Effects of acute normovolemic hemodilution combined with intraoperative recycled autotransfusion on blood transfusion volume and coagulation function in elderly patients undergoing cardiac surgery / 中国输血杂志

【Objective】 To explore the effects of acute normovolemic hemodilution (ANH) combined with intraoperative recycled autotransfusion on blood transfusion volume and coagulation function in elderly patients undergoing cardiac surgery. 【Methods】 A total of 94 elderly patients undergoing cardiac surgery in the hospital were enrolled and randomly divided into observation group (n=47) and control group (n=47) between March 2020 and March 2022. The observation group was given ANH combined with intraoperative recycled autotransfusion, while control group was given routine allogeneic transfusion. The blood transfusion volume, oxygenation status, immune function, inflammatory indexes and adverse reactions in the two groups were compared. 【Results】 The banked blood transfusion volume was less in observation group than control group [(1.73±0.43) U vs (5.71±1.71) U, P<0.05]. At 6 h after surgery, blood oxygen saturation (SvO2) level was higher [(74.59±7.20) % vs (67.22±6.19) %], while oxygen uptake rate (ERO2) level was lower[(0.29±0.06) % vs (0.34±0.05) %] in observation group than control group (P<0.05). At day 1 after surgery, levels of CD3+, CD4+, CD4+ /CD8+ and natural killer cells (NK) were higher [(65.11±5.14) %, (46.93±5.17) %, (1.86±0.30), (8.35±1.23) % vs (57.45±7.24) %, (43.58±4.85) %, (1.47±0.36)%, (7.34±1.38) %], while CD8+ was lower [(25.17±4.01) % vs (30.39±5.06) %] in observation group than control group (P<0.05). At day 1 after surgery, levels of serum interleukin 6/8 (IL-6/8) and tumor necrosis factor-α (TNF-α) were lower in observation group than control group [(104.51±12.55) ng/L vs (125.81±14.96) ng/L, (351.42±52.86) ng/L vs (394.27±55.78) ng/L, (254.93±49.94) ng/L vs (323.60±52.63) ng/L, P<0.05]. The incidence of adverse reactions was lower in observation group than control group (4.26% vs 17.02%), P<0.05. 【Conclusion】 Recycled autotransfusion can reduce allogeneic transfusion volume in elderly patients undergoing cardiac surgery. There is no difference in the effects on blood routine or coagulation function between recycled autotransfusion and allogeneic transfusion. Compared with allogeneic transfusion, recycled autotransfusion can significantly improve oxygenation status, relieve immunosuppression and inflammation response, and reduce the risk of adverse reactions.

Efficacy of autologous ozoneized blood transfusion in improving motor function in convalescent stroke patients / 中国输血杂志

【Objective】 To investigate the efficacy of autologous ozoneized blood transfusion(AOBT) in improving consciousness and motor function in convalescent stroke patients. 【Methods】 A total of 44 patients who were diagnosed as convalescent cerebral apoplexy and received treatment in Rehabilitation Department of our hospital from August 2016 to September 2021 were randomly divided into the experimental group and control group by blind method. The experimental group (n=22) received general rehabilitation training (such as exercises, occupational therapy, acupuncture and transcranial magnetic stimulation) plus AOBT (200 mL venous phlebotomy at the median elbow), once every 2 to 3 days and 12 occasions as a course of treatment; the control group solely recieved general rehabilitation training. The consciousness (GCS score) and ability of daily living (Barthel index score) score of the two groups before and after treatment were statistically compared, and Ueda motor function grade, Brunnstrom stage and muscle tone grade were observed and evaluated. 【Results】 After the treatment, the experimental group and the control were compared as follows: 1) the GCS score and Barthel score was 14.82±0.39 vs 12.41±2.52, 61.14±12.24 vs 52.05±11.72(P<0.05); 2) The recovery rate of motor function was 95.45% (21/22) vs 63.64% (14/22) (P<0.05); 3) The total recovery rate of muscle tone was 90.91% (20/22) vs 63.64% (14/22) (P<0.05). 【Conclusion】 AOBT, with somewhat high safety and effectiveness, can improve the state of consciousness, motor function and muscle tone in convalescent patients with stroke.

