Blood conservation: Preoperative,perioperative, and postoperative blood management options |
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| Institution: | 1. Department of Orthopedic Surgery, Washington University School of Medicine/Barnes-Jewish Hospital, St. Louis, Missouri;2. Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri;1. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY;2. Department of Epidemiology and Biostatistics, Hospital for Special Surgery, New York, NY;3. Department of Orthopedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL;1. The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania;2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;2. Department of Orthopaedic Surgery, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain;3. Department of Orthopaedic Surgery, Martini Hospital, Groningen, The Netherlands;4. Department of Orthopaedic Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands;5. Department of Infectious Diseases, University of Barcelona, Hospital Clinic of Barcelona, Barcelona, Spain;6. Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands |
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| Abstract: | Perioperative blood loss during elective total joint arthroplasty (TJA) can be significant, traditionally resulting in high blood transfusion rates. However, due to the risks and costs of allogeneic blood transfusion, the focus in contemporary TJA has been on strategies to minimize perioperative blood loss. While a multimodal approach is paramount in elective TJA, three main factors have contributed dramatically to the reduced allogeneic blood transfusion rates: (1) preoperative assessment and treatment of anemia, (2) expanded use of antifibrinolytics, particularly tranexamic acid (TXA), and (3) a restrictive transfusion strategy postoperatively. |
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| Keywords: | Total joint arthroplasty (TJA) Total hip arthroplasty (THA) Total knee arthroplasty (TKA) Tranexamic acid (TXA) Blood conservation |
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