Hemodynamic Analysis in Patients Who Underwent Lumbar Spine Fusion Surgery without Blood Transfusion

Min-Woo Kim; Kyu Yeol Lee; Dong Ryul Kim; Young Hoon Jung; Chul Soon Im

doi:10.4055/jkoa.2016.51.4.287

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Kim, Lee, Kim, Jung, and Im: Hemodynamic Analysis in Patients Who Underwent Lumbar Spine Fusion Surgery without Blood Transfusion

Original Article

Journal of the Korean Orthopaedic Association 2016; 51(4): 287-293.

Published online: 11 August 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.4.287

Hemodynamic Analysis in Patients Who Underwent Lumbar Spine Fusion Surgery without Blood Transfusion

Min-Woo Kim, M.D., Kyu Yeol Lee, M.D., Dong Ryul Kim, M.D., Young Hoon Jung, M.D., Chul Soon Im, M.D.

Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea.

Correspondence to: Kyu Yeol Lee, M.D. Department of Orthopedic Surgery, Dong-A University College of Medicine, 32 Daesingongwon-ro, Seo-gu, Busan 49201, Korea. TEL: +82-51-240-2867, FAX: +82-51-243-9764, gylee@dau.ac.kr

Received 19 July 2015 Revised 23 August 2015 Accepted 16 November 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Lumbar fusion surgery was performed on transfusion-free patients and hemodynamic changes were analyzed.

Materials and Methods

A total of 36 transfusion-free patients who had undergone lumbar fusion surgery using recombinant human erythropoietin (rHuEPO) before surgery from April 2007 to March 2014 were included in the study. Hemoglobin and hematocrit levels were measured before surgery, immediately after surgery, 12 hours after surgery, on day 1, day 2, day 3, and day 7. Changes in levels were investigated and the factors affecting the changes in hemoglobin levels were analyzed.

Results

Changes in hemoglobin and hematocrit were -18.11% before surgery and -22.92% on day 7, respectively, and they tended to recover from day 2 after surgery. Depending on the patient's age, gender, body mass index, blood loss, and surgery method (presence of lumbar interbody fusion), the changes in hemoglobin level did not show statistically significant differences; however, significant differences were observed in the surgical time and extent of the operation.

Conclusion

Transfusion alternatives during lumbar spinal fusion are deemed safe methods, leading to good, postoperative hemodynamic outcomes. However, the surgical time and extent of the operation must be determined before surgery.

Keywords: blood transfusion, spinal fusion, erythropoietin, blood substitutes

Figures and Tables

Figure 1

(A) Changes of hemoglobin level following postop. period. (B) Changes of hematocrit level following postop. period. Preop., preoperative; postop., postoperative.

Table 1

Alternative Bloodless Protocol for Preoperation and Postoperation

Hb, hemoglobin; EPO, erythropoietin; T, tablet; NS, normal saline.

Table 2

Hemodynamic Changes according to Follow-Up Period from Preop. to Postop. 7 Days

Values are presented as mean±standard deviation or percent only. Preop., preoperative; Postop., postoperative.

Table 3

Hemodynamic Analysis between Patient's Demographic Factors and Change Rate of the Hemoglobin Level

Values are presented as mean±standard deviation. PLF, posterolateral fusion; PLIF, posterior lumbar interbody fusion.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose

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