Autologous blood salvage in cardiac surgery: clinical evaluation, efficacy and levels of residual heparin

ABSTRACT Objective: Intraoperative blood salvage (cell saver technique) in cardiac surgery is universally used in surgical procedures with a marked risk of blood loss. The primary objectives of this study were to determine the concentration of residual heparin in the final product that is reinfused into the patient in the operating room and to evaluate the efficacy and safety of the cell saver technique. Method: Twelve patients undergoing elective cardiac surgery were enrolled in this study. Using the XTRA Autotransfusion System, blood samples were collected from the cardiotomy reservoir, both prior to blood processing (pre-sample) and after it, directly from the bag with processed product (post-sample). Hematocrit and hemoglobin levels, the protein, albumin and residual heparin concentrations, hemolysis index, and the platelet, erythrocyte and leukocyte counts were measured. Results: Hematocrit and hemoglobin levels and red blood cell counts were higher in post-processing samples, with a mean variation of 54.78%, 19.81 g/dl and 6.84 × 106/mm3, respectively (p < 0.001). The mean hematocrit of the processed bag was 63.49 g/dl (range: 57.2-67.5). The residual heparin levels were ≤0.1 IU/ml in all post-treatment analyses (p = 0.003). No related adverse events were observed. Conclusion: The reduced residual heparin values (≤0.1 IU/ml) in processed blood found in this study are extremely important, as they are consistent with the American Association of Blood Banks guidelines, which establish target values below 0.5 IU/ml. The procedure was effective, safe and compliant with legal requirements and the available international literature.

Effect of psychological counseling nursing in patients receiving advanced autologous apheresis treatment / 中国输血杂志

【Objective】 To investigate whether the psychological counseling nursing could alleviate psychological stress and reduce the incidence of adverse events in patients receiving advanced autologous apheresis (AAA) treatment. 【Methods】 A total of 253 patients who underwent AAA treatment in our department from September 2019 to February 2020 were studied and randomly divided into the observation group (n=127) and the control group (n=126). Other than the routine nursing, the patients in the observation group also received psychological counseling nursing. The scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to compare the psychological stress state and the incidence of adverse events between two groups, and the nursing satisfaction was evaluated by NSNS scores. 【Results】 The SAS and SDS scores in the observation group( after receiving counseling nursing as the psychological intervention) were 30.03±5.06 and 33.59±4.49, respectively, significantly lower than those in the control group (43.55±3.68 and 42.18±4.22, respectively) (P<0.05). The incidences of adverse events (convulsions not included) in the observation group and the control group were 11.8%(15/127) vs 26.2%(33/126) (palpitation and shortness of breath), 6.3%(8/127) vs 16.7%(21/126) (sweating), 8.7%(11/127) vs 23.8%(30/126) (dizziness and numbness in mouth), and 5.5%(7/127) vs 19.8%(30/126) (nausea), respectively (P<0.05). The total nursing satisfaction rate of the observation group was 98.4% (125/127), which was significantly higher than that of the control group (92.9%, 117/126) (P<0.05). 【Conclusion】 The psychological counseling nursing can effectively relieve the psychological stress of patients receiving AAA treatment and reduce the incidence of adverse events.

Effects of transfusion load and suction pressure on renal function in intraoperative salvage autotransfusion

Although some investigations have been performed to determine the effects of transfusion load and suction pressure on renal function during intraoperative salvage autotransfusion, the precise threshold is still undetermined. A total of 625 patients undergoing surgery with the Continuous AutoTransfusion System (CATSplus) were enrolled and divided into groups according to the utilized suction pressure and transfusion volume. Plasma free hemoglobin (FHB) and creatinine clearance (CCr) were assayed to indicate the renal function. Both 0.03 MPa suction (≥4-unit load) and >5 units transfusion changed the levels of FHB and CCr significantly when measured 24 h post-operation compared to pre-operation. Under 0.02 MPa suction (≥4-unit load), the alteration of FHB and CCr returned to normal after 24 h. Under 3 units transfusion, the levels of FHB and CCr at 6 and 12 h post-operation changed significantly compared to pre-operation (P<0.05 or P<0.01, respectively), and this alteration could be restored to normal at 72 h post-operation. After an exhaustive investigation, less than 4 units transfusion and less than 0.03 MPa suction pressure are recommended for intraoperative salvage autotransfusion.

