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Blood transfusion orthopedic

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https://www.readbyqxmd.com/read/28657766/a-suspected-delayed-hemolytic-transfusion-reaction-mediated-by-anti-joa
#1
Ryan P Jajosky, Wendy C Lumm, Scott C Wise, Roni J Bollag, James F Shikle
A 32-year-old African-American woman with a history of sickle cell disease presented for surgical evaluation of left total hip arthroplasty due to avascular necrosis of the femoral head. In anticipation of a complex orthopedic procedure, pre-surgical blood work was ordered. The patient's Fenwal blood sample typed as group O, D+. Although the patient had a history of anti-Fya, the antibody identification was inconclusive, so the workup was sent to a reference laboratory. The patient was last transfused with red blood cells (RBCs) 2 years earlier, but had no history of transfusion reactions...
June 2017: Immunohematology
https://www.readbyqxmd.com/read/28650949/efficacy-and-safety-of-tranexamic-acid-in-orthopedic-fracture-surgery-a-meta-analysis-and-systematic-literature-review
#2
Kamil Amer, Saqib Rehman, Christopher Haydel
BACKGROUND: Tranexamic acid (TXA) is an anti-fibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopedic surgeries. However, the effectiveness of TXA use in orthopedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs...
June 12, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28606258/-meta-analysis-of-the-efficacy-and-safety-of-drainage-after-total-hip-arthroplasty
#3
N Hou, F Jing, W Rong, D W He, J J Zhu, L Fang, C J Sun
Objective: To determine whether suction drainage is safe and effective compared with no-drainage in total hip arthroplasty. Methods: The research was based on PubMed, MEDLINE, EMBASE, Highwire, the Cochrane Library, CBM, CNKI, VIP and WFSD.The data were analysed using RevMan 5.2.Twenty-seven randomised controlled trials involving 3 603 hips were included in the analysis. Results: The meta-analysis indicate that suction drainage increases the rate of homologous blood transfusion (OR=1.98, 95%CI: 1.49-2.64, P<0...
June 6, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28588645/predisposing-factors-for-recurrence-of-chronic-posttraumatic-osteomyelitis-a-retrospective-observational-cohort-study-from-a-tertiary-referral-center-in-brazil
#4
Luciana Souza Jorge, Alceu G Chueire, Patricia Silva Fucuta, Mauricio N Machado, Maria Gabriele L Oliveira, Marcelo A Nakazone, Mauro José Salles
BACKGROUND: The incidence of posttraumatic osteomyelitis (PTO) is increasing despite new treatment strategies. Assessment of patients' outcomes following PTO is challenging due to multiple variables. The study goals are to determine the frequency of recurrence following PTO treatment and identify factors predisposing patients to treatment failure. METHODS: Between August 01, 2007 to August 30, 2012, a single-center retrospective cohort study was performed among 193 patients diagnosed with PTO following orthopedic surgery for fracture care...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28558843/the-effectiveness-of-a-de-implementation-strategy-to-reduce-low-value-blood-management-techniques-in-primary-hip-and-knee-arthroplasty-a-pragmatic-cluster-randomized-controlled-trial
#5
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Stefanie N Hofstede, Cynthia So-Osman, M Elske van den Akker-van Marle, Ad A Kaptein, Theo Stijnen, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
BACKGROUND: Perioperative autologous blood salvage and preoperative erythropoietin are not (cost) effective to reduce allogeneic transfusion in primary hip and knee arthroplasty, but are still used. This study aimed to evaluate the effectiveness of a theoretically informed multifaceted strategy to de-implement these low-value blood management techniques. METHODS: Twenty-one Dutch hospitals participated in this pragmatic cluster-randomized trial. At baseline, data were gathered for 924 patients from 10 intervention and 1040 patients from 11 control hospitals undergoing hip or knee arthroplasty...
May 30, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28514321/patient-blood-management-in-major-orthopedic-surgery-less-erythropoietin-and-more-iron
#6
Emmanuel Rineau, Alexandra Stoyanov, Emmanuel Samson, Laurent Hubert, Sigismond Lasocki
Erythropoietin (EPO) is proposed preoperatively to reduce blood transfusion in anemic patients (hemoglobin < 13 g/dL) scheduled for a major orthopedic surgery. New intravenous iron formulations allow infusion of higher doses, increasing EPO response. In that context, we evaluated in a before-after study (n = 62 and 65 patients for each period) a new EPO administration protocol (2 injections 4 and 3 weeks before surgery, and a third if hemoglobin <13 g/dL instead of <15 g/dL 2 weeks before surgery)...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28394747/risk-and-protective-factors-associated-with-surgical-infections-among-spine-patients
#7
REVIEW
Alyssa G Blood, Melanie F Sandoval, Evalina Burger, Katherine Halverson-Carpenter
BACKGROUND: The purpose of the study was to identify patient-specific and procedure-specific risk and protective factors associated with post-operative surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL, PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the past 10 years (January 2003-March 2015). The keywords and combinations used in the search included: Spine surgery, post-operative infection, risk factors, orthopedic infections...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28367018/blood-transfusion-practices-in-a-tertiary-care-center-in-northern-india
#8
Sonam Kumari
BACKGROUND: Blood transfusion plays vital roles in the medical and surgical practice. To achieve optimum use of blood, transfusion has to be appropriate and judicious consuming minimal resources and manpower. OBJECTIVE: To evaluate the pattern of blood transfusion requests and utilization with the aim of determining transfusion practice. MATERIALS AND METHODS: Blood request forms and cross-match worksheets at the blood bank were analyzed over a 6-month period...
