Perioperative blood and blood product management for spinal deformity surgery.
BACKGROUND
Spinal deformity surgery, like many other orthopedic procedures, involves significant operative blood loss. In order to avoid the necessity of bank blood transfusions, many blood management strategies have been devised.


OBJECTIVE
The goal of this review is to analyze the utility of current blood management strategies.


METHODS
Review paper.


METHODS
Using Medline reviews, pertinent data on blood management agents and strategies were assembled.


RESULTS
Techniques can be organized into preoperative, intraoperative and postoperative categories. Preoperative techniques include autologous blood donation and red cell augmentation. In addition to some established surgical and anesthesia techniques, recent pharmacologic agents have become available to include thrombotic agents and antifibrinolytics, which surgeons may add to their intraoperative armamentarium. A brief mention of postoperative blood salvage drains is also included.


CONCLUSIONS
The judicious use of the agents and techniques can significantly reduce the need for blood transfusions in the setting of spinal deformity surgery.
Kuklo
Timothy R
TR
Department of Orthopaedic Surgery and Rehabilitation, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20307, USA.
Owens
Brett D
BD
Polly
David W
DW
D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D017558:Elective Surgical Procedures; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007432:Intraoperative Period; D019637:Orthopedic Procedures; D012600:Scoliosis / Q000150:complications / Q000601:surgery*