ABSTRACT
The efficacy of predeposited autologous blood transfusion (PABT) with and without intra/postoperative blood salvage to reduce or eliminate the need for homologous blood transfusion (HBT) in primary total hip or knee replacement surgery was investigated by retrospective and prospective studies. Depending on the type of surgery, one to three units of PABT eliminated the need for HBT in 50 to 78% of patients, but, intra/postoperative blood salvage alone reduced the need only in 11 to 29%. In contrast, blood salvage, when combined with three units of PABT, eliminated the need for HBT in all patients undergoing primary joint replacement surgery. A cost comparison analysis showed that blood salvage was more expensive than PABT, and therefore it should be limited to patients who had predeposited fewer than three units of autologous blood.
Subject(s)
Blood Transfusion, Autologous , Hip Prosthesis , Knee Prosthesis , Adult , Aged , Aged, 80 and over , Blood Loss, Surgical , Blood Transfusion/economics , Blood Transfusion/statistics & numerical data , Blood Transfusion, Autologous/economics , Blood Transfusion, Autologous/methods , Blood Transfusion, Autologous/statistics & numerical data , Cementation , Costs and Cost Analysis , Elective Surgical Procedures , Female , Humans , Intraoperative Care , Male , Middle Aged , Postoperative Care , Prospective Studies , Retrospective StudiesABSTRACT
We have measured levels of contaminants (products of cell lysis and other substances) in blood salvaged from patients undergoing primary cemented total hip replacement. Washing of this blood removed an average of 91.4% of the free haemoglobin mass, reduced white cell lysozyme concentrations by 86% and almost totally eliminated fats and particulate matter. Osmotic fragility was significantly improved by washing although not to control levels.
Subject(s)
Blood Transfusion, Autologous/methods , Blood , Bone Cements/therapeutic use , Hip Prosthesis , Anticoagulants , Blood Loss, Surgical , Blood Physiological Phenomena , Centrifugation , Cholesterol/blood , Filtration , Hemoglobins/analysis , Humans , Muramidase/blood , Osmotic Fragility , Sodium Chloride , Triglycerides/bloodABSTRACT
Thirteen male patients were administered 20 mg of temazepam orally 1 to 2 h prior to undergoing spinal anaesthesia for a urological procedure. Samples of blood and CSF were drawn just before insertion of the spinal and the concentration of drug estimated in these two media. The results obtained indicated that a highly significant correlation existed between the unbound concentration of temazepam in plasma and the concentration of drug present in CSF. Temazepam appeared to be an effective light pre-medicant in all of the subjects studied.
