Minimizing Blood Transfusion in Total Hip and Knee Arthroplasty Through a Multimodal Approach

Joshua B Holt; Benjamin J Miller; John J Callaghan; Charles R Clark; Melissa D Willenborg; Nicolas O Noiseux

doi:10.1016/j.arth.2015.08.025

Back

Minimizing Blood Transfusion in Total Hip and Knee Arthroplasty Through a Multimodal Approach

Journal article

Peer reviewed

Minimizing Blood Transfusion in Total Hip and Knee Arthroplasty Through a Multimodal Approach

Joshua B Holt, Benjamin J Miller, John J Callaghan, Charles R Clark, Melissa D Willenborg and Nicolas O Noiseux

The Journal of arthroplasty, Vol.31(2), pp.378-382

02/2016

DOI: 10.1016/j.arth.2015.08.025

PMID: 26391927

View Online

Abstract

We introduced a multimodal, multidisciplinary approach to perioperative blood management aimed at reducing blood transfusions in primary knee (TKA) and hip (THA) arthroplasty. The protocol included (1) preoperative hemoglobin optimization through a multidisciplinary approach, (2) minimization of perioperative blood loss, and (3) adherence to evidence-based transfusion guidelines. Evaluation of 1010 consecutive patients undergoing primary TKA (488) or THA (522) was performed. A significant reduction in the overall transfusion rate (1.4% vs 17.9%, P<.0001) resulted after algorithm introduction, when compared with the 1814 previous patients. Zero (0%) TKA and 4 (0.8%) THA patients adherent to protocol, and 4/488 (0.8%) TKA and 10/522 (1.9%) THA patients overall received transfusions. Adoption of a multimodal blood management algorithm can significantly reduce blood transfusions in primary joint arthroplasty.

Perioperative Care

Blood Loss, Surgical - prevention & control

Postoperative Hemorrhage - prevention & control

Humans

Middle Aged

Anemia - diagnosis

Clinical Protocols

Anemia - therapy

Arthroplasty, Replacement, Hip

Male

Algorithms

Blood Transfusion

Aged, 80 and over

Antifibrinolytic Agents - administration & dosage

Arthroplasty, Replacement, Knee

Female

Aged

Disease Management

Tranexamic Acid - administration & dosage

Hemoglobins - analysis

Details

Title: Subtitle: Minimizing Blood Transfusion in Total Hip and Knee Arthroplasty Through a Multimodal Approach
Creators: Joshua B Holt - University of Iowa Hospitals and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, Iowa
Benjamin J Miller - University of Iowa Hospitals and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, Iowa
John J Callaghan - University of Iowa Hospitals and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, Iowa
Charles R Clark - University of Iowa Hospitals and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, Iowa
Melissa D Willenborg - University of Iowa Hospitals and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, Iowa
Nicolas O Noiseux - University of Iowa Hospitals and Clinics, Department of Orthopaedics and Rehabilitation, Iowa City, Iowa
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.31(2), pp.378-382
Publisher: United States
DOI: 10.1016/j.arth.2015.08.025
PMID: 26391927
ISSN: 0883-5403
eISSN: 1532-8406
Language: English
Date published: 02/2016
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
Record Identifier: 9984040376902771

Metrics

25 Record Views

73 Times Cited - Web of Science

See more details