scholarly journals Perioperative Blood Management in Posterior Instrumented Fusion for Adolescent Idiopathic Scoliosis: Original Study and Short Review of the Literature

Folia Medica ◽  
2018 ◽  
Vol 60 (2) ◽  
pp. 200-207 ◽  
Author(s):  
Lamprini Katranitsa ◽  
Nikolaos Gkantsinikoudis ◽  
Stylianos Kapetanakis ◽  
Georgios Charitoudis ◽  
Anastasios Christodoulou ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Blood Transfusion ◽  
Idiopathic Scoliosis ◽  
Autologous Blood ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Instrumented Fusion ◽  
Group A ◽  
Group B ◽  
Posterior Instrumented Fusion

Abstract Background: The potential hazards of allogeneic blood transfusion are well established in literature. Few things are known, however, about the results of combining different blood saving techniques and their results in avoiding allogeneic blood transfusion (ABT) in scoliosis surgery. Aim: To report specific results about utilization of preoperative autologous blood donation (PABD) and intraoperative blood-saver (BLDS) in conjunction, aiming to minimize the need for ABT. Materials and methods: Between 1989 and 2012, 107 patients underwent posterior instrumented fusion (PIF) for adolescent idiopathic scoliosis (AIS) correction. Retrospective evaluation was conducted. Patients were classified into two groups, according to the method utilized: group A with only allogeneic blood transfusion (ABT) and group B where PABD with BLDS intraoperatively was applied. Hematocrit and hemoglobin values were evaluated preoperatively, postoperatively, and at discharge. The variables we examined included also gender, age, levels fused and number of predeposited blood units, required transfused blood units (TBU), as well as ABT rates between the two groups. Results: More than 70% of the transfusions in both groups were needed intraoperatively. In group A, an average of 2.4 units per patient was transfused and ABT reached 76%. In contrast, in group B an average of 4.5 units per patient was transfused but ABT rate was only 7.3%, while the rest 92.7% was autologous blood. However, the wasted autologous blood reached 24.9%. Conclusions: Our results demonstrated that PABD with intraoperative cell salvage (CS) is associated with statistically significant ABT rates decrement but the combination of these methods cannot assure ABT avoidance.

scholarly journals Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

2020 ◽  
Author(s):  
Yiwei Zhao ◽  
Wubo Liu ◽  
Suomao Yuan ◽  
Yonghao Tian ◽  
Xinyu Liu
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pedicle Screws ◽  
Vertebral Rotation ◽  
Concave Side ◽  
Convex Side ◽  
X Rays ◽  
Group A ◽  
Group B

Abstract Background In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated. Methods 68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT). Results Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05). Conclusion Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws. Trial registration retrospectively registered

Acute normovolemic hemodilution in total knee arthroplasty, a prospective study

2016 ◽  
Author(s):  
Jin Kyu Lee ◽  
Mi Ae Cheong ◽  
Choong Hyeok Choi
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Allogeneic Blood ◽  
Acute Normovolemic Hemodilution ◽  
Allogeneic Transfusion ◽  
Group A ◽  
Total Knee ◽  
Normovolemic Hemodilution ◽  
Group B

Abstract Objective: In this prospective, randomized, controlled trial we sought to evaluate the effectiveness of acute normovolemic hemodilution (ANH) in terms of decreasing the need for allogeneic transfusion after conventional unilateral total knee arthroplasty (TKA). Summary of Background Data: TKA is often performed with an occlusive tourniquet, and thus, it could be considered ideally suited for ANH, because the chief benefit of ANH is red blood cell loss reduction and the shedding of whole blood perioperatively at lower hematocrit levels. Methods: Between January 2012 and May 2012, 40 consecutive patients scheduled to undergo elective, primary, cemented, unilateral TKA for knee osteoarthritis were enrolled. Patients were randomized to either a study (ANH) group (n=20) (Group A) or a control group (n=20) (Group B). Unit of allogeneic blood transfused was considered the primary outcomes. Results : In the ANH group, less allogeneic blood transfusion (6 units in Group A vs 15 units in Group B) was required after operation. Six patients, who required a transfusion in Group A received 1 unit of allogeneic blood. In contrast, 6 of 9 patients, who required transfusion in Group B, received at least 2 units of allogeneic blood (p&lt;0.05). There was no complication related to the methods of the protocol. Conclusions: ANH is likely to reduce postoperative allogeneic transfusion requirement in patients undergoing unilateral TKA. However, adjunctive strategies are required to further reduce allogeneic blood transfusion requirements.

Do autologous blood transfusion systems reduce allogeneic blood transfusion in total knee arthroplasty?

2016 ◽  
Vol 25 (9) ◽  
pp. 2957-2966 ◽  
Author(s):  
Aditya Pawaskar ◽  
Abhijeet Ashok Salunke ◽  
Aashay Kekatpure ◽  
Yongsheng Chen ◽  
G. I. Nambi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Autologous Blood ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Autologous Blood Transfusion ◽  
Total Knee

scholarly journals Intraoperative red blood cell salvage and autologous transfusion during open radical retropubic prostatectomy: a cost–benefit analysis

2011 ◽  
Vol 93 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Sarvpreet Ubee ◽  
Manal Kumar ◽  
Nallaswami Athmanathan ◽  
Gurpreet Singh ◽  
Sean Vesey
Keyword(s):  
Blood Transfusion ◽  
Autologous Blood ◽  
Radical Retropubic Prostatectomy ◽  
Autologous Blood Transfusion ◽  
Cell Saver ◽  
Cell Salvage ◽  
Homologous Blood ◽  
Retropubic Prostatectomy ◽  
Group A ◽  
Group B

INTRODUCTION Open radical retropubic prostatectomy (RRP) has an average blood loss of over 1,000ml. This has been reported even from high volume centres of excellence. 1 – 4 We have looked at the clinical and financial benefits of using intraoperative cell salvage (ICS) as a method of reducing the autologous blood transfusion requirements for our RRP patients. MATERIALS AND METHODS Group A comprised 25 consecutive patients who underwent RRP immediately prior to the acquisition of a cell saver machine. Group B consisted of the next 25 consecutive patients undergoing surgery using the Dideco Electa (Sorin Group, Italy) cell saver machine. Blood transfusion costs for both groups were calculated and compared. RESULTS The mean postoperative haemoglobin was similar in both groups (11.1gm/dl in Group A and 11.4gm/dl in Group B). All Group B patients received autologous blood (average 506ml, range: 103–1,023ml). In addition, 5 patients (20%) in Group B received a group total of 16 units (average 0.6 units) of homologous blood. For Group A the total cost of transfusing the 69 units of homologous blood was estimated as £9,315, based on a per blood unit cost of £135. This cost did not include consumables or nursing costs. CONCLUSIONS We found no evidence that autologous transfusions increased the risk of early biochemical relapse or of disease dissemination. ICS reduced our dependence on donated homologous blood.

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