April 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28336035/effect-of-tranexamic-acid-on-transfusion-rates-following-total-joint-arthroplasty-a-cost-and-comparative-effectiveness-analysis
#9
Perry J Evangelista, Michael W Aversano, Emmanuel Koli, Lorraine Hutzler, Ifeoma Inneh, Joseph Bosco, Richard Iorio
Tranexamic acid (TXA) is used to reduce blood loss in orthopedic total joint arthroplasty (TJA). This study evaluates the effectiveness of TXA in reducing transfusions and hospital cost in TJA. Participants undergoing elective TJA were stratified into 2 cohorts: those not receiving and those receiving intravenous TXA. TXA decreased total hip arthroplasty (THA) transfusions from 22.7% to 11.9%, and total knee arthroplasty (TKA) from 19.4% to 7.0%. The average direct hospital cost reduction for THA and TKA was $3083 and $2582, respectively...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28260430/anesthetic-and-perioperative-management-of-nontransplant-surgery-in-patients-after-liver-transplant
#10
Zeynep Ersoy, Asude Ayhan, Aycan Ozdemirkan, Gulsi Gulsah Polat, Pinar Zeyneloglu, Gulnaz Arslan, Mehmet Haberal
OBJECTIVES: We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. MATERIALS AND METHODS: We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Başkent University Hospital. RESULTS: The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28235532/massive-blood-loss-in-elective-spinal-and-orthopedic-surgery-retrospective-review-of-intraoperative-transfusion-strategy
#11
Demicha Rankin, Alix Zuleta-Alarcon, Suren Soghomonyan, Mahmoud Abdel-Rasoul, Karina Castellon-Larios, Sergio D Bergese
OBJECTIVE: To evaluate the perioperative dynamics of hematologic changes and transfusion ratio in patients undergoing a major spinal surgery accompanied with massive bleeding defined as blood loss >5 liters. DESIGN: Retrospective cohort study. SETTING: Operating room of a university-affiliated hospital. PATIENTS: Adult patients who underwent elective neurosurgical, orthopedic, or combined spinal surgical procedure between 2008 and 2012...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28187076/nutritional-status-as-an-adjunct-risk-factor-for-early-postoperative-complications-following-posterior-cervical-fusion
#12
Nathan J Lee, Parth Kothari, Jun S Kim, Kevin Phan, John Di Capua, John Shin, Samuel K Cho
STUDY DESIGN: Retrospective study on prospectively collected data. OBJECTIVE: To study the impact of nutritional status, as measured by serum albumin level, on patient outcomes following posterior cervical fusion (PCF) surgery. SUMMARY OF BACKGROUND DATA: Malnutrition is a potential modifiable risk factor that has garnered an increasing amount attention within orthopedics in recent years. There is evidence to suggest the role of nutritional status in lumbar and ACDF surgery, yet the data for PCF is still lacking...
February 9, 2017: Spine
https://www.readbyqxmd.com/read/28183556/blood-loss-and-transfusion-requirements-with-epsilon-aminocaproic-acid-use-during-cranial-vault-reconstruction-surgery
#13
Mark E Thompson, Charles Saadeh, Phillip Watkins, Laszlo Nagy, Joshua Demke
OBJECTIVE: To determine whether epsilon-aminocaproic acid (EACA) load of 50 mg∙kg(-1) before skin incision, and infusion of 25 mg∙kg(-1)∙h(-1) until skin closure during cranial vault reconstruction (CVR) were associated with decreased estimated blood loss and transfusion requirements. BACKGROUND: Antifibrinolytic medications decrease bleeding and transfusion requirements during cardiothoracic and orthopedic surgeries with high blood loss, but practical reductions in blood loss and transfusion requirements have not been consistently realized in children undergoing CVR...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28145024/psychopharmacologic-treatment-and-blood-transfusion-in-fast-track-total-hip-and-knee-arthroplasty
#14
MULTICENTER STUDY
Silas Hinsch Gylvin, Christoffer Calov Jørgensen, Anders Fink-Jensen, Pär I Johansson, Henrik Kehlet
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) and other psychotropics are receiving increasing attention due to reports on inhibition of thrombocyte function and an increased bleeding risk in surgical settings. Studies in total hip and total knee arthroplasty (THA and TKA, respectively) have shown conflicting results, questioning whether the potential increased bleeding risk is of clinical importance. STUDY DESIGN AND METHODS: Prospective consecutive collection of data on preoperative comorbidity in patients undergoing primary unilateral THA or TKA was cross-referenced with regional transfusion databases and The Danish National Database of Reimbursed Prescriptions for information regarding blood transfusions and psychopharmacologic treatment...
