Caruso James P, Pernik Mark N, Johnson Zachary D, El Ahmadieh Tarek Y, Ogunnaike Babatunde, Adogwa Owoicho, Aoun Salah G, Bagley Carlos A
Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, United States.
Department of Anesthesia and Pain Management, University of Texas Southwestern, Dallas, Texas, United States.
Surg Neurol Int. 2021 Oct 11;12:515. doi: 10.25259/SNI_901_2021. eCollection 2021.
Complex spine surgery predisposes patients to substantial levels of blood loss, which can increase the risk of surgical morbidity and mortality.
A 29-year-old achondroplastic male required thoracolumbar deformity correction. However, he refused potential allogeneic blood transfusions for religious reasons. He, therefore, underwent pre-operative autologous blood donation and consented to the use of the intraoperative cell salvage device. Immediately prior to the incision, he underwent acute normovolemic hemodilution. Throughout the case, we additionally utilized meticulous hemostasis. Postoperatively, he was supplemented with iron and erythropoietin and recovered well. When he required a revision procedure 3 months later, similar strategies were successfully employed.
Numerous strategies exist pre-operatively, intraoperatively, and post-operatively to optimize blood loss management for patients who refuse blood transfusions but warrant major spinal deformity surgery.
复杂脊柱手术使患者面临大量失血风险，这会增加手术并发症和死亡率。
一名29岁的软骨发育不全男性需要进行胸腰椎畸形矫正。然而，出于宗教原因，他拒绝接受潜在的异体输血。因此，他在术前进行了自体献血，并同意使用术中细胞回收装置。在即将切开之前，他接受了急性等容血液稀释。在整个手术过程中，我们还采用了细致的止血措施。术后，他接受了铁剂和促红细胞生成素补充治疗，恢复良好。3个月后他需要进行翻修手术时，同样的策略也成功应用。
对于拒绝输血但需要进行严重脊柱畸形手术的患者，术前、术中和术后存在多种策略来优化失血管理。
