Blood transfusion in hip arthroplasty: a laboratory hematic curve must be the single predictor of the need for transfusion?

Autor:	Roth F; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Birriel FC; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Barreto DF; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Boschin LC; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Hospital Cristo Redentor, Porto Alegre, RS, Brazil., Gonçalves RZ; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil ; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Hospital Cristo Redentor, Porto Alegre, RS, Brazil., Yépez AK; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil., Silva MF; Centro Universitário Metodista, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil., Schwartsmann CR; Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
Jazyk:	angličtina
Zdroj:	Revista brasileira de ortopedia [Rev Bras Ortop] 2014 Jan 03; Vol. 49 (1), pp. 44-50. Date of Electronic Publication: 2014 Jan 03 (Print Publication: 2014).
DOI:	10.1016/j.rboe.2013.12.016
Abstrakt:	Objective: to determine whether the laboratory hematic curve must be the single predictor of postoperative blood transfusion in total hip arthroplasty. Methods: the laboratory blood samples of 78 consecutive patients undergoing total hip arthroplasty was analyzed during five distinct moments: one preoperative and four postoperative. There was a count of hemoglobin, hematocrit and platelets of the patients samples. Other catalogued variables ascertain possible risk factors related to transfusional practice. They characterized the anthropometric, behavioral and co morbidities data in this population. The study subjects were divided and categorized into two groups: those who received blood transfusion during or after surgery (Group 1, G1), and those who did not accomplish blood transfusion (Group 2, G2). Transfusion rules were lead by guidelines of American Academy of Anesthesiology and the British Society of Hematology. Results: a total of 27 (34.6%) patients received blood transfusions. The curves of hemoglobin, hematocrit and platelet transfusions between G1 and G2 were similar (p > 0.05). None of the analyzed risk factors modified the rate of transfusion rate in their analysis with p value > 0.05, except the race. The sum of clinical co morbidities associated with patients in G1 was a median of 3 (95% CI 2.29-3.40), while in G2 the median was 2 (95% CI 1.90-2.61) with p = 0.09. Conclusion: the curve in red blood cells has limited reliability when used as sole parameter. The existence of tolerant patients hematimetric curve variations assumes that their assessments of clinical, functional evaluation and co-morbidities are parameters that should influence the decision to transfusion red blood cells.
Databáze:	MEDLINE
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