title: Quality of the blood sampled from surgical drainage after total hip arthroplasty.
abstract: Several methods have been found to be successful in reducing the need for allogeneic transfusion among the patients undergoing total hip replacement. The purpose of this prospective study was to analyse the quality and evaluate the effect of postoperative autotransfusion on the need for allogeneic transfusion following total hip replacement. The prospective study was performed in two groups of patients undergoing total hip replacement. Before the operative procedure all patients in both groups predonated two doses of autologous blood. In GROUP 1. the system for postoperative collection and transfusion of shed blood was used. In GROUP 2. the patients underwent total hip replacement without blood salvage system. Standard suction collection sets were used postoperatively. In this group shed blood was not transfused to the patients. The samples of preoperative donated autologus blood, allogeneic blood and postoperative collected autologous blood were analysed for number of red cells, hemoglobin, hematocrit, platelets, white blood cells, values of potassium, sodium, free hemoglobin and acid base status. The postoperatively blood salvage significantly reduced the use of allogeneic transfusion among patients managed with total hip replacement (allogeneic transfusion received 12% patients in Group 1 and 80% patients in Group 2; p<0.001). The values of red blood cells are significantly lower in postoperative collected autotransfusion blood compared with preoperative collected autologous blood and allogeneic blood (p<0.001). The values of potassium and acid base status were in normal range in postoperatively collected autotransfusion blood. These values in preoperatively collected autologous blood and allogeneic blood were out of normal range; (p<0.001). In addition to reducing the risk of complications that are associated with allogeneic transfusion, postoperative blood salvage may offer benefits including reducing the need for allogeneic blood. Our study confirmed that postoperative collection and transfusion of drainaged blood is simple and safe method that significantly reduce the need for allogeneic transfusion in patients underwent total hip replacement. The blood collected and transfused postoperatively has lower values of red blood cells and normal values of potassium and acid base balance. The transfusion of this blood caused no complications in our patients.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia. v.b.tripkovic@email.htnet.hr
authors.forename: Branko
authors.initials: B
authors.lastname: Tripković
authors.forename: Damir
authors.initials: D
authors.lastname: Buković
authors.forename: Katarina
authors.initials: K
authors.lastname: Sakić
authors.forename: Sime
authors.initials: S
authors.lastname: Sakić
authors.forename: Nevia
authors.initials: N
authors.lastname: Buković
authors.forename: Branko
authors.initials: B
authors.lastname: Radaković
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001772:Blood Cell Count; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000097:blood
chemical_list: D006454:Hemoglobins; D012964:Sodium; D011188:Potassium