An Analysis for Blood Transfusion in Revision Total Hip Arthroplasty. |
Sung Eun Sim, Jeong Hwan Ahn, Young Jin Roh, Sang Hwan Do, Sang Chul Lee |
Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea. shdo@snu.ac.kr |
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Abstract |
BACKGROUND This study was performed to investigate the clinical usefulness of acute normovolemic hemodilution to reduce homologous transfusion in revision total hip arthroplasty. To avoid complications of homologous transfusion, many methods are being used in patients who undergo an operation, and autologous transfusion is the most popular modality. METHODS Fifty-five patients operated on for revision THRA were reviewed. In the hemodilution group (n = 21), 2-4 units of autologous blood were procured immediately after anesthetic induction while Ringer's lactate and 6% Haes-steril were infused to maintain normovolemia.
Differences in the amounts of transfusions and postoperative drainage were compared. Statistical analyses were performed by using the Student's t-test. RESULTS No significant differences were observed between groups in terms of preoperative hematocrit and hematocrit at postoperative 7 days. However, in the homologous transfusion group, 10.1 +/- 3.2 units of RBC products were used in 34 patients. In the autologous transfusion group, 7.5 +/- 2.6 units of RBC products were transfused in 21 patients. And this difference in RBC produce usage was significantly different (P < 0.05). The amount of postoperative wound drainage in the two groups was comparable. CONCLUSIONS ANH could reduce the reqirement for homologous transfusion in revision total hip arthroplasty. |
Key Words:
acute normovolemic hemodilution; autotransfusion; homotransfusion; induced hypotention; overtransfusion; revision total hip arthroplasty |
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