Intraoperative blood management in joint replacement surgery.
Interest is growing in blood conservation and avoidance of transfusion in patients undergoing orthopedic surgery, especially in the field of joint replacement. Several methods have proven successful in reducing intraoperative blood loss, which can translate into lessened allogeneic and autologous transfusion requirements. Available techniques include acute normovolemic hemodilution, hypotensive anesthesia, intraoperative blood salvage, specialized cautery, topical hemostatic agents, and pharmacologic agents given in the perioperative period. The greatest potential benefit arises in operations with greater expected blood loss or in special situations such as in patients with religious issues, bilateral joint replacement, coagulation disorders, or significant preoperative anemia.
Tenholder
Mark
M
Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, NY, USA.
Cushner
Fred D
FD
D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D007611:Aprotinin / Q000627:therapeutic use; D019643:Arthroplasty, Replacement; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous; D006438:Hemodilution; D006487:Hemostasis; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007430:Intraoperative Care; D014148:Tranexamic Acid / Q000627:therapeutic use
D000933:Antifibrinolytic Agents; D006490:Hemostatics; D014148:Tranexamic Acid; D007611:Aprotinin