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KMID : 0387720190300010015
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Korean Journal of Blood Transfusion
2019 Volume.30 No. 1 p.15 ~ p.22
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Blood Management Protocol without Transfusion in Orthopedic Surgery
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Suh You-Sung
Lee Jeong-Jae
Nho Jae-Hwi
Chung Ha-Ran
Lee Won-Seok
Chang Byung-Woong
Kim Yong-Beom
Chun Dong-Il
Choi Sung-Woo
Lee Jae-Chul
Choi Hyung-Suk
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Abstract
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We developed a new blood management protocol that allows patients to not undergo transfusion during major orthopaedic surgery. Here, we report the safety of or our protocol. The preoperative pharmacological protocol consisted of the administration of 40 ?g of recombinant erythropoietin subcutaneously and 100 mg of iron supplements intravenously. During the operation, reinfusion of drainage blood using a cell saver and plasma expander was used. The cell saver device passed the collected blood through a filter, which washed the blood, removing the hemolyzed cells and other impurities. Intravenous tranexamic acid 1 g is given just before the operation, except high-risk patients for venous thromboembolism. Postoperatively, recombinant erythropoietin and iron supplements were administered in the same manner with the preoperative protocol and continued until a hemoglobin level reached 10 g/dL.
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KEYWORD
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Orthopaedic surgery, Patient blood management, Transfusion, Erythropoietin, Tranexamic acid
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