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Global blood management in orthopaedic surgery
1Surgical Arthritis Service Hospital for Special Surgery, New York, NY 10021, USA.
Clinical Orthopaedics and Related Research
|January 26, 1999
Summary
Orthopaedic surgery often involves significant blood loss. Strategies like regional hypotensive anesthesia and autologous blood retrieval can minimize this, but must be used judiciously for patient safety and cost-effectiveness.
Area of Science:
- Orthopaedic Surgery
- Anesthesiology
- Transfusion Medicine
Background:
- Orthopaedic procedures frequently result in substantial blood loss due to tissue characteristics and challenges in coagulating bony surfaces.
- Regional hypotensive anesthesia has demonstrated efficacy in mitigating blood loss, particularly during joint replacement surgeries.
Purpose of the Study:
- To review strategies for managing blood loss in orthopaedic surgery.
- To discuss the spectrum of autologous blood retrieval and reinfusion techniques.
Main Methods:
- Review of existing literature on blood management in orthopaedics.
- Description of autologous blood management techniques including predeposit, preoperative hemodilution, and intraoperative/postoperative cell salvage and reinfusion.
Main Results:
- Autologous blood transfusion is universally accepted as safe.
- A comprehensive approach to blood management involves multiple techniques for red cell retrieval and reinfusion.
Conclusions:
- Judicious application of blood preservation measures is crucial to balance patient safety and cost-effectiveness.
- Optimizing autologous blood strategies can significantly reduce the need for allogeneic transfusions in orthopaedic patients.