|
Overview :
Nuttall et al identified risk factors for blood transfusion
associated with spinal fusion surgery. The authors are from the Mayo Clinic in
Rochester, Minnesota.
Factors affecting the amount of both allogeneic and
autologous products:
(1) low preoperative hemoglobin
(2)
increased number of posterior levels fused (which was associated with increased
duration of the surgery)
Additional factors affecting the amount of allogeneic blood
transfused:
(1) tumor surgery (which was associated with not using
intraoperative blood salvage)
(2) history of pulmonary disease
(3) decreased number of autologous products available
(4) not using a Jackson table
Additional factors affecting the amount of autologous blood
transfused:
(1) increased number of autologous products available
where:
• Tables
used were the anterior fusion, crest rolls Wilson frame, Jackson, 4-poster,
tower and other. The Jackson table was used almost half of the patients.
• Patients
undergoing tumor surgery usually did not have autologous products available.
•
Intraoperative blood salvage tends not to be used if operating on malignant
tumors.
• The
Jackson table reduces intra-abdominal pressure, which may reduce bleeding from
epidural veins during surgery.
•
Administration of erythropoietin prior to surgery may help improve the
preoperative hemoglobin, which may reduce the amount of transfused blood
needed.
|