scholarly journals Modified Hidden Blood Loss Based on Drainage in Posterior Surgery on Lumbar Stenosis Syndrome with Rheumatoid Arthritis

2021 ◽  
Author(s):  
Shuai Xu ◽  
Fan‐qi Meng ◽  
Chen Guo ◽  
Yan Liang ◽  
Zhen‐qi Zhu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Loss ◽  
Lumbar Stenosis ◽  
Posterior Surgery ◽  
Hidden Blood Loss

Blood Loss of Posterior Lumbar Interbody Fusion on Lumbar Stenosis in Patients With Rheumatoid Arthritis

Spine ◽  
2019 ◽  
Vol 44 (17) ◽  
pp. E1045-E1052
Author(s):  
Shuai Xu ◽  
Yan Liang ◽  
Jing Wang ◽  
Guanjie Yu ◽  
Chen Guo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lumbar Stenosis

scholarly journals Multiple intravenous tranexamic acid doses in total knee arthroplasty in patients with rheumatoid arthritis: a randomized controlled study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Bing-xin Kang ◽  
Hui Xu ◽  
Chen-xin Gao ◽  
Sheng Zhong ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Randomized Controlled ◽  
Group A ◽  
Total Knee ◽  
Group B ◽  
D Dimer

Abstract Background We aimed to determine the efficacy and safety of multiple doses of intravenous tranexamic acid (IV-TXA) on perioperative blood loss in patients with rheumatoid arthritis (RA) who had undergone primary unilateral total knee arthroplasty (TKA). Methods For this single-center, single-blind randomized controlled clinical trial, 10 male and 87 female participants with RA, aged 50–75 years, who underwent unilateral primary TKA were recruited. The patients received one dose of 1 g IV-TXA 10 min before skin incision, followed by articular injection of 1.5 g tranexamic acid after cavity suture during the surgery. The patients were randomly assigned (1:1) into two groups and received an additional single dose of IV-TXA (1 g) for 3 h (group A) or three doses of IV-TXA (1 g) for 3, 6, and 12 h (group B) postoperatively. Primary outcomes were total blood loss (TBL), hidden blood loss (HBL), and maximum hemoglobin (Hb) level decrease. Secondary outcomes were transfusion rate and D-dimer levels. All parameters were measured postoperatively during inpatient hospital stay. Results The mean TBL, HBL, and maximum Hb level decrease in group B (506.1 ± 227.0 mL, 471.6 ± 224.0 mL, and 17.5 ± 7.7 g/L, respectively) were significantly lower than those in group A (608.8 ± 244.8 mL, P = 0.035; 574.0 ± 242.3 mL, P = 0.033; and 23.42 ± 9.2 g/L, P = 0.001, respectively). No episode of transfusion occurred. The D-dimer level was lower in group B than in group A on postoperative day 1 (P <  0.001), and the incidence of thromboembolic events was similar between the groups (P > 0.05). Conclusion In patients with RA, three doses of postoperative IV-TXA further facilitated HBL and Hb level decrease without increasing the incidence of adverse events in a short period after TKA. Trial registration The trial was registered in the Chinese Clinical Trial Registry (ChiCTR1900025013).

The hidden blood loss after hip fracture

Injury ◽  
2011 ◽  
Vol 42 (2) ◽  
pp. 133-135 ◽  
Author(s):  
G.H. Smith ◽  
J. Tsang ◽  
S.G. Molyneux ◽  
T.O. White
Keyword(s):  
Hip Fracture ◽  
Blood Loss ◽  
Hidden Blood Loss

Hidden Blood Loss In Adolescent Idiopathic Scoliosis Patients Undergoing Posterior Spinal Surgery

2021 ◽  
Author(s):  
Lipeng Wang ◽  
Jiangli Liu ◽  
Xiaoxiao Song ◽  
Xiaoping Gu ◽  
Yongquan Chen
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Spinal Surgery ◽  
Hidden Blood Loss

The efficacy and safety of topical tranexamic acid for spinal surgery: a meta-analysis

2021 ◽  
Vol 27 ◽  
Author(s):  
Tai Guo ◽  
Wenxia Xuan ◽  
Haoyu Feng ◽  
Junjie Wang ◽  
Xun Ma
Keyword(s):  
Blood Loss ◽  
Spinal Surgery ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Total Blood ◽  
Blood Content ◽  
Drainage Volume ◽  
Hidden Blood Loss ◽  
Postoperative Drainage

Background: Spinal surgeries are often accompanied by significant blood loss both intraoperatively and postoperatively. Excessive blood loss caused by surgery may lead to several harmful medical consequences. Tranexamic acid (TXA) is a kind of antifibrinolytic agent that has been widely used in spinal surgery. Currently, it is commonly accepted that intravenous TXA (ivTXA) can reduce blood loss in spinal fusion surgeries. Compared with ivTXA, topical TXA (tTXA) seems to be much easier to administer. This advantage provides a maximum concentration of TXA at the hemorrhagic site with little to no TXA entering the circulation. Objective: To evaluate the effect of tTXA on blood loss during and after spinal surgery via a comprehensive meta-analysis of the published data in randomized controlled trials (RCTs) and other comparative cohort studies. Methods: A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials were performed for RCTs and other comparative cohort studies on the effect of tTXA on blood loss during and after spinal surgery. The outcomes were total blood loss, hidden blood loss, intraoperative blood loss, total postoperative drainage volume, drainage tube duration postoperatively, drainage volume and drainage of blood content at postoperative day (POD) 1 and POD2, length of hospital stay, number of patients who received a blood transfusion, serum HB level at POD1, operative timespan, side effects, and complications. The final search was performed in October 2020. We followed the PRISMA guideline, and the registration number is INPLASY202160028. Results: In total, six studies with 481 patients were included. tTXA treatment, compared with the control conditions, can significantly reduce the total blood loss, hidden blood loss, total postoperative drainage volume, and several patients receiving blood transfusions; reduce the drainage volume and drainage of blood content at POD1; shorten the drainage tube duration postoperatively and length of hospital stay, and enhance the serum HB level at POD1 for spinal surgery. tTXA treatment did not significantly influence the intraoperative blood loss, drainage volume, or drainage of blood content at POD2 or the operative duration. Conclusion: Compared with control conditions, tTXA has high efficacy in reducing blood loss, and drainage volume enable quick rehabilitation and has a relatively high level of safety in spinal surgery.

