Abstract
The number of units and frequency of transfusion is decided by the anesthetist together with the physician performing the transfusion during the first examination, which should take place at least 40 days prior to the operation, according to the clinical condition of the patient (age, weight, basal hemoglobin, any concomitant diseases) and the type of operation and expected perioperative blood loss (1). A subtraction of 350 ± 10% ml of blood from a patient weighing about 70 kg means a reduction of around 1 g of hemoglobin (Hb) and 3 units of hematocrit (Ht). Before major orthopedic surgery enough units should be predeposited so as to avoid the use of homologous blood in more than 90% of patients. Two units of autologous blood are generally needed for total knee and hip arthroplasty and spine fusion, and 3-4 units for partial or total knee or hip revision.
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References
Borghi B, Bassi A, de Simone N, Laguardia AM, Formaro G (1993) Autotransfusion: 15 years experience at Rizzoh Orthopaedic Institute. Int J Artif Organs 16(S-5):241–246
Borghi B, Bassi A, Grazia M, Gargioni G, Pignotti E (1995) Anaesthesia and autologous transfusion. Int J Artif Orpns 18(3):159–166
National Resuree Education Program Coordinating Committee National Institute of Health (1989) Summary Report, Bethesda
Oriani G, Gaietta T, Meazza D, Ronzio A, Sacchi C (1990) Ematocrito di sicurezza in chirurgia ortopedico-traumatologica. Atti XX Corso Naz. di Aggiornamento in Rianimazione e Terapia intensiva. Ed Piccin, Padova, pp 19–27
Borghi B, Oriani G, Bassi A et al (1995) Blood saving program: a multicenter Italian experience. Int J Artif Organs 18(3):150–158
Bombardini T, Borghi B, Caroli GC et al (1994) Short term cardiac adaptation to normovolemic hemodilution in normal and hypertensive patients. An echocardiography study. Eur Heart J 15:637–640
Vara-Thorbeck R, Rossel Pradas J, Mekinassi KL et al (1990) Prevention of thrombotic disease and post-transfusional complication using normovolemic hemodilution in arthroplasty surgery of the hip. Rev Chir Orthop 76(4):267–271
Bombardini T, Borghi B, Montebugnoli M, Picano E, Caroli GC (1995) Normovolemic hemodilution reduces fatal pulmonary embolism: following major orthopaedic surgery. J Vase Surg (in press)
Baron JF et al (1989) Hemodilution, autotransfusion, hemostase. Arnette, Paris, pp 396
Messmer K (1988) Haemodilution. Possibihties and safety aspects. Acta Anaesthesiol Scand Suppl 89:49–53
Duruble M (1988) Place de l’hemodiluition dans la prevention de la maladie thromboembolique. Phlebografie 41:825–829
Caroli GC et al (1994) Profilassi antitromboembolica e rischio emorragico in chirurgia ortopedica. Archivio di Ortopedia e Reumatologia 167(3): 125–130
Macouillard G et al (1989) Beneficies et risques des differentes methodes des prophylaxis avec ou sans heparinoides. Conferences de Consensus. Ann Fr Anesth Reanim 11:298–299
Cosmi B, Hirsh J (1994) Low molecular weight heparin. Curr Opin Cardiol 9(5):612–618
Hirsh J (1990) From unfractionated heparins to low molecular weight heparins. Acta Chir Scand Suppl 556:42–50
Patrignani P, Volpi D, Ferrario R et al (1990) Effects of racemic, S-and R-indobufen on cyclooxygenase and lipooxygenase activities in human whole blood. Eur J Pharmacol 20; 191(l):83–88
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© 1996 Springer-Verlag Italia, Milano
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Borghi, B., Montebugnoli, M., De Simone, N., Gargioni, G., Feoli, M.A. (1996). Transfusion and Thromboembolic Prophylaxis. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2203-4_78
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DOI: https://doi.org/10.1007/978-88-470-2203-4_78
Publisher Name: Springer, Milano
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