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POSTOPERATIVE REINFUSION BLOOD TRANSFUSION: WHAT ARE WE GIVING? A PROSPECTIVE STUDY OF 108 PATIENTS OF HIP AND KNEE ARTHROPLASTY



Abstract

Introduction: There is an increasing trend for autologous blood transfusion in hip and knee replacement and we therefore felt the need to properties of the fluid reinfused.

Objectives of the study: The study objective was to determine the volume and Haemoglobin content of the reinfused blood.

Methods: We prospectively studied 108 patients with primary Hip and knee arthroplasty. The drained blood was reinfused within 6 hours as recommended by the manufacturer. The volume of the drained and reinfused fluid was measured in millilitres.. The Haemoglobin (Hb.) of the patient was measured preoperatively and postoperatively in recovery. The Hb. of the drained blood and reinfused blood were also measured.

Results: The mean volume of the drained blood in the hip replacement group was 180.6 ml. while that of the reinfused blood was 132.7 ml. The mean volume of the drained blood in the knee group was 372.78 ml. while that of the reinfused blood was 362.76 ml.

The mean Haemoglobin of the reinfused blood in the hip group was 6.9 gm/dl significantly lower (p< 0.05) than the drained blood Hb. of 10.9. Similarly the Haemoglobin of the blood reinfused in knee replacements was significantly lower at 6.8 gm/dl. (p< 0.001). This was less than half of the average Hb. content of homologous blood transfusion

Discussion: The Haemoglobin content of the reinfused blood in Hip and knee replacement was quite low to be considered as a replacement for homologous blood transfusion and further studies may be required to confirm the efficacy of reinfusion drainage compared to homologous blood transfusion

Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.