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Hidden blood loss

Longfei Wen, Daxiang Jin, Weixing Xie, Yue Li, Weijian Chen, Jinyong Ding, Jixi Xu, Dongcheng Ren
STUDY DESIGN: Descriptive study. OBJECTIVES: This study aimed to evaluate the hidden blood loss (HBL) of patients who underwent lumbar fusion surgery for degenerative spine and to analyze its risk factors. SUMMARY OF BACKGROUND DATA: When planning transfusion strategies, blood loss calculation is important. However, in clinical practice, spine surgeons usually ignore the possibility that a large amount of HBL may occur after lumbar fusion surgery...
March 9, 2018: Clinical Spine Surgery
Zi-Jian Li, Min-Wei Zhao, Lin Zeng
Background: Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Our previous study suggested that about two-thirds of the total blood loss (TBL) came from hidden blood loss (HBL) on postoperative days 1 and 2...
March 20, 2018: Chinese Medical Journal
Guorui Cao, Zeyu Huang, Jinwei Xie, Qiang Huang, Bin Xu, ShaoYun Zhang, FuXing Pei
BACKGROUND: The purpose of this study was to determine whether the administration of multiple boluses of oral and intravenous tranexamic acid (TXA) postoperatively was equivalent in reducing blood loss in primary THA. METHODS: A total of 108 patients were randomized into two groups: oral TXA group (54 patients receiving 1 dose of 20 mg/kg intravenous TXA 5-10 min before skin incision and 3 doses of 2 g oral TXA 4 h, 10 h and 16 h postoperatively) and intravenous TXA group (54 patients receiving 1 dose of 20 mg/kg intravenous TXA 5-10 min before skin incision and 3 doses of 1 g intravenous TXA 6 h, 12 h and 18 h postoperatively)...
February 15, 2018: Thrombosis Research
Bohua Li, Jun Li, Shanxi Wang, Lei Liu
The purpose of this study was to quantify the peri-operative blood loss of elderly patients with intertrochanteric fractures treated by unreamed proximal femoral nail anti-rotation (PFNA) and analyze whether the substantial hidden blood loss was induced by initial trauma or the operation. The clinical data of 123 patients with intertrochanteric fracture treated with unreamed PFNA from Jan 2013 to Apr 2017 were analyzed retrospectively. Blood routine on admission day (ADM), pre-operative day one (PRE), post-operative days one and three (POD1 and POD3) and the visible blood loss (VBL) were obtained...
February 19, 2018: Scientific Reports
Zhan-Feng Zhang, Ji-Kang Min, Dan Wang, Jian-Ming Zhong, Heng Li
OBJECTIVE: To calculate the volume of occult blood loss after unicompartment knee arthroplasty(UKA), and analyze its influential factors by comparing with total knee arthroplasty. METHODS: A retrospective study of 130 cases from July 2012 to July 2015 were enrolled, of which and 65 cases were UKA, and 65 cases were TKA. In UKA group there were 27 males and 38 females, and the mean age was (62.3±4.3) years old (ranged, 50 to 82 years old). There were 14 cases older than 70 years old, while 51 cases among 50 to 70 years old...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
K N Subramanyam, P Khanchandani, P V Tulajaprasad, J Jaipuria, A V Mundargi
AIMS: The aims of this study were to compare the efficacy and safety of intra-articular and intravenous (IV) tranexamic acid (TXA) in controlling perioperative blood loss in total knee arthroplasty (TKA) using a randomized, double-blinded equivalence trial. PATIENTS AND METHODS: A total of 182 patients aged between 45 and 75 years undergoing unilateral TKA at a tertiary centre were randomized to receive TXA, either 1.5 g intra-articularly after closure of the wound (n = 91) or two doses of 10 mg/kg IV (n = 91)...
