Cieliński Łukasz, Kusz Damian, Hajduk Grzegorz, Wojciechowski Piotr, Igielski Michał, Gebuś Mateusz, Kusz Błazej
Department and Chair of Orthopaedic and Traumatology Medical University of Silesia, Katowice.
Ortop Traumatol Rehabil. 2010 Mar-Apr;12(2):144-54.
Total knee arthroplasty is associated with a perioperative blood loss, which is usually addressed with transfusion of allogenic blood. The possible risks of such treatment include viral infection, immunologic complications and occasional lack of blood products. Recently, retransfusion of blood recovered from the operative field or drains has become an effective treatment for blood loss. The purpose of this study was to evaluate the clinical usefulness of autologous transfusion of blood recovered from drains and to determine if the retransfusion alone is sufficient for treatment of the perioperative blood loss.
A retrospective evaluation of 214 patients (240 knees) was performed. Standard suction drains were used in 127 cases, whereas in 113 cases we used the HandyVac retransfusion system. The comparative analysis included the preoperative haemoglobin level, surgery time, length of hospitalisation, incidence of fever and demand for allogenic blood transfusion.
Retransfusion of blood from drains decreased the incidence of allogenic transfusion from 69.3% to 43.4%. The global demand for blood products was reduced by 42%. The use of retransfusion kits did not increase surgery time. In the retransfusion group, the incidence of elevated body temperature and number of days with fever per one patient were higher than in the allogenic transfusion group.
Retransfusion of shed blood from drains decreases the demand for allogenic blood. However, it does not eliminate the need for transfusion. The method is simple and relatively safe. It does not increase surgery time. No serious adverse effects were noted apart from elevated body temperature. A low preoperative haemoglobin level was a risk factor for additional allogenic transfusions in patients who have received retransfusion.
全膝关节置换术与围手术期失血有关,通常通过输注异体血来解决。这种治疗的潜在风险包括病毒感染、免疫并发症以及偶尔出现的血制品短缺。最近,回输从手术区域或引流管回收的血液已成为治疗失血的有效方法。本研究的目的是评估引流管回收血自体输血的临床实用性,并确定单纯回输是否足以治疗围手术期失血。
对214例患者(240个膝关节)进行回顾性评估。127例使用标准吸引引流管,而113例使用HandyVac回输系统。比较分析包括术前血红蛋白水平、手术时间、住院时间、发热发生率和异体输血需求。
引流管血液回输使异体输血发生率从69.3%降至43.4%。血液制品的总体需求减少了42%。使用回输套件并未增加手术时间。在回输组中,体温升高的发生率和每位患者发热天数高于异体输血组。
引流管回收血回输减少了异体血的需求。然而,它并不能消除输血的必要性。该方法简单且相对安全。它不会增加手术时间。除体温升高外,未观察到严重不良反应。术前血红蛋白水平低是接受回输患者额外异体输血的一个危险因素。