The effectiveness evaluation of different red blood cell infusion in elderly patients
Jianjiang Wu, Jiang Wang, Hong Zheng · Zhonghua shiyan waike zazhi · 2014
Objective Through the establishment of blood transfusion-effectiveness of assessment criteria,to evaluate and analysis the effectiveness of perioperative red blood cell infusion for orthopedics in elderly patients.Methods 108 USA society of Anesthesiologists score standard (ASA) Ⅱ-Ⅲ patients of both sexes aged 60-80 yr scheduled for elective orthopedic s~gery were randomly divided into 2 groups:Group Ⅰ (n =54),use traditional method of red blood cell infusion; group Ⅱ (n =54),use goal-oriented by hemoglobin (Hb) and hematocrit (Hct) of red blood cell infusion,comparison the changes of the Hb,Hct,red blood cell (RBC),platelet (PLT),prothrombin time (PT),activated partial thromboplstin time (APTT),alveolar-arterial oxygen partial pressure [P (A-a)O2],oxygenation index (OI) and vigileo monitoring indicators after red blood cell composition transfusion before and after surgery and wound healing time,days of hospitalization and ICU transferred rate,through the establishment of blood transfusion-effectiveness of assessment criteria,to evaluate the efficacy and safety of the blood cell infusion in orthopedic elderly patients.Results Two sets of statistical efficiency of 59.3％ and 72.2％ respectively,no significant statistical difference between the two (P ＞ 0.05).Compared with the traditional red blood cell infusion group,the method goal-oriented by Hb and Hct of red blood cell infusion group with higher RBC,Hb and Hct,decreased PT,APTT,shorter wound healing time,ICU transferred rate decreased (P ＜ 0.05).Conclusion The method goal-oriented by Hb and Hct of red blood cell infusion will be more effective to improve the effectiveness of perioperative red blood cell infusion for orthopedics in elderly patients. Key words: Elderly patients; Goal orientation; Red blood cell transfusion; Effectiveness