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A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries
BACKGROUND AND AIMS: Anaesthetic management of patients undergoing supra-major orthopaedic oncosurgeries is challenging. We wanted to evaluate the effects of pre-operative co-morbid conditions, intraoperative blood loss and transfusion, haemodynamic instability on post-operative complications and ho...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840808/ https://www.ncbi.nlm.nih.gov/pubmed/27141111 http://dx.doi.org/10.4103/0019-5049.179465 |
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author | Gupta, Ankit Kulkarni, Atul |
author_facet | Gupta, Ankit Kulkarni, Atul |
author_sort | Gupta, Ankit |
collection | PubMed |
description | BACKGROUND AND AIMS: Anaesthetic management of patients undergoing supra-major orthopaedic oncosurgeries is challenging. We wanted to evaluate the effects of pre-operative co-morbid conditions, intraoperative blood loss and transfusion, haemodynamic instability on post-operative complications and hospital outcomes in patients after such surgeries. METHODS: We collected data from the patient files, anaesthesia records and the electronic medical records about pre-operative morbidities, intraoperative management, complications, blood loss, fluid therapy and blood products transfused. We also collected data on post-operative complications, intensive care unit (ICU) and hospital length of stay (LOS) and status at discharge. Data were summarised using percentages for categorical data and mean and median for continuous data. RESULTS: The mean blood loss was 4567.44 ml (range 1200–16,000 ml); 95% of all patients received blood transfusion. Twenty patients needed massive blood transfusion. Fresh frozen plasma was needed in 17 patients while 1 patient needed single donor platelets. Haemodynamic instability was present in 38 patients, of which 8 needed continuous vasopressor infusion. Nineteen patients were ventilated post-operatively. Coagulopathy occurred in 22 patients while thrombocytopaenia was seen in 6 patients. The median ICU LOS was 3 (1–6) days, and median hospital stay was 17 (6–53) days. All patients were discharged alive. CONCLUSION: Supra-major orthopaedic oncosurgeries are associated with massive intraoperative blood loss and transfusion. Common complications include anaemia, coagulopathy and hyperbilirubinaemia and prolonged ICU stay. Meticulous care, anticipating the complications with timely treatment can lead to excellent outcomes. |
format | Online Article Text |
id | pubmed-4840808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-48408082016-05-02 A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries Gupta, Ankit Kulkarni, Atul Indian J Anaesth Original Article BACKGROUND AND AIMS: Anaesthetic management of patients undergoing supra-major orthopaedic oncosurgeries is challenging. We wanted to evaluate the effects of pre-operative co-morbid conditions, intraoperative blood loss and transfusion, haemodynamic instability on post-operative complications and hospital outcomes in patients after such surgeries. METHODS: We collected data from the patient files, anaesthesia records and the electronic medical records about pre-operative morbidities, intraoperative management, complications, blood loss, fluid therapy and blood products transfused. We also collected data on post-operative complications, intensive care unit (ICU) and hospital length of stay (LOS) and status at discharge. Data were summarised using percentages for categorical data and mean and median for continuous data. RESULTS: The mean blood loss was 4567.44 ml (range 1200–16,000 ml); 95% of all patients received blood transfusion. Twenty patients needed massive blood transfusion. Fresh frozen plasma was needed in 17 patients while 1 patient needed single donor platelets. Haemodynamic instability was present in 38 patients, of which 8 needed continuous vasopressor infusion. Nineteen patients were ventilated post-operatively. Coagulopathy occurred in 22 patients while thrombocytopaenia was seen in 6 patients. The median ICU LOS was 3 (1–6) days, and median hospital stay was 17 (6–53) days. All patients were discharged alive. CONCLUSION: Supra-major orthopaedic oncosurgeries are associated with massive intraoperative blood loss and transfusion. Common complications include anaemia, coagulopathy and hyperbilirubinaemia and prolonged ICU stay. Meticulous care, anticipating the complications with timely treatment can lead to excellent outcomes. Medknow Publications & Media Pvt Ltd 2016-04 /pmc/articles/PMC4840808/ /pubmed/27141111 http://dx.doi.org/10.4103/0019-5049.179465 Text en Copyright: © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Gupta, Ankit Kulkarni, Atul A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries |
title | A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries |
title_full | A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries |
title_fullStr | A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries |
title_full_unstemmed | A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries |
title_short | A retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries |
title_sort | retrospective analysis of massive blood transfusion and post-operative complications in patients undergoing supra-major orthopaedic oncosurgeries |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840808/ https://www.ncbi.nlm.nih.gov/pubmed/27141111 http://dx.doi.org/10.4103/0019-5049.179465 |
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