Patient blood management in Hip and Knee surgery: A methodological approach Part 1  Preoperative time and erythropoiesis

Abstract

Actually a “patient blood management” as to be considered a basis for all the elective orthopaedic major surgery. But discuss about such a project doesn’t  mean to write on blood, surgery, anesthesia, .. ! We have to consider the whole problem, strictly linked in all the components.

First of all the preoperative period and the specific role of a preoperative evaluation. And, more, the erythropoiesis optimization, the adoption of restrictive criteria in blood transfusion (comprehensive of the activity in limiting blood losses) and, really a cornerstone of this scheme, some facts on “low Ht physiology”.

Our experience in Orthopaedic surgery (mainly in prosthesis surgery!), in a clinical application of the low Ht physiology, in a good knowledge about blood recovery, antithrombotic prophylaxis, anfibrynolitic activity and, least but not last, pain treatment, allowed us a complete evaluation of the problems and the possible solutions.

And the data we present offer a good suggestion to everyone should face such a theme

Key words: Hip /Knee surgery- Blood- Anemia- Low Hematocrit - Anesthesia