NoBlood

Nika · #1 (**permalink**) 04-13-2005, 08:04 PM

Source:
Can J Anaesth. 2005 Apr;52(4):362-8.

Full Text Article (Subscription Required):
http://tinyurl.com/5f344

Erythropoietin is an effective clinical modality for reducing RBC transfusion in joint surgery: [Le traitement a l'erythropoietine reduit efficacement les transfusions de culots globulaires en chirurgie orthopedique].

Karkouti K, McCluskey SA, Evans L, Mahomed N, Ghannam M, Davey R.

Department of Anesthesia, Toronto General Hospital, Eaton North, 3-405, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. keyvan.karkouti@uhn.on.ca.

PURPOSE: Efficacy trials of preoperative erythropoietin therapy (PET) recommend a dosing schedule that cannot always be adhered to in everyday clinical practice. Consequently, we instituted a flexible dosing schedule and routinely offered it to anemic patients [hemoglobin (Hb)] 70 kg) every three to seven days before surgery. Since treatment was not randomly assigned, multivariable logistic regression analysis and propensity score case-control matching were used to adjust for baseline differences in patient demographics and perioperative risk factors for RBC transfusion. The adjusted relationship between PET and RBC transfusion was then determined. RESULTS: Of the 1,782 patients that underwent TJA during the study period, 770 (47.9%) had a Hb < 130 g.L(-1). Of these patients, 214 received PET and their RBC transfusion rate was 16.4%, whereas the transfusion rate was 56.1% in those who did not receive PET (P < 0.0001). The adjusted odds ratio of RBC transfusion with PET was 0.33 (95% confidence interval = 0.21-0.49). CONCLUSION: PET, used as part of routine clinical practice, is an effective blood conservation modality.

PMID: 15814749 [PubMed - in process]