title: Evaluation of effectiveness and analysis of goal-directed blood transfusion in peri-operation of major orthopedic surgery in elderly patients.
abstract: Through the establishment of blood transfusion-effectiveness assessment criteria, we aimed to evaluate and analyze the effectiveness of peri-operative red blood cell transfusion for major orthopedics in elderly patients. Male and female patients (n=106) with American Society of Anesthesiologists (ASA) stage II-III, aged 60-80 years and scheduled for elective orthopedic surgery were randomly divided into 2 groups: group I (n=52), received the traditional method of red blood cell transfusion and group II (n=54) received hemoglobin (Hb) and hematocrit (Hct) goal-directed red blood cell (RBC) transfusion. We compared the changes in Hb, Hct, RBC, platelet (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), alveolar-arterial oxygen partial pressure [P(A-a)O(2)], oxygenation index (OI) and Vigileo monitoring indicators following RBC composition transfusion before and after surgery. We also monitored wound healing time, number of hospitalization days and intensive care unit (ICU) transfer rate. Blood transfusion-effectiveness assessment criteria were used to evaluate the efficacy and safety of Hb and Hct goal-directed RBC transfusion in orthopedic elderly patients. The two groups demonstrated an efficiency of 61.5 and 72.2%, respectively (P>0.05). The P(A-a)O(2) and OI in the two groups were not significantly different (P>0.05). Compared with the traditional RBC transfusion group, the Hb and Hct goal-directed RBC transfusion group presented increased RBC, Hb and Hct, as well as decreased PT and APTT and shorter wound healing time. The number of days of hospitalization and ICU transfer rate also decreased (P<0.05). The Hb and Hct goal-directed method for RBC transfusion was found to be more effective as a form of peri-operative RBC transfusion for major orthopedics in elderly patients.
authors: Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054,  P.R. China.
authors: Hong
authors: H
authors: Zheng
authors: Jian-Jiang
authors: JJ
authors: Wu
authors: Jiang
authors: J
authors: Wang
keywords: blood transfusion; effectiveness; goal orientation; orthopedic elderly patients
references: Lancet. 2009 May 2;373(9674):1532-42
references: 19410717
references: J Vasc Surg. 2011 Aug;54(2):433-9
references: 21458203
references: Health Policy. 2011 Oct;102(2-3):214-22
references: 21680044
references: Arch Surg. 2012 Jan;147(1):49-55
references: 22250113
references: Crit Care Med. 2004 Apr;32(4 Suppl):S92-105
references: 15064668
references: Transfus Apher Sci. 2012 Oct;47(2):235-43
references: 22770808
references: J Surg Res. 2002 Feb;102(2):237-44
references: 11796024
references: Int J Surg. 2007 Apr;5(2):89-94
references: 17448971
references: Transfusion. 2002 Jul;42(7):812-8
references: 12375651
references: Can J Anaesth. 2003 Jun-Jul;50(6 Suppl):S60-4
references: 14629055
references: Acta Anaesthesiol Scand. 2010 Oct;54(9):1039-49
references: 20626354
references: Infect Disord Drug Targets. 2011 Feb;11(1):45-56
references: 21303341
references: Med J Aust. 1995 Oct 2;163(7):356-9
references: 7565259
references: Can J Anaesth. 2006 Jun;53(6 Suppl):S40-58
references: 16766790
references: J Am Geriatr Soc. 2001 Aug;49(8):1080-5
references: 11555070
references: Anesthesiology. 2000 Jun;92(6):1646-52
references: 10839915
references: Transfusion. 2008 Jul;48(7):1447-58
references: 18482183
references: J Vasc Surg. 2010 Mar;51(3):616-21, 621.e1-3
references: 20110154
references: Anesthesiol Clin North Am. 2005 Jun;23(2):315-25, vii
references: 15922903
references: J Orthop Trauma. 2002 Jan;16(1):39-44
references: 11782632
references: Ann Vasc Surg. 2010 Jan;24(1):48-56
references: 19619975