Combined Administration of Dextran 70 and Dalteparin Does Not Increase Perioperative Blood Loss Compared to Dextran 70 Alone in Major Orthopedic Surgery

1999 ◽  
Vol 29 (5) ◽  
pp. 262-268 ◽  
Author(s):  
Ola E. Dahl ◽  
Heidi K. Walsøe ◽  
Trude Aspelin ◽  
Olav Røise ◽  
Harald Arnesen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Orthopedic Surgery ◽  
Perioperative Blood Loss ◽  
Dextran 70 ◽  
Major Orthopedic Surgery ◽  
Combined Administration

scholarly journals Antifibrinolytic Therapy and Perioperative Blood Loss in Cancer Patients Undergoing Major Orthopedic Surgery

2003 ◽  
Vol 98 (2) ◽  
pp. 337-342 ◽  
Author(s):  
David Amar ◽  
Florence M. Grant ◽  
Hao Zhang ◽  
Patrick J. Boland ◽  
Denis H. Leung ◽  
...  
Keyword(s):  
Blood Loss ◽  
Cancer Patients ◽  
Orthopedic Surgery ◽  
Controlled Trial ◽  
Caproic Acid ◽  
Double Blind ◽  
Perioperative Blood Loss ◽  
Transfusion Requirements ◽  
Major Orthopedic Surgery ◽  
Duration Of Surgery

Background Aprotinin has been reported to reduce blood loss and transfusion requirements in patients having major orthopedic operations. Data on whether epsilon amino-caproic acid (EACA) is effective in this population are sparse. Methods Sixty-nine adults with malignancy scheduled for either pelvic, extremity or spine surgery during general anesthesia entered this randomized, double-blind, placebo-controlled trial, and received either intravenous aprotinin (n = 23), bolus of 2 x 10(6) kallikrein inactivator units (KIU), followed by an infusion of 5 x 10(5) KIU/h, or EACA (n = 22), bolus of 150 mg/kg, followed by a 15 mg/kg/h infusion or saline placebo (n = 24) during surgery. Our goal was to determine whether prophylactic EACA or aprotinin therapy would reduce perioperative blood loss (intraoperative + first 48h) >30% when compared to placebo. Results The mean age of the study population was 52 +/- 17 yr. The groups did not differ in age, duration of surgery, perioperative blood loss or number of packed erythrocyte units transfused. When compared to the placebo group, the two treated groups had a significantly lower D-Dimer level immediately after surgery, P < 0.01. Conclusions Under the conditions of this study, we were unable to find a clinical benefit to using aprotinin or EACA to reduce perioperative blood loss or transfusion requirements during major orthopedic surgery in cancer patients.

Use of aprotinin to reduce blood loss and transfusion in major orthopedic surgery: a meta-analysis

2014 ◽  
Vol 51 (2) ◽  
pp. 152-161 ◽  
Author(s):  
Fei Huang ◽  
Quancheng Zhao ◽  
Chongyong Guo ◽  
Guangwen Ma ◽  
Qing Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Orthopedic Surgery ◽  
Meta Analysis ◽  
Reduce Blood Loss ◽  
Major Orthopedic Surgery

Aprotinin Decreases Blood Loss and Homologous Transfusions in Patients Undergoing Major Orthopedic Surgery 

1998 ◽  
Vol 88 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Xavier Capdevila ◽  
Yves Calvet ◽  
Philippe Biboulet ◽  
Christine Biron ◽  
Josh Rubenovitch ◽  
...  
Keyword(s):  
Placebo Group ◽  
Blood Loss ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Orthopedic Surgery ◽  
Total Blood Loss ◽  
Postanesthesia Care Unit ◽  
Total Blood ◽  
Transfusion Requirements ◽  
Major Orthopedic Surgery