A risk analysis of acute kidney injury after orthotropic liver transplantation for benign end-stage liver disease in adults / 临床麻醉学杂志

Objective To analyze the risk factors of acute kidney injury after orthotropic liver transplantation for adult benign end-stage liver disease.Methods A retrospective analysis was conducted in 30 recipients (18 males,12 females,aged 23-68 years,ASA grade Ⅲ or Ⅳ) who underwent orthotropic liver transplantation for benign end-stage liver disease at Tongji Hospital from May,2014 to December,2014.Both demographic characteristics and perioperative parameters were collected,including general condition,surgery and anesthesia factors and intraoperative salvage autotransfusion or not.Perioperative laboratory findings related to renal function including urine volume,serum creatinine (Scr) and urea nitrogen (BUN) were collected,too.All variables tested in the univariate analysis with a P<0.10 were included in a multiple logistic regression analysis.Results There were less intraoperative salvage autotransfusion,more platelet transfusion and a higher using rate of vasopressors in the AKI group after surgery than those did not.Patients who received intraoperative salvage autotransfusion had 0.058 time odds (95%CI 0.005-0.649) of AKI than those did not;patients who required platelet transfusion had 10.706 times higher odds (95%CI 1.212-94.963) of AKI than those did not.Conclusion It is likely that intraoperative salvage autotransfusion was able to decrease the morbidity of AKI,while platelet transfusion and vasopressor administration to maintain blood pressure could increase the possibility of AKI.

Study of influence of predeposited autotransfusion and intraoperative autotransfusion on immune function of patients with selective operation / 国际检验医学杂志

Objective To investigate the influence of predeposited autotransfusion and intraoperative autotransfusion on immune function of patients with selective operation .Methods A retrospective analysis was made on 100 cases of patients with selective op-eration in our hospital from September 2014 to August 2016 ,and all cases were divided into control group and research group .Con-trol group was treated with allogeneic transfusion ,while research group was treated with combination of preoperative autologous blood donation and intraoperative autotransfusion ,and general indexes ,immune cells and immune protein levels between two groups were compared .Results The allogeneic transfusion volume and postoperative incision infection rate of research group were lower than those of control group ,and the difference was statistically significant (P<0 .05) .There was no significant difference in intrao-perative ,postoperative and total blood loss between the two groups (P>0 .05) .Before treatment ,immune cell level between two groups had no significant difference (P>0 .05) .At 1 d and 7 d after surgery ,CD3+ ,CD4+ ,CD4+ /CD8+ and NK cell levels of re-search group were higher than those of control group ,CD8+ level of research group was lower than that of control group ,and the difference was statistically significant (P<0 .05) .Before treatment ,immunoglobulin level between two groups had no difference (P>0 .05) .At 1 d and 7 d after surgery ,IgG ,IgM and C3 levels of research group were higher than those of control group ,and the difference was statistically significant (P<0 .05) .Conclusion Combination of predeposited autotransfusion and intraoperative au-totransfusion has fewer influence on immune function of patients with selective operation ,and has good safety .

Application of acute normovolemic hemodilution combined with salvaged autotransfusion in surgical patients with ectopic pregnancy / 国际检验医学杂志

