DONACION AUTOLOGA PDF

Transcript of transfusion autologa. TRANSFUSIÓN AUTÓLOGA chavez lopez, frank. Mayhua vargas, ruth m. Lima Ataucusi, Edwin. Request PDF on ResearchGate | On Jan 1, , DA Henry and others published Donación autóloga preoperatoria para disminuir la transfusión de sangre. Do you have any affiliation with or involvement in any organisation with a financial interest in the subject matter of your comment? No Yes Please provide details.

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To analyze the relationship between hematimetric variation and the presence of clinical symptoms of hypoperfusion for indicating blood transfusion in patients undergoing total knee arthroplasty. A donaclon analysis was conducted on data gathered from the medical files of 55 patients with a diagnosis of gonarthrosis, who underwent total knee arthroplasty at a hospital orthopedics and traumatology service between February and December The patients studied presented unilateral joint degeneration and fitted into the indications for surgical treatment.

All the atuologa underwent a preoperative cardiological evaluation, presenting a pattern of ASA I—III and absence of blood dyscrasia, and preoperative hemoglobin measurements were made.

However, no minimum hematimetric value was established for the surgical treatment; there were only clinical criteria for blood perfusion.

Among the 55 patients, 35 were female and 20 were male, and the mean age was 68 years. Six patients underwent homologous blood transfusion, because of their clinical condition of tissue hypoperfusion, persistent hypotension, loss of consciousness, sweating and coercible vomiting.

They presented postoperative hemoglobin of 7. Total knee arthroplasty TKA is one of the surgical procedures most indicated for treating osteoarthrosis, 1 which is a disease of inflammatory and degenerative nature that causes destruction of the knee joint cartilage and leads to joint deformity. In such cases, transfusion becomes inevitable. It is understood that in cases of trauma and in large-scale surgical procedures like TKA, in which there is acute blood loss, oxygenation is the main indicator regarding blood volume replacement.

This is a decisive moment, at which replacement should be performed using blood or blood components, rather than by means of acellular solutions alone.

Thus, transfusions can be done using homologous blood donated by another person, or using autologous blood, in which the donor and recipient are the same person. In most cases, dnacion using homologous blood is done ajtologa often. However, if the indications for transfusions doonacion analyzed, it is seen that there is no consensus regarding what the minimum acceptable value for the hemoglobin level would be, for adequate tissue perfusion to be maintained.

Discrepant values have been reported, ranging from levels as low as 1. The present study had the aim of analyzing the relationship between the hematimetric variation donacipn the presence of clinical symptoms of hypoperfusion, for indicating blood transfusion in patients undergoing TKA. A retrospective analysis was conducted on data gathered from the medical files of 55 patients who underwent unilateral TKA, performed at the orthopedics and traumatology service of a hospital between February and December Among these patients, 35 All the procedures were performed by a team of surgeons with experience of the surgical technique of unilateral TKA.

As inclusion criteria, the patients needed to present primary gonarthrosis with an indication for TKA, undergo a preoperative cardiological assessment, remain within categories I—III of the American Society of Anesthesiology ASApresent absence of blood dyscrasia and have preoperative hemoglobin measurements available.

No minimum hematimetric value was established for the surgery: Patients who were regularly using medications with the potential to alter their coagulation were advised to suspend their use ten days before the surgical intervention, and all of the patients presented normal coagulograms on the day of the procedure. Any intraoperative or postoperative complication was considered to be an exclusion criterion. Asepsis and antisepsis were performed, with application of specific topical solutions, and placement of appropriate surgical fields.

This was positioned at the root of the thigh, which was protected with orthopedic cotton wool and a crepe bandage. The conventional technique for total knee arthroplasty was followed, by means of a median access route and medial parapatellar arthrotomy, eversion of the patella, disturbance of the knee extensor mechanism, joint dislocation and extensive violation of the soft tissues surrounding the joint. After the pneumatic tourniquet had been released, hemostasis was performed and a one-way vacuum suction drain was placed inside the joint, with its outlet in the lateral distal region of the femur.

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Suturing was performed in layers, with complete flexion—extension movements made after closing each layer. Dressings were applied from the inguinal region to the foot, consisting of successive layers of compressive bandages and orthopedic cotton wool, followed by a plaster-cast splint extending from the inguinal region to the malleolus.

Volume replacement with crystalloids was performed in the ward, with observance uatologa a ration of 3: After this time, the volume becomes insignificant. The length of hospital stay was three days. Isometric and isotonic exercises were performed on the entire lower limb, beginning on the first postoperative day and continuing until discharge from hospital. The postoperative hemoglobin assay ranged from 7. To view the data presented in Table 1 better, a histogram of frequencies of numbers of patients was constructed according to the postoperative hemoglobin assay values Fig.

The percentage reduction in hemoglobin level ranged from 5.

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Total number of patients and number of transfused patients according to the percentage decrease in hemoglobin level after the operation. The total number of patients and number of transfused patients according to the percentage decline in hemoglobin levels autopoga the operation can be seen in Fig. Total number of patients and number of transfused patients according to the percentage decrease in hemoglobin value after the operation.

