PURPOSE: To evaluate the effect of a preoperative protocol that triages patients awaiting total joint arthroplasty to one of four strategies designed to mitigate the risk of allogeneic blood transfusion (ABT) based on a priori transfusion risk on perioperative exposure to allogeneic blood. METHODS: We compared the transfusion experiences of a historical control series of 160 subjects with a study group of 160 subjects treated by protocol. Protocol subjects with hemoglobin (Hb) 100-129 g.L(-1) were given erythropoietin, dosed by weight. Subjects with Hb 130-139 g.L(-1) underwent preoperative autologous blood harvest and perioperative re-infusion as deemed clinically necessary. Subjects with Hb >139 g.L(-1) received no special intervention, unless they were aged >70 yr and weighed < 70 kg, in which case they received oral iron and folate supplementation. RESULTS: The relative risk of ABT in the Study group was 0.68 (95% confidence interval 0.54-0.85). The Control group received 104 units of allogeneic blood and the Study group received 35 units (P = 0.0007). These differences cannot be explained by differences in transfusion risk or autologous units transfused. There was no worsening of anemia or its consequences in the Study group. CONCLUSION: A simple protocol based on easily obtained preoperative clinical indices effectively targets interventions that mitigate the risk of ABT.\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Editorial: Can J Anaesth Fecha: 01\/04\/2010 Rashiq S, Jamieson-Lega K, Komarinski C, Nahirniak S, Zinyk L, Finegan B. Acceso al<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[4],"tags":[],"_links":{"self":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/377"}],"collection":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/comments?post=377"}],"version-history":[{"count":1,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/377\/revisions"}],"predecessor-version":[{"id":684,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/377\/revisions\/684"}],"wp:attachment":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/media?parent=377"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/categories?post=377"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/tags?post=377"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}