Title

Perioperative Management for Orthopaedic Patients with Sickle Cell Anaemia

Document Type

Article

Publication Date

2009

Keywords

anemia, sickle cell, blood component transfusion, blood transfusion, orthopedics, preoperative care

Abstract

Purpose: To compare outcomes of 2 types of perioperative optimisation for patients with sickle cell anaemia (SCA) undergoing various orthopaedic surgeries.

Methods: 12 female and 11 male patients aged 13 to 40 (mean, 18) years with SCA underwent 31 separate orthopaedic procedures for osteonecrosis of the femoral head. They were referred to a haematologist for 2 types of perioperative optimisation, based on the choice of the attending paediatrician. In the aggressive management group, patients received packed red blood cells preoperatively to increase the haemoglobin level to 9 to 11 g/dl and to lower the haemoglobin S level to

Results: No patient in the aggressive management group received supplemental oxygen or had an estimated intra-operative blood loss of >400 ml. Three patients in the conservative management group received multiple intra- and post-operative transfusions and supplemental oxygen.

Conclusion: Both aggressive and conservative protocols may be safely used in SCA patients. The more aggressive protocol resulted in lower rates for postoperative complications, transfusions, and resorting to supplemental oxygen.

Digital Object Identifier (DOI)

https://doi.org/10.1177%2F230949900901700321

Citation / Publisher Attribution

Journal of Orthopaedic Surgery, v. 17, issue 3, p. 346-350

Was this content written or created while at USF?

Yes

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