Background Major orthopedic surgery can be associated with dramatic blood loss, thereby requiring high-volume homologous transfusions in patients unable to benefit from blood salvage techniques. The effect of aprotinin on blood loss and transfusion requirements during orthopedic surgery for either the resection of malignancies of the removal of infected hardware was prospectively studied. Methods Twenty-three patients scheduled for orthopedic surgery of the hip, femur, or pelvis for sepsis or malignant tumors, all under general anesthesia, were randomly allocated to receive during operation, in a blinded manner, either aprotinin administered as a bolus of 1.106 kallikrein inactivation units (KIU) followed by an infusion of 5 x 10(5) KIU/h, or the equivalent volume of saline. The anesthesia and perioperative management, as well as the designated transfusion criteria, were standardized. The total blood loss of each patient was evaluated using intraoperative suction losses, sponge weights, and postoperative volumetric drainage. Homologous transfusion requirements were noted. Hemoglobin and hematocrit measures, as well as coagulation and fibrinolytic pathway explorations, were performed before and after surgery. Deep venous thrombosis prophylaxis was applied, and the incidence of this complication was assessed. Results Twelve patients received aprotinin. Aprotinin reduced the total blood loss from a median of 5,305 ml (range, 3,000-9,770 ml) to a median of 1,783 ml (range, 1,140-4,955 ml; P < 0.05). A blood loss reduction of 56% during surgery and 68% on discharge from the postanesthesia care unit was observed. Seven units (range, 4-16) of packed erythrocytes were transfused per patient in the placebo group, and 3 (range, 2-5) were transfused in the aprotinin group (P < 0.05). In the aprotinin group, platelet counts were higher, and postoperative prothrombin times and D. Dimer values were lower. The activated partial thromboplastin time values showed no significant difference between the two groups. No side effects were observed in the aprotinin group. A deep venous thrombosis developed in one patient in the placebo group. Conclusion Aprotinin treatment during major orthopedic surgery significantly reduces both blood loss and consequent homologous blood transfusion requirements.

scholarly journals The Comparison of Pre and Post-Operative Hemoglobin Level in Elderly Undergoing Major Orthopedic Surgery

2019 ◽  
Author(s):  
Naghi Abedini ◽  
Ali Sadeghpour ◽  
Haleh Farzin ◽  
Roza Amadi ◽  
Masoud Parish
Keyword(s):  
Blood Loss ◽  
Orthopedic Surgery ◽  
Older Patients ◽  
Mean Difference ◽  
Common Disease ◽  
Bipolar Hemiarthroplasty ◽  
Cross Sectional ◽  
Post Operative Period ◽  
Major Orthopedic Surgery ◽  
The Mean

Background: Anemia is a common disease in older patients and prevalence of anemia increases with high age. Preoperative anemia is associated with high mortality after surgery. The severity of anemia is variable and is affected by blood loss volume, pre-operative hemoglobin (Hb) value and transfusion during surgery. However, the strategies of blood management for optimization of Hb before surgery are more important. Therefore, surgery and anesthesia teams always follow these issues: how we can decrease intraoperative blood loss and complications of bleeding and transfusion? However, the aim of study was comparison of Hb in pre- and post- operative period in older patients undergoing major orthopedic operation. Methods: A descriptive cross-sectional study was conducted on 230 patients aged more than 65 years who underwent orthopedic surgery from 2016 through 2017. Hb value was measured after and before surgery and compared. Results: The mean age of participants was 75.8. 54.3% of cases were female. Most of the patients (70.4%) had concurrent disease such as hypertension, diabetes mellitus and heart disease. The most common types of surgery were as follows: DHS, total replacement of knee and hip bipolar hemiarthroplasty. The mean difference value of Hb in pre and post– operative period was significant and was reduced from 12.6 to 10.3g/dL. Conclusion: The mean difference value of Hb in pre and post– operative period was significant. However, orthopedic surgeries can reduce Hb in older patients. In regard to older subjects being considered as high-risk group, routine control and proper correction of Hb in such operations is necessary.

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