Blood Conservation Techniques and Strategies in Orthopedic Anesthesia Practice

Richa Sharma; Yolanda Huang; Anis Dizdarevic

doi:10.1016/j.anclin.2022.06.002

Blood Conservation Techniques and Strategies in Orthopedic Anesthesia Practice

Anesthesiol Clin. 2022 Sep;40(3):511-527. doi: 10.1016/j.anclin.2022.06.002. Epub 2022 Jul 12.

Authors

Richa Sharma¹, Yolanda Huang², Anis Dizdarevic³

Affiliations

¹ Department of Anesthesiology, Columbia University Irving Medical Center, 622 West 168th Street, PH 5, New York, NY 10032, USA. Electronic address: https://twitter.com/Drsharma_richa.
² Department of Anesthesiology, Columbia University Irving Medical Center, 622 West 168th Street, PH 5, New York, NY 10032, USA.
³ Department of Anesthesiology, Columbia University Irving Medical Center, 622 West 168th Street, PH 5, New York, NY 10032, USA. Electronic address: ad2689@cumc.columbia.edu.

PMID: 36049878
DOI: 10.1016/j.anclin.2022.06.002

Abstract

Orthopedic surgery procedures involving joint arthroplasty, complex spine, long bone and pelvis procedure, and trauma and oncological cases can be associated with a high risk of bleeding and need for blood transfusion, making efforts to optimize patient care and reduce blood loss very important. Patient blood management programs incorporate efforts to optimize preoperative anemia, develop transfusion protocols and restrictive hemoglobin triggers, advance surgical and anesthesia practice, and use antifibrinolytic therapies. Perioperative management of anticoagulant therapies, a multidisciplinary decision-making task, weighs in risks and benefits of thromboembolic risk and surgical bleeding and is patient- and surgery-specific.

Keywords: Anemia management; Blood conservation; Orthopedic anesthesia; Orthopedic surgery; Patient blood management; Tranexamic acid.

Publication types

Review

MeSH terms

Anemia* / therapy
Anesthesia*
Antifibrinolytic Agents*
Blood Loss, Surgical / prevention & control
Blood Transfusion / methods
Humans

Substances

Antifibrinolytic Agents