[Effectiveness of preoperative autologous plateletpheresis combined with intraoperative autotransfusion on the blood coagulation in orthopaedic patients].
OBJECTIVE
To investigate the effectiveness of preoperative plateletpheresis combined with intraoperative autotransfusion on the blood coagulation of orthopaedic patients.


METHODS
Sixty patients (ASA I-II) undergoing selective orthopaedic surgery were randomized into three groups (n = 20), that is, preoperative plateletpheresis combined with intraoperative autotransfusion for group I, intraoperative autotransfusion for group II, and group III without any managements of blood conservation. Coagulation parameters (prothrombin time, partial thromboplastin time, fibrinogen), hemoglobin and hematocrit values, platelet counts and aggregability were evaluated before the anaesthesia, 10 minutes after plateletpheresis, 10 minutes before the infusion of platelet rich plasma or autologous blood, 10 minutes after infusion, 24 and 48 hours postoperation. Intra- and postoperation blood loss and homologous blood transfusion requirements were also recorded.


RESULTS
Among three groups, there were no differences in intraoperative blood loss, perioperative haemoglobin level (Hb and Hct). As compared with group I, significant lower level of platelet counts and aggregability were observed in group II and III at the time of 24 and 48 hours after operation (P < 0.05), while postoperation blood loss and homologous blood-transfusion requirements increased at the same period (P < 0.01).


CONCLUSIONS
Preoperative plateletpheresis combined with intraoperative autotransfusion can ameliorate the blood coagulation in orthopaedic patients, and it is an effective way to decrease blood loss and homologous blood-transfusions requirements.
Department of Anesthesiology, Longsai Hospital, Zhenhai, Ningbo 315200, China. xiafei1003@126.com
Xia-Fei
XF
Zhang
Jian-Min
JM
Dong
Min-Li
ML
Gong
Shi-Ming
SM
Shen
Yan
Y
Zhou
Ying-Feng
YF
Pan
Jun-Peng
JP
Mao
D001777:Blood Coagulation; D001804:Blood Transfusion, Autologous; D006801:Humans; D009985:Orthopedics; D010983:Plateletpheresis