Anemia and Patient Blood Management in Hip and Knee Surgery A Systematic Review of the Literature

被引:517
作者
Spahn, Donat R. [1 ,2 ]
机构
[1] Univ Zurich Hosp, Inst Anesthesiol, CH-8091 Zurich, Switzerland
[2] Univ Zurich, Zurich, Switzerland
基金
瑞士国家科学基金会;
关键词
RECOMBINANT-HUMAN-ERYTHROPOIETIN; ACUTE NORMOVOLEMIC HEMODILUTION; INTRAVENOUS IRON SUPPLEMENTATION; IMPROVE TRANSFUSION PRACTICE; RANDOMIZED CONTROLLED-TRIAL; CHRONIC-RENAL-FAILURE; RED-CELL TRANSFUSION; SHED BLOOD; ALLOGENEIC BLOOD; EPOETIN-ALPHA;
D O I
10.1097/ALN.0b013e3181e08e97
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
A systematic search was conducted to determine the characteristics of perioperative anemia, its association with clinical outcomes, and the effects of patient blood management interventions on these outcomes in patients undergoing major orthopedic surgery. In patients undergoing total hip or knee arthroplasty and hip fracture surgery, preoperative anemia was highly prevalent, ranging from 24 +/- 9% to 44 +/- 9%, respectively. Postoperative anemia was even more prevalent (51% and 87 +/- 10%, respectively). Perioperative anemia was associated with a blood transfusion rate of 45 +/- 25% and 44 +/- 15%, postoperative infections, poorer physical functioning and recovery, and increased length of hospital stay and mortality. Treatment of preoperative anemia with iron, with or without erythropoietin, and perioperative cell salvage decreased the need for blood transfusion and may contribute to improved patient outcomes. High-impact prospective studies are necessary to confirm these findings and establish firm clinical guidelines.
引用
收藏
页码:482 / 495
页数:14
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