Hidden blood loss during posterior spine fusion surgery

2013 ◽  
Vol 13 (8) ◽  
pp. 877-881 ◽  
Author(s):  
Yossi Smorgick ◽  
Kevin C. Baker ◽  
Casey C. Bachison ◽  
Harry N. Herkowitz ◽  
David M. Montgomery ◽  
...  
Keyword(s):  
Blood Loss ◽  
Spine Fusion ◽  
Fusion Surgery ◽  
Hidden Blood Loss ◽  
Posterior Spine

Endoscopic decompression for the treatment of lumbar spinal stenosis: an updated systematic review and meta-analysis

2021 ◽  
pp. 1-9
Author(s):  
Roberto J. Perez-Roman ◽  
Wendy Gaztanaga ◽  
Victor M. Lu ◽  
Michael Y. Wang
Keyword(s):  
Systematic Review ◽  
Back Pain ◽  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Meta Analysis ◽  
Lumbar Stenosis ◽  
Lumbar Spinal ◽  
Endoscopic Methods

OBJECTIVE Lumbar stenosis treatment has evolved with the introduction of minimally invasive surgery (MIS) techniques. Endoscopic methods take the concepts applied to MIS a step further, with multiple studies showing that endoscopic techniques have outcomes that are similar to those of more traditional approaches. The aim of this study was to perform an updated meta-analysis and systematic review of studies comparing the outcomes between endoscopic (uni- and biportal) and microscopic techniques for the treatment of lumbar stenosis. METHODS Following PRISMA guidelines, a systematic search was performed using the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Ovid Embase, and PubMed databases from their dates of inception to December 14, 2020. All identified articles were then systematically screened against the following inclusion criteria: 1) studies comparing endoscopic (either uniportal or biportal) with minimally invasive approaches, 2) patient age ≥ 18 years, and 3) diagnosis of lumbar spinal stenosis. Bias was assessed using quality assessment criteria and funnel plots. Meta-analysis using a random-effects model was used to synthesize the metadata. RESULTS From a total of 470 studies, 14 underwent full-text assessment. Of these 14 studies, 13 comparative studies were included for quantitative analysis, totaling 1406 procedures satisfying all criteria for selection. Regarding postoperative back pain, 9 studies showed that endoscopic methods resulted in significantly lower pain scores compared with MIS (mean difference [MD] −1.0, 95% CI −1.6 to −0.4, p < 0.01). The length of stay data were reported by 7 studies, with endoscopic methods associated with a significantly shorter length of stay versus the MIS technique (MD −2.1 days, 95% CI −2.7 to −1.4, p < 0.01). There was no significant difference with respect to leg visual analog scale scores, Oswestry Disability Index scores, blood loss, surgical time, and complications, and there were not any significant quality or bias concerns. CONCLUSIONS Both endoscopic and MIS techniques are safe and effective methods for treating patients with symptomatic lumbar stenosis. Patients who undergo endoscopic surgery seem to report less postoperative low-back pain and significantly reduced hospital stay with a trend toward less perioperative blood loss. Future large prospective randomized trials are needed to confirm the findings in this study.

Blood loss and knee function after unicompartment knee arthroplasty(UKA) without tourniquet

2020 ◽  
Author(s):  
Zhanfeng Zhang ◽  
Jianming Zhong ◽  
Jikang Min ◽  
Dan Wang ◽  
Lidong Wu
Keyword(s):  
Blood Loss ◽  
Knee Arthroplasty ◽  
Knee Function ◽  
Whole Process ◽  
Hidden Blood Loss ◽  
Total Knee ◽  
American Society ◽  
Without Tourniquet ◽  
And Function ◽  
American Society Of Anesthesiologists

Abstract BackgroundThe characteristics of blood loss and knee function after unicompartment knee arthroplasty(UKA) remains unclear. Utilization of tourniquet is considered to compromise the outcome of knee arthroplasty. This study aims to evaluate the hidden blood loss and function restoration of UKA without tourniquet by comparing with total knee arthroplasty(TKA).MethodsIn this retrospective study, a total of 112 patients were included from August 2017 to October 2018. Both the UKA group (n = 56) and the TKA group (n = 56) underwent procedure without utilization of tourniquet during the whole process. The gender, age, body mass index, American Society of Anesthesiologists score, Kellgren-Lawrence grade, preioperative Hb, and volume of hidden blood loss (HBL) were recorded and analysed. Knee function was assessed at 3 month and 12 month after procedure by using HSS score.ResultThe mean volume of HBL was significant lower in UKA group (324.23ml ± 147.05, 864.82ml ± 206.37, P = 0.001). The HSS score was higher in UKA group 3 month after procedure (88.16 ± 5.57, 83.04 ± 4.88, P = 0.033). No HBL difference was observed in either groups in terms of gender nor age. Hb level dropped to the bottom at the 4th day postoperatively. No correlation was observed between HBL and knee function.ConclusionWithout utilization of tourniquet, the HBL could not be ignored in UKA though it is much less than TKA, and the knee function was not compromised by it.Trial registrationCurrent trial ISRCTN85133278 (Retrospectively registered on 06 April 2020).

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