Perioperative blood transfusions in orthopaedic surgery.
Blood transfusion after orthopaedic surgery accounts for 10% of all packed red blood-cell transfusions, but use varies substantially across hospitals and surgeons. Transfusions can cause systemic complications, including allergic reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, graft-versus-host disease, and infections. Tranexamic acid is a new cost-effective blood management tool to reduce blood loss and decrease the risk of transfusion after total joint arthroplasty. Current clinical evidence does not justify transfusions for a hemoglobin level of >8 g/dL in the absence of symptoms. Studies have also supported the use of this trigger in patients with a history or risk of cardiovascular disease.
c/o Elaine P. Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, #A665, Baltimore, MD 21224-2780. E-mail address: ehenze1@jhmi.edu.
Karthikeyan E
KE
Ponnusamy
c/o Elaine P. Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, #A665, Baltimore, MD 21224-2780. E-mail address: ehenze1@jhmi.edu.
Thomas J
TJ
Kim
c/o Elaine P. Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, #A665, Baltimore, MD 21224-2780. E-mail address: ehenze1@jhmi.edu.
Harpal S
HS
Khanuja
D055371:Acute Lung Injury / Q000209:etiology; D000328:Adult; D001803:Blood Transfusion / Q000379:methods / Q000401:mortality; D017848:Blood-Borne Pathogens; D006086:Graft vs Host Disease / Q000209:etiology / Q000235:genetics; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D056747:Immunomodulation / Q000502:physiology; D019637:Orthopedic Procedures; D059035:Perioperative Period; D012769:Shock / Q000209:etiology; D065227:Transfusion Reaction; D054556:Venous Thromboembolism / Q000209:etiology