A blood-conservation algorithm to reduce blood transfusions after total hip and knee arthroplasty

The Journal of Bone and Joint Surgery. American Volume
Jeffery L PiersonDonald R Earles

Abstract

Donation of autologous blood before total joint arthroplasty is inconvenient and costly, causes a phlebotomy-induced anemia, and may be wasteful and unnecessary for the nonanemic patient. We developed a blood-conservation algorithm that does not require predonation of autologous blood, employs selective use of epoetin alfa, and uses evidence-based transfusion criteria. Our hypothesis was that use of this algorithm would reduce the rate of transfusion after unilateral total hip and knee arthroplasty as compared with the rates described in previous reports. We retrospectively reviewed the records of 500 consecutive patients in whom unilateral primary total hip or knee arthroplasty had been performed by a single surgeon. The same blood-conservation algorithm was recommended to all patients. Two groups of patients were identified: the first group consisted of 433 patients in whom the algorithm was followed, and the second group consisted of sixty-seven patients in whom the algorithm was not followed. In the group in which the algorithm was followed, the rates of allogeneic transfusion after total knee and total hip arthroplasty were 1.4% (three of 220) and 2.8% (six of 213), respectively. The overall rate of transfusion in this gro...Continue Reading

References

Mar 1, 1992·Annals of Internal Medicine·H G WelchL T Goodnough
Feb 26, 1987·The New England Journal of Medicine·P T ToyL T Goodnough
Sep 1, 1995·Chest·H L CorwinA Gettinger
Mar 16, 1995·The New England Journal of Medicine·J EtchasonR Brook
Feb 1, 1996·Transfusion·G A NuttallS Bryant
Mar 1, 1996·American Journal of Surgery·N BlumbergJ M Heal
Aug 1, 1996·The Journal of Bone and Joint Surgery. American Volume·M J Lemos, W L Healy
Aug 26, 1998·Transfusion·S J LeeM Johannesson
Feb 11, 1999·The New England Journal of Medicine·L T GoodnoughJ P AuBuchon
Feb 11, 1999·The Journal of Bone and Joint Surgery. American Volume·B E BierbaumR B Welch
Feb 18, 1999·The New England Journal of Medicine·L T GoodnoughJ P AuBuchon
Jun 22, 2000·Anesthesiology·D R Spahn, M Casutt
Apr 12, 2001·Transfusion Medicine·B G FeaganA Kirkley
Oct 18, 2001·Current Opinion in Hematology·L T Goodnough
Aug 15, 2002·The Journal of Bone and Joint Surgery. American Volume·Dinna B BilloteRichard L Wixson
Sep 3, 2002·Journal of the Royal Society of Medicine·Francesco TorellaCharles N McCollum
Jan 21, 2003·The Journal of Bone and Joint Surgery. American Volume·Nizar N MahomedJohn A Baron
Mar 15, 2003·The Journal of Bone and Joint Surgery. American Volume·Gurdev S GillAtul B Joshi

❮ Previous
Next ❯

Citations

Oct 21, 2006·Current Opinion in Hematology·Aryeh Shander, Lawrence T Goodnough
Sep 28, 2007·Pharmacotherapy·Bradley A Boucher, Timothy J Hannon
Oct 6, 2011·Quality Management in Health Care·Anita MohandasCataldo Doria
Nov 28, 2013·Archives of Orthopaedic and Trauma Surgery·M C Struijk-MulderH B Ettema
Jul 29, 2015·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Young Gon NaTae Kyun Kim
May 14, 2016·Orthopedics·Nicholas FrischCraig D Silverton
Sep 7, 2016·Knee Surgery & Related Research·David LiuElaine Beller
Jun 8, 2006·The Journal of Bone and Joint Surgery. American Volume·Peter J MillettJon J P Warner
Aug 19, 2009·Annals of the Royal College of Surgeons of England·H BoralessaJ Grant-Casey
Jun 17, 2009·Archives of Orthopaedic and Trauma Surgery·Wieger Geert HorstmannCees C P M Verheyen
Jul 20, 2012·Advances in Orthopedics·Lawrence A DelasottaAlvin C Ong
Apr 18, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Tae Kyun KimSun Hyung Lee
Mar 12, 2019·Journal of Orthopaedic Surgery·Marta Santos SilvaJosé Costa E Castro
May 26, 2012·The Open Orthopaedics Journal·Lawrence A DelasottaAlvin Ong
Aug 22, 2014·The Journal of Bone and Joint Surgery. American Volume·Kyle R DuchmanJohn J Callaghan
Dec 18, 2015·Knee Surgery & Related Research·Jai-Gon SeoByung Hoon Lee
Aug 1, 2015·Revista Brasileira De Ortopedia·José Ricardo Negreiros VicenteAlberto Tesconi Croci
Oct 3, 2012·Orthopedics·Issaq AhmedPhilip Walmsley
Mar 12, 2017·Clinical Orthopaedics and Related Research·Sung Yup LeeTae Kyun Kim
Dec 20, 2014·Clinical Orthopaedics and Related Research·Chris A AnthonyCarolyn M Hettrich
Jan 26, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Saifudin RashiqBarry Finegan
Jul 29, 2015·Clinical Orthopaedics and Related Research·David C MarkelNicole M Zappa
Sep 21, 2010·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Hideyuki SasanumaYuichi Hoshino
Aug 12, 2014·Clinical Orthopaedics and Related Research·Hany BedairJoseph C McCarthy
May 27, 2014·The Journal of the American Academy of Orthopaedic Surgeons·Brett Russell LevineRachel M Frank
Feb 4, 2010·Clinical Orthopaedics and Related Research·Eun Seok SeoTae Kyun Kim
Apr 12, 2021·Archives of Orthopaedic and Trauma Surgery·Dietmar KrappingerThomas Freude
Nov 24, 2004·Journal of the American College of Surgeons·John E McDermott
Jul 2, 2005·The Journal of Arthroplasty·John J CallaghanSteve S Liu
Aug 1, 2006·Neurosurgery Clinics of North America·R Shay Bess, Lawrence G Lenke
Aug 29, 2021·Journal of Orthopaedic Surgery and Research·Viju Daniel VargheseSuzanne Edwards
Oct 25, 2011·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Marco PavesiFilippo Randelli
Nov 8, 2011·The Journal of Arthroplasty·Mickey F PlymaleSun J Kim

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.