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Changing transfusion practices in hip and knee arthroplasty
D O Warner1, M A Warner, D R Schroeder
1Department of Anesthesiology, Mayo Foundation, Rochester, Minnesota, USA.
Transfusion
|August 26, 1998
Summary
Autologous blood conservation strategies reduced intraoperative red blood cell (RBC) transfusions in hip and knee surgeries. However, this shift may postpone, not prevent, the need for RBC transfusions.
Area of Science:
- Orthopedic Surgery
- Transfusion Medicine
- Patient Blood Management
Background:
- Introduction of autologous blood conservation strategies into clinical practice.
- Evaluation of changes in perioperative transfusion practices.
Purpose of the Study:
- To examine changes in perioperative transfusion practices.
- Assess the impact of autologous blood conservation strategies.
Main Methods:
- Retrospective review of medical records.
- Analysis of patients undergoing total hip or knee arthroplasty.
- Data collected over three distinct time periods: 1981-82, 1987-88, and 1993-94.
Main Results:
- Significant decrease in patients receiving red blood cell (RBC) units (85% to 65%).
- Shift in transfusion timing from preoperative/intraoperative to postoperative periods.
- Increased postoperative RBC units transfused per procedure (0.6 to 1.1 units).
Conclusions:
- Blood conservation strategies effectively reduced intraoperative RBC transfusions.
- Avoidance of intraoperative transfusion may lead to delayed, rather than prevented, transfusions.