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In einer prospektiven Studie wurden bei 200 Patienten mit endoprothetischem Ersatz des Hüft- oder Kniegelenkes, wobei 100 Patienten davon als Vergleichsgruppe ohne Retransfusion dienten, die Hb- und Hk-Verläufe, Menge und Qualität des retransfundierten Drainageblutes, der Bedarf an Eigen- und Fremdblut sowie auftretende Komplikationen und Kosten verglichen. Die retransfundierte Menge des Drainageblutes nach Hüftendoprothesenimplantation betrug durchschnittlich 387 ± 194 ml und nach Knieendoprothesenimplantationen 595 ± 250 ml. Das Retransfusionsblut hatte einen durchschnittlichen Hämoglobinwert von 5,2 ± 0,9 mmol/l bei einem Hämatokrit von 0,24 ± 0,05. Unmittelbar mit der Retransfusion zu assoziierende Komplikationen traten nicht auf. Der Transfusionsbedarf von Eigen- bzw. Fremdblut verringerte sich in der Knieendoprothesengruppe um 30% und bei den Hüftendoprothesenpatienten um ca. 25 %. Die autologe Retransfusion ungewaschenen Drainageblutes ist eine effiziente Methode zur Einsparung perioperativer Fremdbluttransfusionen bei endoprothetischem Ersatz von Hüft- und Kniegelenken. Wesentliche Komplikationen traten nicht auf, so dass dieses Verfahren für die klinische Anwendung ausreichend sicher erscheint. Die Methode ist in ihrer Handhabung einfach und ohne wesentlichen technischen Aufwand einsetzbar. Die autologe Retransfusion von Drainageblut kann zu einer deutlichen Kosteneinsparung beitragen. The method of retransfusion of drainage blood as known from the literature was investigated in a prospectiv study regarding effectivness and rate of side effects. 200 patients who underwent total hip and knee arthroplasty were investigated concerning hemoglobin, hematocrit, amount and quality of the retransfused drainage blood, the amount of autologous and homologous transfusions as well as complications and costs. 100 of these patients were selected as the control group. The amount of the retransfused drainage blood after hip arthroplasty amounted an average of 387 ± 194 ml and after knee arthroplasty 595 ± 250 ml. The retransfused blood had an average hemoglobin of 5,2 ± 0,9 mmol/l with a hematocrit of 0,24 ± 0,05. No complications directly associated to the retransfusion were found. The need of transfusion was reduced for patients with knee arthroplasty about 30 % and for hip arthroplasty about 25 %. The retransfusion of unwashed drainage blood is a sufficient method to reduce perioperative homologous blood transfusion in patients with arthroplasty of hip and knee. Substantial complications were not observed, so that this method seems to be save enough for clinical usage. The method is easy to handle and usable without special technical devices. The autologous retransfusion of drainage blood can contribute to lower costs in patients treatement.
Biomedizinische Technik / Biomedical Engineering – de Gruyter
Published: Nov 1, 2005
Keywords: Retransfusion; Drainageblut; Hüftendoprothese; Knieendoprothese
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