Objective To explore the application value of acute normovolemic hemodilution(ANH) combined with salvaged autotransfusion in surgical patients with ectopic pregnancy.Methods From Mar.2015 to Apr.2016,46 surgical patients with ectopic pregnancy,receiving ANH combined with salvaged autotransfusion,were enrolled as observation group,and 39 surgical patients with ectopic pregnancy,receiving allogeneic blood transfusion were enrolled as control group.The baseline data,including age,body mass index(BMI),preoperative hemoglobin(Hb),abdominal pain time and menopause time were collected.The amounts of blood loss and blood transfusion were recorded.Preoperative and postoperative levels of white blood cells(WBC),C-reaction group(CRP) and erythrocyte sedimentation rate(ESR) were detected.Results The baseline data,including age,BMI,preoperative Hb,abdominal pain time and menopause time of the two groups were without statistical difference(P>0.05).The preoperative preexisting blood volume was (559±128)mL and the intraoperative blood collection was(510±103)mL in observation group.The cases and volume of banked blood infusion in observation group were lower than those in control group(P0.05).The levels of CRP and ESR at the postoperative 1st,3rd and 5th day and WBC levels at the postoperative 1st and 3rd day were higher than those before operation in the two groups(P<0.05).The levels of CRP and ESR at the postoperative 1st,3rd and 5th day in observation group were significantly lower than those in control group(P<0.05).Conclusion (Department of Gynaecology,the Fourth People's Hospital of Langfang City,Langfang,Hebei 065700,China)

A review of the application of autologous blood transfusion

Autologous blood transfusion (ABT) has been gradually attracting more attention due to the increasingly prominent problem of blood transfusion safety and blood shortage in recent years. With the rapid development of blood conservation techniques, blood component separation technology, blood transfusion medicine and a constant increase in clinical needs, ABT technology has been expanded and innovated to a large degree. In this study, the development of preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH), intraoperative and postoperative autotransfusion, and other new technologies and theories are reviewed and existing questions are analyzed. Challenges and applications are also discussed in order to provide reference for peers.

Care of Preoperative Autologous Blood Donation in Late Pregnancy / 浙江中医药大学学报

[Objective] To ensure the safety of preoperative autologous blood donation in late pregnancy through a series of nursing measures.[Methods]From January 2010 to November 2011, 52 cases of pregnant women in late pregnancy took storage autotransfusion. After prenatal guardianship, psychological care, health education, blood were col ected before and after care, custody and from the blood transfusion care; record blood col ection process pregnant women with maternal-fetal reaction, the vital signs of pregnant women, birth outcomes, since the amount of al ogeneic blood transfusion, and achieve satisfactory re-sults.[Results] 52 cases of pregnant women with the blood col ection process were good, normal, with stable vital signs, abnormal fetal heart rate monitoring, one case of fetal moved too much, given the oxygen, improved with the left lateral decubitus position. In the process of self-blood transfusion, there's no ma-ternal discomfort, but with safe motherhood. [Conclusion] Effective care measures and storage of a pregnant woman autologous transfusion are relatively safe, economical and effective in the transfusion way, achieve good results, and help to improve the quality of obstetric care.

The Effect of Autotransfusion System in Minimally Invasive Total Knee Arthroplasty

PURPOSE: To evaluate the effect of autotransfusion system in minimally invasive total knee arthroplasty (TKA). MATERIALS AND METHODS: Seventy-one patients who underwent unilateral minimally invasive TKA between October 2009 and June 2010 were selected. The first group included 36 patients who received standard vacuum drainage and the second group, 35 patients who underwent autologous retransfusion drainage. In the first group, allogeneic blood transfusion was performed if the postoperative hemoglobin level was <7.0 g/dL or 7.0-8.0 g/dL with the presence of a medical complication and an anemic symptom. The second group received autotransfusion and allogeneic transfusion additionally according to the same criteria. Changes in the pre- and postoperative hemoglobin level, amount of auto- or allotransfusion, and frequency of allogeneic transfusion were assessed. RESULTS: Allogeneic transfusion was required in 13 patients (36.1%) in the first group and four patients (11.4%) in the second group. The mean allogeneic transfusion volume was significantly low in the second group compared to the first group (64.4 mL vs. 278.9 mL; p<0.05). The hemoglobin level on the 1st postoperative day compared to the preoperative level decreased by 22.6% in the first group and 11.7% in the second group. The postoperative hemoglobin level was higher in the second group (p<0.05). CONCLUSIONS: Minimally invasive unilateral TKA with an autotransfusion system can be beneficial in patients with no medical complications because of the decreased allogeneic transfusion.

