[Perioperative management based on kinetics of bleeding during total primary arthroplasty].

Introduction: Management of the perioperative hemorrhagic risk is of major interest in patients undergoing total arthroplasty of the lower limb. Anemia in the postoperative period of that increasingly performed surgery carries its own morbidity and mortality. Better anticipation of its occurrence could be done with a refined knowledge of bleeding kinetics.

Tranexamic acid reduces blood loss and financial cost in primary total hip and knee replacement surgery.

Background: Blood conservation strategies have been developed to diminish blood transfusion requirements in patients undergoing hip or knee replacement surgery. Tranexamic acid (TA) is an inexpensive antifibrinolytic agent that is little used in orthopaedic surgery due to the absence of standardised optimal administration regimens.

Hypothesis: Blood transfusion requirements and induced costs can be diminished by using TA according to a standardised administration protocol in a large cohort of patients.

Patients with and without rheumatoid arthritis benefit equally from preoperative epoetin-alpha treatment.

Background: Preoperative epoetin-alpha administration is said to have a limited effect in patients with chronic inflammatory diseases such as rheumatoid arthritis (RA), due to lower iron availability. We studied the effects of preoperative epoetin-alpha treatment in orthopedic surgery patients in a daily life setting in which iron supplementation was assured, and compared the effects in RA and non-RA patients.

Methods: In an open, naturalistic, randomized controlled trial, 695 orthopedic surgery patients with preoperative hemoglobin (Hb) values of 10-13 g/dL, either with RA (113) or without RA (582), received either preoperative epoetin-alpha treatment added to standard care, or standard care alone.

Effects of epoetin alfa on blood transfusions and postoperative recovery in orthopaedic surgery: the European Epoetin Alfa Surgery Trial (EEST).

Background And Objective: Preoperative epoetin alfa administration decreases transfusion requirements and may reduce transfusion complications, such as postoperative infection due to immune suppression and thus hospitalization time. This study examined the impact of preoperative epoetin alfa administration on postoperative recovery and infection rate.

Methods: In an open randomized controlled multicentre trial in patients undergoing orthopaedic surgery, the effects of preoperative administration of epoetin alfa vs.