Blood-loss Management in Spine Surgery

The Journal of the American Academy of Orthopaedic Surgeons
Jesse E BibleMark A Knaub

Abstract

Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding. Conversely, the use of intraoperative blood salvage has come into question, both for its potential inability to reduce the need for allogeneic transfusions as well as its cost-effectiveness. Allogeneic blood transfusion is associated with elevated risks, including surgical site infection. Thus, desirable transfusion thresholds should remain restrictive.

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Citations

May 15, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Drew A Bednar
Jan 15, 2020·Global Spine Journal·Christopher MikhailSamuel K Cho
May 15, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Jesse E Bible
Aug 28, 2020·Anesthesia and Analgesia·Yuchen YuanYuguang Huang
Oct 21, 2020·Anesthesia and Analgesia·Yuchen YuanYuguang Huang
Jul 1, 2020·The Spine Journal : Official Journal of the North American Spine Society·Zach PenningtonDaniel M Sciubba
Dec 8, 2021·Minerva anestesiologica·Davide FurlanTiziana Bove
Dec 8, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Colby OitmentMark Pahuta

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