The application value of autologous blood transfusion damage anemia in abdomen / 中国基层医药

Objective To study application of hematocoelia reinjection in abdominal injury with massive hemorrhage and anemia ,and to estimate the impact of salvaged autotransfusion on blood routine and blood coagulation of patients.Methods In 75 patients with intra-abdominal injury bleeding anemia undergoing autologous hematocoelia reinfusion,compare the anemia index and coagulation indexes before and after surgery to evaluate the therapeutic effect.Results Among 75 cases,1 cases died of brain injury,the other 74 cases were cured.After the second days of review,red blood cell,hemoglobin,hematocrit,platelet were elevated,compared with preoperative,the differences were statistically significant(all P0.05).Conclusion Salvaged autotransfusion can improve anemia prompt-ly without any impact on coagulation function in rescuing abdominal injured patients with massive hemorrhage and a -nemia.The treatment is effective .It has an important application in primary hospital .

The Efficacy and Safety of Postoperative Autologous Transfusion of Filtered Shed Blood and Anticoagulant Prophylaxis in Total Knee Arthroplasty Patients

PURPOSE: To assess the efficacy and safety of autologous transfusion of filtered shed blood in total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 42 patients with TKA (group A; without autologous transfusion in 15 patients, group B; with autologous transfusion in 27 patients) were evaluated retrospectively. The influence of autologous reinfusion of filtered blood, bleeding tendency, amount of blood drainage, rate of allogenic transfusion, and the postoperative changes of hemoglobin were analyzed. RESULTS: Allogenic transfusion was needed in 26.7% (4/15) of group A and none of group B till postoperative 48 hours. Till postoperative 14 days, 46.7% (7/15) of group A needed allogenic transfusion while 7.4% (2/27) in group B. The average drained blood volume was 1,197+/-400 mL in group A and 975+/-422 mL in group B. The average decrease of hemoglobin at postoperative 1, 7, and 14 days was 2.9+/-1.5, 2.9+/-1.6, and 2.3+/-1.5 g/dL respectively in group A and 2.7+/-0.8, 4.0+/-1.0, and 2.9+/-1.3 g/dL respectively in group B. CONCLUSIONS: An autotransfusion system lowered the allogenic transfusion rate, while anticoagulants did not increase the amount of drained blood. An autotransfusion system with anticoagulants was effective and safe to save the shed blood in TKA.

An Autotransfusion Device Reduces the Amount of Allogenic Transfusion in Bilateral Sequential Total Knee Arthroplasty

PURPOSE: This study examined the difference in the reduction of the amount of required allogenic transfusion after bilateral total knee arthroplasty when an autotransfusion device was used. MATERIALS AND METHODS: The subjects were ninety five patients who underwent sequential bilateral total knee arthroplasty from January 2006 to May 2010 by one surgeon. The first group was 50 patients who did not have an autotransfusion device used and second group of 45 patients were those who had an autotransfusion device used during the postoperative period. Group 1 received allogenic blood transfusion with a standard level of postoperative hemoglobin. The group 2 patients were reinfused with as much blood as was collected by an autotransfusion suction bag and then they received allogenic blood transfusion with a standard level of postoperative hemoglobin. RESULTS: The total blood loss and amount of blood transfusion were almost the same in the two groups. The mean amount of allotransfusion was 1,270.0 mL in group 1 and 564.4 mL in group 2 and the reduced amount of allotransfusion in group 2 was statistically significant (p<0.05). CONCLUSION: Using an autotransfusion device is a good method to reduce the mean amount of allotransfusion after bilateral sequential total knee arthroplasty.

