Strategies for minimizing the use of allogeneic blood during orthopedic surgery.
Selected orthopedic surgical procedures, such as total joint arthroplasty and spinal instrumentation, have some of the highest perioperative transfusion rates of all surgical procedures. Blood transfusions carry the risk of complications, including the transmission of disease, immunomodulation, and hemolytic and non-hemolytic reactions. Strategies that reduce or remove the risk of allogeneic transfusion include preoperative autologous donation, acute normovolemic hemodilution, perioperative cell salvage techniques, deliberate hypotension, and pharmacologic interventions. This paper will review the current status of these therapies in the orthopedic surgical patient.
Rosenblatt
Meg A
MA
Division of Orthopedic Anesthesiology, Box 1010, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029, USA.
D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D002469:Cell Separation / Q000379:methods; D017707:Erythrocyte Transfusion / Q000379:methods*; D004921:Erythropoietin / Q000627:therapeutic use; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D007023:Hypotension, Controlled; D019637:Orthopedic Procedures; D015912:Thrombolytic Therapy
D004921:Erythropoietin