February 2018: Bone & Joint Journal
Shuwei Tian, Zheyuan Shen, Yang Liu, Yanlong Zhang, Aqin Peng
OBJECTIVE: To investigate the effect of tranexamic acid (TXA) on hidden bleeding in older intertrochanteric fracture patients treated with intramedullary nails. METHOD: Between January 2016 and January 2017, 100 cases of intertrochanteric fractures eligible for the study were treated with proximal femoral nail antirotation (PFNA) in our hospital. All patients were divided into two groups of 50 patients each: the TXA group and a blank control group. In the TXA group, all patients received TXA at a dose of 10 mg/kg-1 intravenously, 10 min preoperatively and 5 h postoperatively...
February 2, 2018: Injury
Jefferson George, Krishna Kiran Eachempati, Koushik Narayan Subramanyam, A V Gurava Reddy
BACKGROUND: Total Knee Arthroplasty (TKA) can be associated with significant perioperative blood loss and blood transfusions. This is a prospective randomised non-inferiority trial comparing intraarticular (IA) and intravenous (IV) routes of administering Tranexamic acid (TXA) with regard to efficacy and safety. METHODS: A total of 113 patients who underwent primary unilateral TKA from January to June 2017 randomly received either 1.5g TXA in 100mL normal saline solution (IA group, n=58) or 10mg/kg TXA (IV group, n=55) at 10min before the tourniquet inflation and at tourniquet release...
January 14, 2018: Knee
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
D V Chugaev, N N Kornilov, S A Lasunskii
THE HYPOTHESIS OF THE STUDY: The use of bidirectional knotless barbed sutures for closure of capsule and subcutaneous fat tissue in primary total knee arthroplasty (TKA) is safe and time-saving. MATERIAL AND METHODS: 302 patients with end-stage osteoarthritis scheduled for primary non-complex TKA were randomly divided into two prospective groups: in group I (N=102) the capsule of the knee joint and subcutaneous fat tissues were closed by continuous braided suture while in group II (N=200) by bidirectional knotless barbed sutures...
2017: Khirurgiia
Zhirui Li, Daohong Liu, Gong Long, Gong Ke, An Xiao, Peifu Tang, Jiyuan Dong
Obesity not only gives rise to more blood loss volume but also correlates with postoperative rehabilitation and complications in surgical patients. It is not clear at present whether tourniquet utilization is associated with blood loss, rehabilitation, and complications, and it is imperative to ascertain the tactics of utilizing tourniquet in obese patients undergoing total knee arthroplasty (TKA). The present study was designed to explore the association of tourniquet utilization with blood loss, rehabilitation, and complications, and ascertain the tactics of utilizing tourniquet in obese patients undergoing TKA...
December 2017: Medicine (Baltimore)
Wentao Wang, Kun Duan, Minjie Ma, Yong Jiang, Tuanjiang Liu, Jijun Liu, Dingjun Hao
STUDY DESIGN: A randomized, double-blind, placebo-controlled clinical trial OBJECTIVE.: To evaluate the efficacy and safety of tranexamic acid (TXA) administered during the surgical correction of thoracolumbar fracture-dislocation SUMMARY OF BACKGROUND DATA.: Thoracolumbar fracture-dislocation surgery is generally associated with substantial blood loss and a high risk of deep vein thrombosis (DVT). TXA has been shown to improve hemostasis in surgical procedures. METHODS: We investigated 80 patients with thoracolumbar fracture-dislocation who underwent transforaminal thoracic interbody fusion (TTIF) between March 2014 and December 2016...
November 17, 2017: Spine
Guo-Liang Wu, Ji-Liang Zhai, Bin Feng, Yan-Yan Bian, Chi Xu, Xi-Sheng Weng
OBJECTIVE: To report the results of mid-term to long-term follow-up after primary total hip arthroplasty (THA) in hemophiliacs and to hypothesize that THA can provide satisfactory outcomes in these patients. METHODS: Twenty-four primary THA performed in 21 hemophilia patients between 2002 and 2012 were reviewed retrospectively, including 20 cases of hemophilia A and 1 case of hemophilia B. The standard lateral approach was used for all implantations. Substitution therapy for factor VIII and activated prothrombin complex concentrates were administered to patients with hemophilia A and B, respectively...
