scholarly journals Bipolar sealer can reduce intraoperative blood loss and transfusion in major orthopedic surgery: a meta-analysis and trial sequence analysis

Oncotarget ◽  
2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Zhan Wang ◽  
Ai-Xian Tian ◽  
Kai-Qiang Feng ◽  
Qingsong Wang ◽  
Yi Wang
Keyword(s):  
Sequence Analysis ◽  
Blood Loss ◽  
Orthopedic Surgery ◽  
Meta Analysis ◽  
Intraoperative Blood Loss ◽  
Trial Sequence ◽  
Major Orthopedic Surgery ◽  
Bipolar Sealer

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

scholarly journals Is deliberate hypotension a safe technique for orthopedic surgery?: a systematic review and meta-analysis of parallel randomized controlled trials

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jia Jiang ◽  
Ran Zhou ◽  
Bo Li ◽  
Fushan Xue
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Orthopedic Surgery ◽  
Meta Analysis ◽  
Age Groups ◽  
Controlled Trials ◽  
Intraoperative Blood Loss ◽  
Deliberate Hypotension ◽  
Transfusion Volume ◽  
Quality Evidence

Abstract Background Deliberate hypotension has been shown to reduce the intraoperative bleeding and the need for allogeneic blood transfusion, and improve the surgical field, but there is still controversy on its clinical safety. This systematic review was designed to assess the safety and benefits of deliberate hypotension for orthopedic surgery. Methods The review met the requirements of the PRISMA guidelines. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, ISI Web of Science, ScienceDirect, and four Chinese databases (China National Knowledge Infrastructure, Wanfang, vip citation database, and updated version of China Biology Medicine disc from January 1, 2000 to January 1, 2019) were searched. All parallel randomized controlled trials comparing the effects of using deliberate hypotension with not using deliberate hypotension on clinical outcomes of patients undergoing orthopedic surgery were selected. The primary outcome was overall mortality. The secondary outcomes were the intraoperative blood loss, blood transfusion volume, and serious adverse postoperative events. Results A total of 30 studies with 36 comparisons (1454 participants) were included in meta-analysis. Two studies with 120 participants reported overall mortality and the result was zero (low-quality evidence). The use of deliberate hypotension reduced the intraoperative blood loss (mean difference, − 376.7; 95% CI − 428.1 to − 325.3; I2 = 94%; 29 studies, 36 comparisons, and 1398 participants; low-quality evidence) and blood transfusion volume (mean difference, − 242.5; 95% CI − 302.5 to − 182.6; I2 = 95%; 13 studies, 14 comparisons, and 544 participants; low-quality evidence). Six studies with 286 participants reported the occurrence of serious adverse postoperative events and the result was zero (low-quality evidence). Subgroup analyses according to age groups, controlled mean artery pressure levels, types of orthopedic surgeries, different combinations of other blood conservative method, and hypotensive methods mostly did not explain heterogeneity; significant differences were identified in almost all subgroups. Conclusions Based on the available evidence, it is still unclear whether or not deliberate hypotension is a safe technique for orthopedic surgery due to limited studies with very small sample size, though it may decrease the intraoperative blood loss and blood transfusion volume irrespective of age groups, controlled mean artery pressure levels, types of surgeries, hypotensive methods, or different combinations of other blood conservation strategies. Trial registration PROSPERO CRD42016045480.

Temporary Intraoperative Porto-Caval Shunts in Piggy-Back Liver Transplantation Reduce Intraoperative Blood Loss and Improve Postoperative Transaminases and Renal Function: A Meta-Analysis

2016 ◽  
Vol 40 (12) ◽  
pp. 2988-2998 ◽  
Author(s):  
Sebastian Pratschke ◽  
Alexandra Rauch ◽  
Markus Albertsmeier ◽  
Markus Rentsch ◽  
Michaela Kirschneck ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Renal Function ◽  
Blood Loss ◽  
Meta Analysis ◽  
Intraoperative 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.

Effects of Preoperative Iodine Administration on Thyroidectomy for Hyperthyroidism: A Systematic Review and Meta-analysis

2019 ◽  
Vol 160 (6) ◽  
pp. 993-1002 ◽  
Author(s):  
Chung-Hsin Tsai ◽  
Po-Sheng Yang ◽  
Jie-Jen Lee ◽  
Tsang-Pai Liu ◽  
Chi-Yu Kuo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operative Time ◽  
Meta Analysis ◽  
Thyroid Volume ◽  
Vocal Cord Palsy ◽  
Significant Heterogeneity ◽  
Intraoperative Blood Loss ◽  
Significant Difference ◽  
And Control

Objective The current guidelines recommend that potassium iodide be given in the immediate preoperative period for patients with Graves’ disease who are undergoing thyroidectomy. Nonetheless, the evidence behind this recommendation is tenuous. The purpose of this study is to clarify the benefits of preoperative iodine administration from published comparative studies. Data Sources We searched PubMed, Embase, Cochrane, and CINAHL from 1980 to June 2018. Review Methods Studies were included that compared preoperative iodine administration and no premedication before thyroidectomy. For the meta-analysis, studies were pooled with the random-effects model. Results A total of 510 patients were divided into the iodine (n = 223) and control (n = 287) groups from 9 selected studies. Preoperative iodine administration was significantly associated with decreased thyroid vascularity and intraoperative blood loss. Significant heterogeneity was present among studies. We found no significant difference in thyroid volume or operative time. Furthermore, the meta-analysis showed no difference in the risk of postoperative complications, including vocal cord palsy, hypoparathyroidism/hypocalcemia, and hemorrhage or hematoma after thyroidectomy. Conclusion Preoperative iodine administration decreases thyroid vascularity and intraoperative blood loss. Nonetheless, it does not translate to more clinically meaningful differences in terms of operative time and postoperative complications.

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.

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