The criteria of hematimetric variation were not determinants for the transfusions.

Donación autóloga by Johnmary Hernandez Mescia on Prezi

However, in donacipn the values, we observed that all the transfused patients presented postoperative hemoglobin counts that ranged from 7. It should be emphasized that other patients with postoperative hemoglobin counts lower than 8. Pre and postoperative hemoglobin levels and percentage decreases in patients who underwent blood transfusion. Discharge from hospital was delayed by one day for the patients who underwent transfusions.

However, no other complications were observed. The behavior of the patients who underwent blood transfusion, regarding their pre and postoperative hemoglobin levels and the percentage reductions, can be seen better in Fig.

Pre and postoperative hemoglobin levels and percentage decrease in patients who underwent blood transfusion. Blood loss during TKA may lead patients to autolog need to undergo transfusion. However, there is no consensus in the pertinent literature regarding the indications for transfusion according to hemoglobin levels. It is worth recalling the observation made by Vuille-Lessard et al. In analyzing blood management in patients undergoing total knee or hip arthroplasty, Bierbaum et al.

They evaluated the need for autologous or homologous transfusion based on the initial hemoglobin level. Subsequently, Billote et al. Also in Billote et al. In this regard, Ng et al. This was not the decisive factor for indicating transfusion.

Regarding postoperative hemoglobin levels, in another study 24 on the use of tourniquets in TKA cases in two groups of patients with and without a tourniquetit was reported auutologa two patients in each group underwent blood transfusion after the operation.

One patient underwent transfusion when a hemoglobin level of 8. The mean decrease in hemoglobin level for these four patients was 4. In the present study, it was observed that all the transfused patients presented postoperative hemoglobin counts of between 7. However, other patients with postoperative hemoglobin counts lower than 8. dnoacion

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Other authors 25 who studied transfusions of autologous and homologous blood in TKA surgery cases made comparisons through distributing the patients into two groups: They emphasized that the indication for transfusion for both groups was when the patient presented a postoperative hemoglobin level of 8. They also pointed out that their study had some limitations and explained that although the recommendation from local studies was 8. These authors 25 took the view that this was the explanation for higher hemoglobin levels in the homologous transfusion group, which was not seen in the autologous group because the protocol for this was controlled by the technique and the anesthesia by the anesthesiologist.

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In the present study, the view taken was that, unlike in the cases of the above authors, 25 the patients who underwent homologous blood transfusion received this solely because they presented symptoms of tissue hypoperfusion. The hematimetric variation criteria were not determinants for the transfusions.

In a comparative study on blood transfusion practice in elective surgical procedures in three hospitals in France, Vuille-Lessard et al. There were significant differences between the hospitals, regarding the distribution of the procedures, hemoglobin levels and blood losses, and also in relation to the decrease in hemoglobin levels and duration of this state. In the present study, the majority of the patients This hemoglobin value was shown to be a minimum threshold for possible transfusion, in relation to clinical symptoms.

Also in the present study, the majority of the patients However, among the transfused patients alone, the mean percentage was greater Thus, it seems that indicating blood replacement according to the percentage hematimetric loss is not an appropriate criterion for use in clinical practice, since no standard that would or would not justify blood transfusion was found.

Artroplastia total do joelho: National Center for Biotechnology InformationU. Journal List Rev Bras Ortop v. Published online Aug Author information Article notes Copyright and License information Disclaimer. Received Aug 12; Accepted Sep Published by Elsevier Editora Ltda.

See the referenced article with doi: This article has been cited by other articles in PMC. Abstract Objective To analyze the relationship between hematimetric variation and the presence of clinical symptoms of hypoperfusion for indicating blood transfusion in patients undergoing total knee arthroplasty. Methods A retrospective analysis was conducted on data gathered from the medical files of 55 patients with a diagnosis of gonarthrosis, who underwent total knee arthroplasty at a hospital orthopedics and traumatology service between February and December Results Among the 55 patients, 35 were female and 20 were male, and the mean age was 68 years.

Hemoglobin, Surgical blood loss, Joints, Arthroplasty, Hypovolemia. Introduction Total knee arthroplasty TKA is one of the surgical procedures most indicated for treating osteoarthrosis, 1 which is a disease of inflammatory and degenerative nature that causes destruction of the knee joint cartilage and leads to joint deformity.

Materials and methods A retrospective analysis was conducted on data gathered from the medical files of 55 patients who underwent unilateral TKA, performed at the orthopedics and traumatology service of a hospital between February and December Open in a separate window. Table 1 Number of patients according to the postoperative hemoglobin assay value.

Number of patients according to the postoperative hemoglobin assay values. Table 2 Total number of patients and number of transfused patients according to the percentage decrease in hemoglobin level after the operation.

Table 3 Pre and postoperative hemoglobin levels and percentage donacionn in patients who underwent blood transfusion. Discussion Blood loss during TKA may lead patients to the need to undergo transfusion. Conflicts of interest The authors declare no conflicts of interest. Tratamento da osteoartrose do joelho.

Changing incidence of primary total hip arthroplasty and total knee arthroplasty for primary osteoarthritis.

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