they could restore. It was applied controlled hypotension to decrease bleeding intensity. It resulted in drainage bleeding reduction. Simultaneously it was conducted complex infusion-transfusion therapy, substitution therapy with blood preparations, it was transfused fresh frozen plasma by the generally accepted methods. Infusion therapy was done with crystalloids and colloids in ratio 2/1. In 3 days there were improved coagulogramm performances and total blood count, the critical status of the patient was improved. Therefore, we should note that acute bleeding is a serious problem that requires adequate complex infusion-transfusion therapy, circulating blood volume restoration, microcirculation improvement and prevention of all reasons of bleeding. In case of need in order to reduce bleeding intensity at the same time with the complex infusion-transfusion therapy use controlled hypotension.