April 2017: Transfusion
https://www.readbyqxmd.com/read/27871515/perioperative-antiplatelet-therapy-and-cardiovascular-outcomes-in-patients-undergoing-joint-and-spine-surgery
#15
Nathaniel R Smilowitz, Brandon S Oberweis, Swetha Nukala, Andrew Rosenberg, Steven Stuchin, Richard Iorio, Thomas Errico, Martha J Radford, Jeffrey S Berger
STUDY OBJECTIVE: Perioperative thrombotic complications after orthopedic surgery are associated with significant morbidity and mortality. The use of aspirin to reduce perioperative cardiovascular complications in certain high-risk cohorts remains controversial. Few studies have addressed aspirin use, bleeding, and cardiovascular outcomes among high-risk patients undergoing joint and spine surgery. DESIGN/SETTING/PATIENTS: We performed a retrospective comparison of adults undergoing knee, hip, or spine surgery at a tertiary care center during 2 periods between November 2008 and December 2009 (reference period) and between April 2013 and December 2013 (contemporary period)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27783839/intraoperative-hypothermia-in-total-hip-and-knee-arthroplasty
#16
Nicholas B Frisch, Andrew M Pepper, Edward Rooney, Craig Silverton
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes...
January 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27779977/anticipated-transfusion-requirements-and-mortality-in-patients-with-orthopedic-and-solid-organ-injuries
#17
COMPARATIVE STUDY
Devon S Callahan, Zane Ashman, Dennis Y Kim, David S Plurad
Long bone fractures are cited as an etiology for significant blood loss; however, there is scant supporting literature. We examined the relationship between long bone fractures, blood transfusions, and solid organ injuries. We hypothesize that transfusions are rare with long bone fractures in the absence of a liver or splenic injury. We performed a retrospective analysis of patients admitted with femur, tibia, and humerus fractures. Outcomes included transfusion requirements and mortality. A total of 1837 patients were included...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27761223/topical-versus-intravenous-administration-of-tranexamic-acid-in-primary-total-hip-arthroplasty-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Sammy A Hanna, Anoop Prasad, Joshua Lee, Pramod Achan
Tranexamic acid (TA) is widely used by orthopedic surgeons to decrease blood loss and the need for transfusion following total hip arthroplasty (THA). Although both intravenous and topical applications are described in the literature, there remains no consensus regarding the optimal regimen, dosage and method of delivery of TA during THA. In addition, concerns still exist regarding the risk of thromboembolic events with intravenous administration. The purpose of this meta-analysis was to compare the efficacy and safety of topical versus intravenous administration of TA in THA...
September 19, 2016: Orthopedic Reviews
https://www.readbyqxmd.com/read/27732721/clinical-practice-guidelines-from-the-aabb-red-blood-cell-transfusion-thresholds-and-storage
#19
Jeffrey L Carson, Gordon Guyatt, Nancy M Heddle, Brenda J Grossman, Claudia S Cohn, Mark K Fung, Terry Gernsheimer, John B Holcomb, Lewis J Kaplan, Louis M Katz, Nikki Peterson, Glenn Ramsey, Sunil V Rao, John D Roback, Aryeh Shander, Aaron A R Tobian
Importance: More than 100 million units of blood are collected worldwide each year, yet the indication for red blood cell (RBC) transfusion and the optimal length of RBC storage prior to transfusion are uncertain. Objective: To provide recommendations for the target hemoglobin level for RBC transfusion among hospitalized adult patients who are hemodynamically stable and the length of time RBCs should be stored prior to transfusion. Evidence Review: Reference librarians conducted a literature search for randomized clinical trials (RCTs) evaluating hemoglobin thresholds for RBC transfusion (1950-May 2016) and RBC storage duration (1948-May 2016) without language restrictions...
November 15, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27716330/survival-rate-and-perioperative-data-of-patients-who-have-undergone-hemipelvectomy-a-retrospective-case-series
#20
Alfredo Guilherme Haack Couto, Bruno Araújo, Roberto André Torres de Vasconcelos, Marcos José Renni, Clóvis Orlando Da Fonseca, Ismar Lima Cavalcanti
BACKGROUND: Hemipelvectomy is a major orthopedic surgical procedure indicated in specific situations. Although many studies discuss surgical techniques for hemipelvectomy, few studies have presented survival data, especially in underdeveloped countries. Additionally, there is limited information on anesthesia for orthopedic oncologic surgeries. The primary aim of this study was to determine the survival rate after hemipelvectomy, and the secondary aims were to evaluate anesthesia and perioperative care associated with hemipelvectomy and determine the influence of the surgical technique (external hemipelvectomy [amputation] or internal hemipelvectomy [limb sparing surgery]) on anesthesia and perioperative care in Brazil...
October 7, 2016: World Journal of Surgical Oncology
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