November 2017: Orthopaedic Surgery
Y Li, M Lu, H Tian, Z J Li, K Zhang
Objective: To explore the influences on peri-operative blood loss and postoperative blood transfusion in primary total knee arthroplasty when using different methods to release the pneumatic tourniquet. Methods: From January 2015 to December 2016, 484 patients with osteoarthritis were enrolled, undergoing primary unilateral total knee arthroplasty in the Orthopedics Department of Peking University Third Hospital. Retrospective data was used, and all the patients had been operated on by three independent working groups...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
J Xie, Q Hu, J Ma, Q Huang, F Pei
AIMS: The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA). PATIENTS AND METHODS: A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C)...
November 2017: Bone & Joint Journal
Chao Zhang, Heng-Wei Fan, Wan-Wan Yi, Zhi-Qiang Zheng
INTRODUCTION: Laparoscopy-assisted gastrectomy (LAG) is a minimally invasive procedure for the treatment of gastric cancer. It is generally thought that a minimally invasive technique results in less visible blood loss during the surgery. Nevertheless, a meaningful perioperative hidden blood loss (HBL) is often ignored. In this study, we investigated the amount of HBL and the influential factors after LAG for gastric cancer. METHODS: A retrospectively analyzed clinical data of 62 consecutive patients who underwent laparoscopy-assisted total or distal gastrectomy at our center from May 2016 to May 2017...
October 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Longfei Wen, Daxiang Jin, Weixing Xie, Yue Li, Weijian Chen, Shuncong Zhang, Xiaobing Jiang
STUDY DESIGN: a retrospective study. OBJECTIVES: Anterior cervical fusion surgery is widely used procedure in cervical spondylosis. When considering the blood re-infusion strategies of cervical fusion surgery, the amount of blood loss is one of the key element. We usually calculate the blood loss according to the surgical bleeding plus the postoperative drainage; however, it ignored the possibility that there may be a partly amount of hidden blood loss. METHODS: We performed a retrospective study to determine the risk factors for HBL in patients underwent anterior cervical fusion surgery for degenerative spine from 2013 to 2016...
October 17, 2017: World Neurosurgery
Zhinan Ren, Shugang Li, Lin Sheng, Qianyu Zhuang, Zheng Li, Derong Xu, Xin Chen, Pengxiang Jiang, Xiao Zhang
In spinal fusion surgery, total blood loss (TBL) is composed of visible blood loss from the surgical field and wound drainage, and hidden blood loss (HBL). Until now, no published studies exist reporting the effect of topical use of tranexamic acid (tTXA) on HBL in patients undergoing posterior lumbar spinal fusion surgery. This study aimed to explore the effect of tTXA on HBL during primary posterior lumbar spinal fusion surgery. Between September 2014 and September 2016, 100 adult patients (age > 18 years) with lumbar disc herniation or lumbar spinal stenosis undergoing primary posterior lumbar instrumented spinal fusions at 1 institution were divided into tTXA and control groups...
October 2017: Medicine (Baltimore)
Hassan A Al-Jafar
INTRODUCTION: Anemia is a condition, in which the number of red blood cells (RBC) and the hemoglobin (Hb) is insufficient to meet the body's physiologic needs. Hypoferritinemia without anemia (HWA) could cause masked clinical manifestations as general weakness, easy fatigability, depressed mode, and hair loss but with normal complete blood count (CBC) parameters. HWA is deferent from iron deficiency anemia (IDA) because there is no reduction in the RBC, Hb, or any of the other parameters of the CBC...
January 2017: Journal of Family Medicine and Primary Care
J Lošťák, J Gallo, M Večeřa, J Špička, K Langová
PURPOSE OF THE STUDY The primary aim of our study was to identify the effects of local application of tranexamic acid (TXA, Exacyl) on the amount of postoperative blood loss and blood transfusion requirement in primary total hip arthroplasty. We also recorded the levels of postoperative haemoglobin and its drop in early period after surgery. In each patient, we monitored in detail the incidence of early complications (haematoma, wound exudate). Lastly, the economic aspect of TXA administration was also taken into account...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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