Minimizing Blood Transfusion in Total Hip and Knee Arthroplasty Through a Multimodal Approach

作者：Holt Joshua B^*; Miller Benjamin J; Callaghan John J; Clark Charles R; Willenborg Melissa D; Noiseux Nicolas O

来源：Journal of Arthroplasty, 2016, 31(2): 378-382.

DOI：10.1016/j.arth.2015.08.025

• total hip arthroplasty
• total knee arthroplasty
• tranexamic acid
• blood transfusion
• adult reconstruction

Background: We introduced a multimodal, multidisciplinary approach to perioperative blood management aimed at reducing blood transfusions in primary knee (TKA) and hip (THA) arthroplasty. The protocol included (1) preoperative hemoglobin optimization through a multidisciplinary approach, (2) minimization of perioperative blood loss, and (3) adherence to evidence-based transfusion guidelines.
Methods: Evaluation of 1010 consecutive patients undergoing primary TKA (483) or THA (522) was performed.
Results: A significant reduction in the overall transfusion rate (1.4% vs 17.9%, P<.0001) resulted after algorithm introduction, when compared with the 1314 previous patients. Zero (0%) TKA and 4 (0.8%) THA patients adherent to protocol, and 4,/488 (0.8%) TKA and 10/522 (1.9%) THA patients overall received transfusions.
Conclusion: Adoption of a multimoclal blood management algorithm can significantly reduce blood transfusions in primary joint arthroplasty.

• 出版日期2016-2