Implementación de un Programa de Donación Autóloga Preoperatoria (DAP) en el Hospital Regional de Río Gallegos, Provincia de Santa Cruz / Preoperative Autologous Blood Donation in the Regional Hospital, Rio Gallegos, Santa Cruz, Argentina

Desde que el Dr. BLUNDELL realizara en el siglo XIX la primera autotransfusión a una puérpera, la do­nación de sangre autóloga ha atravesado distintas eta­pas y superado diversas controversias. A pesar de que la donación autóloga preoperatoria (DAP) es la modalidad más usada en la actualidad, aun continua siendo subutilizada. Entre Junio de 2007 y Mayo de 2008 realizamos en nuestro hospital un estudio que mostró que dentro de las cirugías electivas, el 85% de los reemplazos tota­les de cadera, el 100% de los reemplazos totales de rodilla, el 100 por ciento de las artrodesis cervicales y el 87 por ciento de las artrodesis lumbares , podrían haberse incluido dentro de la DAP. Incluir en la consulta con el médico especialista en Medicina Trasfusional, a los pacientes candidatos a cirugías electivas y dentro de la rutina prequirúrgica ambulatoria, permitirá maximizar el uso de la DAP y otras estrategias, con el fin minimizar la exposición del paciente a la sangre homóloga.

Since Dr. Blundell made in 19th Century the first autologous transfusion to a puerperal patient, autologous blood donation has gone through different stages and overcome several controversies. Even though preoperative autologous blood donation (PAD) is the most used practice today, it is still underused. Between June 2007 and May 2008 we did a study in our Hospital. results of which showed that among elective surgeries, 85 % of total hip replacement, 100% of total knee replacement, 100% of cervical arthrodesis and 87% of lumbar arthrodesis qualified and could have been included for PAD. To include an appointment with the transfusion MD in the preoperative test routine to those pacients selected to an elective surgery, will allow to maximize PAD and other strategies in order to minimize patients expousure to homologous blood.

The Effect of Intraoperative Autotransfusion using a Continuous Autotransfusion System (CATS(R)) on for Homologous Transfusion in Children / 대한마취과학회지

BACKGROUND: Until recently, it was not easy to conduct intraoperative autotransfusion in children due to technical limitations, however, due to advanced technology this is now possible. This study was conducted to determine if the intraoperative use of the continuous autotransfusion system (CATS(R)) can reduce homologous transfusion during pediatric orthopaedic surgery. METHODS: Fifty-five children scheduled for elective orthopaedic surgery were reviewed and divided into two groups according to the availability of the CATS(R). The control group (n = 29) had surgery without the cell saver, whereas the CATS(R) group (n = 26) had surgery with the cell saver. The amounts of perioperative homologous transfusion were then compared between the two groups. RESULTS: The amount of homologous blood transfusion required during the operation was significantly less in the CATS(R) group 5 +/- 10 (ml/kg) than in the control group 15 +/- 13 (ml/kg) (P < 0.01). There was no difference in the amount of homologous blood transfusion required after operation between the groups. CONCLUSIONS: CATS(R) can reduce the need for intraoperative homologous transfusion during pediatric orthopaedic surgery.

Effect of Autotransfusion Using the Drained Blood after Bilaterla Total Knee Arthroplasty / 대한마취과학회지

BACKGROUND: This study investigated the clinical usefulness of an autotransfusion of drained blood using postoperative wound drainage and a reinfusion system to reduce the allogenic blood transfusion without complications. METHODS: Eighty patients were allocated randomly to either a control group using a standard drainage system or an autotransfusion group using postoperative wound drainage and a reinfusion system. The collection period was 12 h, and the drainage blood retransfused after 6 h, or a maximum of 500 ml of blood was collected after connecting the reinfusion system. Immediately before reinfusion, blood samples were taken from the reinfusion system and analyzed for the functional and metabolic status of the drained blood and compared with the preoperative values of patient. The hemoglobin level, blood loss, allogenic blood requirement and transfusion-related complications were assessed. RESULTS: The drained blood had lower hematological values, a prolonged PT and aPTT, a lower fibrinogen, and metabolic acidotic status than the preoperative values of the patients. There were no significant differences in the amount of blood loss compared with the control group. However, the autotransfusion group required significantly less allogenic blood (almost 20% less) without significant complications. CONCLUSIONS: Autotransfusion by reinfusion with drained blood in bilateral total knee arthroplasty reduces the allogenic blood requirement without significant complications.

