Minimizing Blood Loss and Transfusions in Total Knee Arthroplasty

J Knee Surg DOI: 10.1055/s-0038-1648223Blood loss management is critical to positive outcomes in patients undergoing total knee arthroplasty (TKA). Transfusions are associated with an increased risk of major and minor adverse events, length of hospitalization, and overall cost associated with surgery. Many techniques have been investigated and compared. Tranexamic acid (TXA), an antifibrinolytic drug widely known to reduce blood loss, may be a bridge to the goal of eliminating blood transfusions from TKA. Administration of TXA can be performed intravenously, topically at the knee joint, orally, or in combination. A single bolus or multiple doses have reduced total blood loss and transfusion rates consistently, safely, and cost-effectively. The uptake in use of TXA by surgeons has been slow due to concerns in patients deemed high risk for thromboembolic events. Newer evidence from studies specifically involving high-risk patients demonstrates that TXA is indeed safe in this cohort and provides benefits that greatly outweigh potential risks. Incorporation of TXA as a routine part of TKA is in the best interest of patients, health care teams, and medical institutions. TXA can be employed seamlessly with other blood saving techniques and has the capacity to increase productivity and decrease overall cost. This can be achieved by reducing the incidence of transfusion and length of stay, and the need for practices such as preoperative anemia treatment and suction drainage. [...] Th...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Special Focus Section Source Type: research

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Source: BMC Health Services Research - Category: General Medicine Authors: Tags: Research article Source Type: research
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Source: Journal of B.U.ON. - Category: Cancer & Oncology Tags: J BUON Source Type: research
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Source: Chinese Medical Sciences Journal - Category: General Medicine Source Type: research
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Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
In conclusion, Cameron lesion is still an overlooked diagnosis in patients with iron deficiency anaemia in whom a 5–9.2% prevalence has been reported.
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
This study aims to investigate the rate of allogeneic red blood cell(RBC) transfusion in patients receiving ICS, and to evaluate irrationality of allogeneic RBC transfusion and its risk factors.MethodsMedical records of all patients associated with ICS approach from January 2013 to July 2014 were retrospectively reviewed. Theoretical hemoglobin level after reinfusion of salvaged RBC at the end of operations was estimated. Irrational transfusion was defined as initiating allogeneic transfusion with theoretical hemoglobin above 100 g/L. The clinical variables, including the surgical department, gender, age, body weight, rati...
Source: Chinese Medical Sciences Journal - Category: General Medicine Source Type: research
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Source: Transfusion - Category: Hematology Authors: Tags: Transfusion Source Type: research
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Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
In conclusion, Cameron lesion is still an overlooked diagnosis in patients with iron deficiency anaemia in whom a 5–9.2% prevalence has been reported.
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
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