Perioperative Blood Transfusions in Orthopaedic Surgery

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➤ Blood transfusion after orthopaedic surgery accounts for 10% of all packed red blood-cell transfusions, but use varies substantially across hospitals and surgeons.➤ Transfusions can cause systemic complications, including allergic reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, graft-versus-host disease, and infections.➤ Tranexamic acid is a new cost-effective blood management tool to reduce blood loss and decrease the risk of transfusion after total joint arthroplasty.➤ Current clinical evidence does not justify transfusions for a hemoglobin level of >8 g/dL in the absence of symptoms.➤ Studies have also supported the use of this trigger in patients with a history or risk of cardiovascular disease.

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