Authors
Pokhabov D.S., Shestakov E.A., Pimanchev O.V., Ryapolov Yu.V., Zhiburt E.B.
Pirogov National Medical and Surgical Center, Moscow
Abstract
When analyzing 586 medical records of patients of the Pirogov Center who underwent hip arthroplasty in the first half of 2024, it was found that during treatment (the average hospitalization period in a surgical hospital is 7.0±0.1 days), the average hemoglobin concentration decreases to 108.0±1.5 g/l in women and 121.9±1.8 g/l in men. The need for blood transfusion developed in 2.2% of women and 0.4% of men, 1 patient underwent hardware reinfusion of autologous red blood cells. 6.7% of patients received tranexamic acid and 2.7% – iron preparations.
It is advisable to include the use of blood components, reinfusion and other patient blood management technologies in clinical guidelines and the standard of medical care for adults with coxarthrosis.
Keywords: coxarthrosis, hip replacement, blood transfusion, patient blood management, standard, evidence-based medicine.
References
1. Shevchenko YL, Karpov OE, Zhiburt EB. Blood transfusion: history and modernity (on the 100th anniversary of blood transfusion in Russia). Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2019; 14(4): 4-11. (In Russ.) doi: 10.25881/BPNMSC.2020.29.78.001.
2. Zhiburt EB. Patient blood management for critical bleeding and massive transfusion. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I. Pirogova. 2013; 8(4): 71-77. (In Russ.)
3. Shevchenko YL, Zhiburt EB, Shestakov EA. The implementation of a blood-saving ideology in the practice of the Pirogov Center. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2008; 3(1): 14-21. (In Russ.)
4. Williamson LM. Transfusion triggers in the UK. Vox Sang. 2002; 83(S1): 217-9. doi: 10.1111/j.1423-0410.2002.tb05305.x.
5. Perekhodov SN, Volodin YuS, Ismailov KhG, Zhiburt EB. Outpatient preparation of transfusion support during hip replacement. Vestnik sluzhby krovi Rossii. 2008; 1: 20-22. (In Russ.)
6. Brizhan LK, Davydov DV, Buryachenko BP, et al. Efficiency of using modern technologies in postoperative treatment in patients after total knee replacement. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2018; 13(2): 74-77. (In Russ.)
7. Brizhan LK, Panyushin KA, Buryachenko BP, et al. Organizational and clinical aspects of hip replacement in young patients. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2014; 9(2): 43-47. (In Russ.)
8. Pimanchev OV, Ryapolov YuV, Nebelas RP, et al. Hip replacement using a robotic system. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2022; 17(2): 125-128. (In Russ.) doi: 10.25881/20728255_2022_17_2_125.
9. Pimanchev OV, Popov NV, Ryapolov YuV, et al. Advantages of anterior access in hip replacement. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2023; 18(1): 86-90. (In Russ.) doi: 10.25881/20728255_2023_18_1_86.
10. Shevchenko YuL, Stoyko YuM, Gritsyuk AA, et al. Local antibiotic prophylaxis in replacement of large joints (literature review). Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2010; 5(3): 44-56. (In Russ.)
11. Borisov DB, Shevelev AV, Vylyurov IV, et al. Intravenous iron and epoetin alpha in the treatment of postoperative anemia in orthopedics. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2013; 8(2): 72-75. (In Russ.)
12. Zhiburt EB, Maksimov VA, Ismailov HG, Vergopulo AA. Postoperative blood salvage in joint replacement. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2008; 3(2): 12-14. (In Russ.)
13. Grechanyuk ND, Zverkov AV, Ovsyankin AV, Zhiburt EB. Transfusion therapy in replacement of large joints. Gematologiya i transfuziologiya. 2015; 60(4): 35-38. (In Russ.)
14. Karpov OE, Nikitenko DN, Lyashchev SA. New management technologies. System of management standards. Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2013; 8(2): 87-90. (In Russ.)
15. Shestakov EA, Karavaev AV, Vasilashko VI, Zhiburt EB. Standardization of blood transfusion in cardiovascular surgery Vestnik Nacional’nogo mediko-hirurgicheskogo centra im. N.I.Pirogova. 2012; 7(1): 107-111. (In Russ.)
16. WHO, Chan M. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva, Switzerland: World Health Organization. 2011.
17. Klinicheskie rekomendacii «Anemiya pri zlokachestvennyh novoobrazovaniyah», 2024 (ID:624) (In Russ.)
18. Van der Linden P, Hardy JF. Implementation of patient blood management remains extremely variable in Europe and Canada: the NATA benchmark project: An observational study. Eur J Anaesthesiol. 2016; 33(12): 913-921. doi: 10.1097/EJA.0000000000000519.
19. Arya S, Howell A, Vernich L, et al. Re-evaluating treatment thresholds in patient blood management: Female patients experience more perioperative anaemia and higher transfusion rates in major elective surgery. Vox Sang. 2024; 119(10): 1090-1095. doi: 10.1111/vox.13717.
20. Klinicheskie rekomendacii «Koksartroz» (2021, odobreny Minzdravom Rossii), ID:666. (In Russ.)
21. Prikaz Minzdrava Rossii ot 16.01.2023 №11n (red. ot 30.07.2024) «Ob utverzhdenii standarta medicinskoj pomoshchi vzroslym pri koksartroze (diagnostika, lechenie i dispansernoe nablyudenie) i o vnesenii izmeneniya v standart pervichnoj mediko-sanitarnoj pomoshchi pri oslozhneniyah, svyazannyh s vnutrennimi ortopedicheskimi proteznymi ustrojstvami, implantami i transplantatami tazobedrennogo sustava, utverzhdennyj prikazom Ministerstva zdravoohraneniya Rossijskoj Federacii ot 29 dekabrya 2012 g. №1669n». (In Russ.)
