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PERIOPERATIVE BLOOD LOSS AND PRO C SYSTEM IN ORTHOPAEDIC PATIENTS



Abstract

In modern surgery, one main goal is to reduce perioperative and postoperative transfusion need.

The haemostatic disorders, the patients’ gender and the type of the operation seems to predict the blood loss in orthopaedic surgery.

It has been reported recently, an association of the Factor V Leiden mutation and with a lower rate of intra-partum blood loss,

Purpose: The aim of our study was to evaluate if there is an association between blood loss and pro c global system in orthopaedic operations.

Pro C Global system is influenced by FRO C, PRO S, APC resistance (FV Leiden) and FV111.

Materials and methods: We studied 42 patients, 31 women and 11 men, between 22–86 years old, who were operated in our hospital.

19 with total knee arthroplasty, 11 with total hip arthroplasty, 11 with fractures and 1 patient with amputation of -the lower leg.

The blood loss for each patient was calculated according the Mercurialli formula: Total blood loss: total blood volume x (Ht preop-Ht day 5 postop)+ml of RBC transfused. The total blood loss was expressed in terms of percentage of total blood volume and defined as relative blood loss.

Patients were divided into two groups with high and low relative blood loss, according the median value of the relative blood loss.

Pro C global values was monitored in all patients pre-operatively on a BCT analyzer (Dade Behring). Values > 0.8 are considered normal.

Results: The median value of relative blood loss was 15,05%. 21 patients were below this level and considered to have low relative blood loss. 21 patients were above this level and considered to have high relative blood loss. 18 patients had pro C Global values < 0.8 and 24 patients had Pro C Global > 0.8. Patients with low relative blood loss tend to show lower Pro C Global values than patients with high relative blood loss. (0,87 versus 0.90, p= 0.7 NS) without statistical difference.

Conclusions: In this study the Pro C global system does not seems to predict perioperative blood loss in patients with orthopaedic surgery and so it is useless to be monitored preoperatively.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.