Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial

BMC Anesthesiology

Research Article

Jens Børglum¹  Kenneth Jensen¹  Kamilla Nielsen²  Lars S Rasmussen²  Michael Wagner³  Britt Frausing³  Jens Stürup⁴  Benny Dahl⁴  Jesper Hvolris⁵  Pär I Johansson⁶ 

[1] Department of Anaesthesia and Intensive Care Medicine, Copenhagen University Hospital, Bispebjerg, Denmark;Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Denmark;Department of Occupational Therapy and Physiotherapy, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Denmark;Department of Orthopaedic Surgery, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Denmark;Department of Orthopedic Surgery, Copenhagen University Hospital, Bispebjerg, Denmark;Section for Transfusion Medicine, Capital Region Blood Bank, Copenhagen University Hospital, Rigshospitalet, Denmark;

关键词: Transfusion threshold;    Haemoglobin concentration;    Red blood cells;    Ambulation;    Hip surgery;   

DOI  :  10.1186/1471-2253-14-89

 received in 2013-10-06, accepted in 2014-09-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundTransfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision surgery.MethodsThe trial was registered at Clinicaltrials.gov (NCT00906295). Sixty-six patients aged 18 years or older undergoing hip revision surgery were randomized to receive RBC at a Hb threshold of either 7.3 g/dL (restrictive group) or 8.9 g/dL (liberal group). Postoperative ambulation was assessed using Timed Up and Go-test (TUG) and ability to walk was also assessed daily by a physiotherapist blinded to the allocation.ResultsFifty-three patients were able to perform the TUG and included in the analysis. The TUG could be completed in a median of 36 sec vs. 30 sec in the restrictive group and the liberal group, respectively (P = 0.02). The mean difference in TUG was 14.5 sec (95% CI 2.8-26.2 sec). No difference was found in the day patients could perform TUG or walk 10 meters. The Hb at the day of testing was 10.2 g/dL in the restrictive group and 9.9 g/dL in the liberal group. Only 26 patients received RBC.ConclusionsA Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing.

【 授权许可】

CC BY   
© Nielsen et al.; licensee BioMed Central Ltd. 2014