Effect of drainage blood autotransfusion after total knee or hip arthroplasty / 中国矫形外科杂志

[Objective] To evaluate the efficacy and safety of drainage blood autotransfusion after total knee or hip arthroplasty.[Methods]Drainage blood in the first 6 hours postoperation was collected and reinfused using the ContavacTM CBCⅡ system in 30 patients taken total knee or hip arthroplasty.The efficacy was evaluated basing on the amount of the allogenic transfusion,the decreasing of the hemoglobin level and the morphology of the red blood cells in the drainage blood.The safety was evaluated basing on whether the patients had autotransfusion complications including fever,hemolytic reaction,coagulation disorders,pulmonary embolism and systemic infection.[Results]The volumes of total blood drainage,autotransfusion and allogenic transfusion were(946?433)ml,(622?313)ml and(233?348)ml,respectively.The average hemoglobin level of drainage blood was 99.67g/L and no apparente haemolysis happened.However,the hemoglobin level significantly decreased after operation in the peripheral blood.Only one rheumatoid arthritis patient had an abnormal fever during autotransfusion process,no other complication was observed.[Conclusion]Drainage blood in the first 6 hours postoperation is valid blood content.Drainage blood autotransfusion is an effective and safe way to slow down the hemoglobin reduction and reduce allogenic blood transfusion in patients being treated with total knee or hip arthroplasty.

Effect of autotrasfusion device affecting allotransfusion after total knee arthroplasty

OBJECTIVES: We tried to find out the use of allogeneic blood transfusion can be reduced after total knee arthroplasty, when autotransfusion device is used. MATERIALS AND METHODS: Seventy one patients who were performed unilateral total knee arthroplasty (TKA) from January 2001 to February 2005 by one surgeon were selected. They were divided into 2 groups. First group of 29 patients were those who did not use the autotransfusion device and second group of 42 patients were those who used the autotransfusion device in postoperative period. Retrospective analysis was done. First group received allogeneic blood transfusion by a standard level of postopera - tive hemoglobin. Second group were reinfused as much blood as collected by autotransfusion suction bag and then received allogeneic blood transfusion by a standard level of postoperative hemoglobin. Postoperative hemoglobin, hematocrit, total blood loss, total amount of blood transfusion in group 1, 2 were analyzed. These categories were statistically analysed. RESULT: Total blood loss and amount of blood transfusion were almost the same in two groups. The mean amount of allotransfusion was 77.1+/-66.3 cc in group II and 440.7+/-252.7 cc in group I. It showed statistically less amount in group II (multiple regression test, P=0.04). Other factors such as age, sex and disease categories, etc did not show the statistical correlation. CONCLUSION: Using autotransfusion device reduced the mean 363.6 cc of allotransfusion after unilateral TKA. Therefore Autotransfusion device seemed to be a good method to reduce allotransfusion for TKA.

An Analysis for Blood Transfusion in Revision Total Hip Arthroplasty / 대한마취과학회지

BACKGROUND: This study was performed to investigate the clinical usefulness of acute normovolemic hemodilution to reduce homologous transfusion in revision total hip arthroplasty. To avoid complications of homologous transfusion, many methods are being used in patients who undergo an operation, and autologous transfusion is the most popular modality. METHODS: Fifty-five patients operated on for revision THRA were reviewed. In the hemodilution group (n = 21), 2-4 units of autologous blood were procured immediately after anesthetic induction while Ringer's lactate and 6% Haes-steril were infused to maintain normovolemia. Differences in the amounts of transfusions and postoperative drainage were compared. Statistical analyses were performed by using the Student's t-test. RESULTS: No significant differences were observed between groups in terms of preoperative hematocrit and hematocrit at postoperative 7 days. However, in the homologous transfusion group, 10.1 +/- 3.2 units of RBC products were used in 34 patients. In the autologous transfusion group, 7.5 +/- 2.6 units of RBC products were transfused in 21 patients. And this difference in RBC produce usage was significantly different (P < 0.05). The amount of postoperative wound drainage in the two groups was comparable. CONCLUSIONS: ANH could reduce the reqirement for homologous transfusion in revision total hip arthroplasty.