Influence of anemia on the perioperative blood loss during total hip arthroplasty in patients with end-stage renal disease

The OBJECTIVE was to determine the effect of anemia on the volume of blood loss during total hip arthroplasty in patients with end-stage renal disease. MATERIAL AND METHODS . The study was based on the data of 41 patients with pathology of hip joint who underwent primary hip replacement. In the group 1 – the group of comparison (n=20), there was no correction of anemia. In the group 2 – the main group (n=21), erythropoietin was applied 2 months before the operation, until the blood hemoglobin level exceeded 100 g/l, hematocrit – more than 30 %. RESULTS . In the first group of patients, there was the severe anemia: hemoglobin – (88.6±4.6) g/l, the number of red blood cells – (2.7±0.3·1012)/l, hematocrit – (27±2) %. In the second group, 2 months after using erythropoietin, hemoglobin level was (114.9±7.1) g/l, red blood cell count was (3.6±0.4·1012)/l, hematocrit was (33±2) %. Blood coagulation time before operation was (15.1±2.4) min in the first group, (8.7±1.8) min in the second group. Statistically significant difference was noted in blood loss: 59.2 %. In the first group, red blood cell mass transfusion was required in the volume of (554±205) ml for 18 patients (26 doses), plasma – in the volume of (641±67) ml for 20 patients (40 doses). In the second group, blood transfusion was performed for 3 patients in the volume of (321±116) ml. An inverse correlation between blood hematocrit, blood clotting time and blood loss was noted. The correlation coefficient was 0.9. CONCLUSION . The inverse correlation was indicated between the level of hematocrit, blood clotting time and blood loss. The use of erythropoietin in advance of reaching a blood hematocrit of >30 % could significantly reduce the risk of bleeding, reduce the amount of operating blood loss and reduce complications in the postoperative period.